Infertility, Assisted Reproductive Technology & Parenting Flashcards
(56 cards)
1
Q
What is the WHO definition of infertility
A
the failure to conceive after 12 months of trying
2
Q
what percentage is infertility due to female factors only
A
34%
3
Q
what percentage is due to male factors only
A
28%
4
Q
what percentage is due to male and female combined
A
14%
5
Q
what percentage of infertility is unexplained
A
22%
6
Q
what are some western cultural changes that have effected having babies
A
- contraception
- male/female roles redefined
- fewer marriages
- more divorces
- emphasis on careers for women
- postponement of first child
7
Q
discuss choice/control over having babies
A
women & men are choosing to not have babies BUT later ages in deciding to have children means infertility is more common
8
Q
What did the early psychological research on infertility suggest, how has this evolved
A
that women were psychologically to blame for their infertility - proposed psychogenic origins
-recently growing awareness of the male factor in infertility
9
Q
in 2011, what percentage of aus babies were a result of IVF
A
3.8% - one child in each classsroom
10
Q
discuss Verhaak et al., 2006 systematic review of the psychological components of infertility
A
- few differences b/w ART women and “norms” at treatment outset
- unsuccessful treatment cycles did increase negative emotions, but most adjust well
- less is known about long-term adjustment after unsuccessful
11
Q
what are the 5 different treatments for infertility
A
- IVF
- ICSI - intra-cytoplasmic sperm injection
- donor sperm, eggs, gamtes
- embryo adoption
- surrogacy
12
Q
what’s involved in IVF
A
- medical investigations
- ovulation stimulation
- ultrasound & blood monitoring of egg maturity
- further hormonal stimulation via injection
- laparaoscopic egg collection & collection of a sperm sample from the male partner
- fertilised embryo is transferred to the uterus
13
Q
discuss ICSI
A
- the sperm sample is modified
- they get a tiny needle and inject the sperm into the egg
14
Q
discuss a diagnosis of infertility as a life crisis
A
- salient feelings of loss of control
- desire for a child & life plan is thwarted
- challenges to relationship
15
Q
discuss the impact of infertility on individuals
A
- self-esteem
- sexuality
- emotional state
- stigmatised identity - isolation/social networks
- general health & wellbeing - physical demands & side effects of drugs
- moderated by pre-existing emotional problems & individual differences*
16
Q
discuss the impact on self-esteem for men
A
men are supposed to be manly
17
Q
what can infertility be conceptualised as?
A
a chronic disease/chronic health problem
18
Q
in regards to health & wellbeing, what is longterm infertility associated with
A
- associated with lower quality of life & wellbeing for men & women
- depression & anxiety elevated, more health complaints
19
Q
discuss the impact of infertility treatment on lifestyle
A
- economic costs
- impact on career, women may put careers on hold, men may need to alter schedules
- process & practical demands
20
Q
can the treatment process be addictive
A
yes
21
Q
discuss the relationship stressors that infertility can have
A
- women “cover” for partners
- sexual difficulties - performance pressure
- emotional intensity of experience of infertility is unequal?
- disagreement regarding treatment
- using donor gametes may be threatening
22
Q
what were some of the problems predicted with the rise of ART by ‘Life: 1969 Science and Sex’
A
- removing biological foundations of morality
- diff meanings of decoupling sex, love, procreations
- end of institutions of marriage, family
- virgin births may be common
- mothers unable to love children they haven’t carried
23
Q
what is the clinical anecdote associated with IVF parents
A
“highly anxious, perfectionist parents” - evidence doesn’t support
24
Q
what are some hypotheses regarding parenting after conception through ART
A
- depleted psychologically
- unrealistic expectations, vulnerable to depression
- overprotective, intrusive parenting
- devoted, highly motivated parents, optimal parenting
25
discuss what the studies found on IVF and non-IVF mother's adjustment to pregnancy
- IVF mothers reported higher anxiety regarding outcome of pregnancy
- differences in fetal attachment: shown mothers conceiving through IVF have a more intense attachment, less intense because of anxiety & no difference
26
what overall did they find about pregnancy re qualitative/quantitative measures
no differences in quantitative measures b/w IVF pregnancies & normal, but there are qualitative differences
27
discuss qualitative differences in IVF & normal pregnancies
- coping strategies mean very different path to parenthood
- IVF mothers are less likely to prepare a nursery
- afraid to speculate about baby
- less likely to attend antenatal classes
- kept pregnancy secret for longer
28
discuss the significant differences IVF mothers have in comparison to normal in their adjustment to parenting at 4 & 12 mths
- lower self-esteem for IVF mothers
- more concerns about child's behaviour but this has changed (better temperament)
- thought their children were more vulnerable at 12 mths
- tendency to view child as 'special' 12 mths
29
what were there no differences in at age 4 & 12 mths of IVF parents & normal
-mood state, competence, work patterns
30
when investigating the difference between IVF and non-IVF mothers parent-child relationship what were the observational methods used
- still-face procedure
- strange situation procedure
- emotional availability during free play
31
