Current perceptions and decisions of patients about cryopreserved embryos in Argentina
DOI:
https://doi.org/10.31053/1853.0605.v76.n2.23099Keywords:
fertilization in vitro, psychology, ethics, embryonic structuresAbstract
Introduction: Worldwide there is an increase in the number of assisted reproduction treatments. The developments in culture media and drugs, associated with the occurrence of rapid freezing or vitrification techniques has improved the procedures encouraging transfers of a single embryo per cycle. This generates a greater number of viable surplus embryos. Embryo disposition decision making is a complex phenomenon.
Method: This descriptive exploratory study investigates the perceptions and opinions of a sample of 59 participants who have started an assisted reproduction treatment in a specialized Fertility Center of the City of Buenos Aires.
Results: The absence of children in the majority of the sample (70.6% still have no children) makes the prevailing option to “continue cryopreservation” (35.6%). The majority, 40.7% (24 people) consider that the option that best represents the embryo is "a child". Although there are relatively few people who have decided to donate their embryos (5 participants) several study participants report having reflected on it (43%). The vast majority (86.5%) of respondents would not be willing to face the costs of maintaining long-term cryopreservation.
Conclusion: After more than three decades of assisted reproduction, Argentinean patients still face high degree of uncertainty regarding what to do with the surplus embryos. Knowing more in depth the decision-making process can help to implement communication strategiesDownloads
References
Dyer, S., Chambers, G. M., de Mouzon, J., Nygren, K. G., Zegers-Hochschild, F., Mansour, R., et al. International Committee for Monitoring Assisted Reproductive Technologies world report: assisted reproductive technology 2008, 2009 and 2010. Hum Reprod. 2016. May 20;31(7) :1588-1609, https://doi.org/10.1093/humrep/dew082
Zegers-Hochschild, F., Schwarze, J.E., Crosby, J.A., Musri, C., Urbina, M.T. Assisted reproductive techniques in Latin America: The Latin American Registry, 2014. JBRA Assist Reprod. 2017 Sep 1;21(3):164-175. https://doi.org/10.5935/1518-0557.20170034
Bruno, C., Dudkiewicz-Sibony, C., Berthaut, I., Weil, E., Brunet, L., Fortier, C., et al. Survey of 243 ART patients having made a final disposition decision about their surplus cryopreserved embryos: the crucial role of symbolic embryo representation. Hum Reprod. 2016. Jul 1;31(7):1508-1514. https://doi.org/10.1093/humrep/dew104
Goedeke, S., Daniels, K., Thorpe, M., & du Preez, E. The Fate of Unused Embryos: Discourses, Action Possibilities, and Subject Positions. Qual Health Res. 2017 Aug. 27(10): 1529-1540. https://doi.org/10.1177/1049732316686759.
Cattapan, A., & Baylis, F. Frozen in perpetuity: ‘abandoned embryos’ in Canada. Reprod Biomed Soc Online. 2015, 1(2): 104-112. https://doi.org/10.1016/j.rbms.2016.04.002
Álvarez-Díaz, J. A. Sobre la posibilidad de la donación de embriones en Hispanoamérica. An. Fac. med. 2009 Jun, 70(2):135-142. Disponible en: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1025-55832009000200009&lng=es.
Álvarez-Díaz, J. A. Donación de embriones en países desarrollados. Gac Méd Méx, 2010, 146(3): 228-241.
Herrera, M. & Lamm, E. Cobertura médica de las técnicas de reproducción asistida. Reglamentación que amplía el derecho humano a formar una familia. La Ley. Año 2013 N°140.
Ariza, L. «No pagarás»: el Consentimiento Informado como productor de solidaridad en la medicina reproductiva. Ciencia, docencia y tecnología, (52): 240-268. Disponible en: http://www.scielo.org.ar/scielo.php?script=sci_arttext&pid=S1851-17162016000100004
Lyerly, A. D., Steinhauser, K., Voils, C., Namey, E., Alexander, C., Bankowski, B., et al. Fertility patients’ views about frozen embryo disposition: Results of a multi-institutional U.S. survey. Fertil Steril. 2010, 93(2): 499–509. http://doi.org/10.1016/j.fertnstert.2008.10.015
Provoost, V., Pennings, G., De Sutter, P., & Dhont, M. A private matter: how patients decide what to do with cryopreserved embryos after infertility treatment. Hum Fertil (Camb. 2012, 15(4), 210-216. https://doi.org/10.3109/14647273.2012.745015
Roberts, E. El embrión extra: ética de vida, ética de parentesco y cryopreservación en las clínicas ecuatorianas de fertilización in-vitro. Iconos. Revista de Ciencias Sociales, May 2005:75-82. Disponible en: http://repositorio.flacsoandes.edu.ec/bitstream/10469/741/4/RFLACSO-I22-06-Roberts.pdf
Collard, C., Kashmeri, S. De embriones congelados a siempre familias: Ética del parentesco y ética de la vida en la circulación de embriones entre las parejas donantes y las adoptantes en el programa Snowflakes. Revista de Antropología Social [Internet]. 2009;18:43-65. Recuperado de: https://www.redalyc.org/articulo.oa?id=83817222003
Lima, NS. Martínez, AG. Dilemas éticos y morales en embriones humanos: abordaje interdisciplinario en salud reproductiva. Buenos Aires: Ascune; 2018.
Mohler-Kuo M, Zellweger U, Duran A, Hohl, M et al. Attitudes of couples towards the destination of surplus embryos: results among couples with cryopreserved embryos in Switzerland. Hum Reprod. 2009 24(8): 1930–1938. https://doi.org/10.1093/humrep/dep103
Nachtigall RD, Mac Dougall K, Harrington J, Duff J, Lee M, Becker G. How couples who have undergone in vitro fertilization decide what to do with surplus frozen embryos. Fertil Steril 2009;92:2094–2096. https://doi.org/10.1016/j.fertnstert.2009.06.027
Provoost V, Pennings G, DeSutter P, Gerris J, Van de Velde A, DeLissnyder E, et al. Infertility patients’ beliefs about their embryos and their disposition preferences. Hum Reprod Oxf Engl. 2009;24:896–905. https://doi.org/10.1093/humrep/den486
De Lacey, S. Parent identity and ‘virtual’ children: why patients discard rather than donate unused embryos. Hum Reprod. 2005, 20(6), 1661-1669. https://doi.org/10.1093/humrep/deh831
De Lacey, S. Patients' attitudes to their embryos and their destiny: social conditioning? Best Pract Res Clin Obstet Gynaecol. 2007, 21(1), 101-112. https://doi.org/10.1016/j.bpobgyn.2006.08.003
ASRM. Ethics Committee of the American Society for Reproductive Medicine. Disposition of abandoned embryos: a committee opinion. Fertil Steril. 2013, 99(7):1848-1849. https://doi.org/10.1016/j.fertnstert.2013.02.024
Franklin, S. Biologization Revisited: Kinship Theory in the Context of the New Biologies. FRANKLIN, Sarah y MCKINNON, Susan. (eds.) Relative Values. Reconfiguring Kinship Studies. Durham, Duke University Press, pp. 302-325;2001.
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