what were the differences found in parent-child relationship between IVF at 4 & 12 mths
- no differences between observed sensitivity, security of attachment, maternal sensitivity or child responsiveness at 12 months,
- no differences more difficult child behaviour
32
discuss differences found in parent-child relationship for IVF & non-IVF at child 5 years
- no differences in mood state, marital adjustment, child behaviour problems
- IVF parents report lower parenting stress than comparison older first-time parents
33
discuss some conclusions from the reviews on parents
IVF parents:
- lower self-esteem, self-efficacy early on
- more likely to seek help with early parenting
- more protective - child viewed as more vulnerable, less child autonomy
34
discuss some conclusions from reviews on child neurodevelopment
epidemiological
studies:
- increased relative birth defects
-multiple birth more common, perinatal risks
-epigenetics
neurodevelopmental outcomes:
-not associated with cerebral palsy
-are associated with higher preterm birth & multibirth (and those are related to increase handicap)
-not associated with neurodevelopmental disorders
35
what did they find regarding longer-term outcomes of young adults conceived by ART compared with not
n = 659, young adults aged 18-29 years who were conceived by ART had similar quality of life BMI & pubertal development to non-ART children
-self-report only
36
ART women are ___ times more likely to have a ____
1.5 times more likely to have a preterm birth
37
what percentage of ART births are pre-term compared to non ART
```
10% = ART
6.8% = non-ART
```
38
ART mothers are...
older, more socio--economically advantaged & less likely to smoke
-more likely to have hyper-tension & complications during pregnancy
39
discuss some issues for children conceived with donor gametes in heterosexual families & same-sex couples - Golombok et al.
-impact of secrecy (child not told father is not father etc.)
-no genetic link b/w father & child
-"genealogical bewilderment"
same sex couples:
-absence of male or female role model
-stigma
40
what did Golombok et al. find
- DI & IVF parents showed greater warmth & emotional involvement with children at 4 & 11 mths
- no differences re fathering problems
- no differences re marital problems or child adjustment
- BUT none had told the children about their origins at middle childhood & only 2 by adolescence
41
when Golombok et al. studied 4 groups of children (natural conceiving, ED, DI & surrogacy) what did she find regarding the children
-no differences overall compared with SC children
42
what did golombok et al. find regarding children produced by a surrogate, what does it suggest
- children born through surrogacy had more difficulties aged 7
- suggests that lack of gestational link may be more problematic than lack of genetic
43
what are the research findings in general about lesbian parenting
- consistent evidence mothers in fatherless families expressed greater warmth & interacted more with children
- no differences in child emotional/behaviour or gender role development
- lesbian co-mothers more involved than typical fathers
- some evidence for positive psychological development
- generally no better no worse
44
what was found about the differences between lesbian families created through DI than heterosexual families
-less secrecy than heterosexual couples
45
discuss gay men choosing parenthood generally
- its a growing phenomenon
- usually involved an egg donor and gestational carrier: often international
- most are in committed relationships and have thought a great deal about it
- most have supportive families
- more research needed
46
what are donor issues
- child's right to know genetic origins
- implications of commercial egg & sperm donation
- potential exploitation of surrogate mothers
- reproductive tourism
47
how many frozen embryos were in storage in 2011 in Aus
>120,000
48
what are the factors influencing decision making of what to do with remaining frozen embryos
- success or failure in meeting reproductive goals
- fears and fantasies about donation of genetic offspring
- altruism
49
what did the research find regarding remaining frozen embryos
-many opt to put decision off as long as possible
->90% think of embryos as potential child & potential sibling of existing children
<10% intend to donate to research or other couples
50
discuss the percentages found regarding conditional donation
- 4% indicated they would donate to other couples
- 48% thought donors should be able to specify characteristics of recipients
- 41% indicated they would be more likely to donate if donation was conditional
51
What is the most common reason women are having babies later
had to wait to find a partner who wanted to commit to having a baby as well
52
what did the big study (n=592) regarding older women's pregnancy find
- less pregnancy and anxiety symptoms
| - lower fetal attachment
53
what did the big study (n=592) regarding older women's pregnancy find was more important than age
-personality (hardiness) and context factors
54
what was associated with more complex pregnancy adjustment regardless of age
ART conception
55
what did the big study (n=592) regarding postpartum adjustment for older women find
- adjustment generally better
- maturity associated with more positive experience of motherhood
- no evidence of increased PND for older mothers
56
what did the big study find for mothers conceiving through ART and postnatal depression/child's temperament
- no evidence of increased PND for mothers who conceived through ART
- ART mothers report less difficult temperament
