Reproductive travel to, from and within sub-Saharan Africa: A scoping review.

Scholarly interest in reproductive travel has increased in recent years, but travel within, to and from the African continent has received much less attention. We reviewed the literature on cross-border reproductive travel to and from countries of sub-Saharan Africa in order to understand the local forms of this trade. Access to fertility care remains deeply stratified, which is an ongoing concern in a region with some of the highest rates of infertility. We found a wide variety of reasons for reproductive travel, including a lack of trusted local clinics. Destinations were chosen for reasons including historical movements for medical treatment broadly, diasporic circulations, pragmatic language reasons, and ties of former colonial relations. We describe the unique tempos of treatment in the region, ranging from some intended parents staying in receiving countries for some years to the short-term contingent support networks that reprotravellers develop during their treatment and travel. Unique to the region is the movement of medical professionals, such as the 'fly-in, fly-out' clinic staff to deliver fertility care. Future research should include practices and movements to presently neglected 'reprohubs', particularly Kenya and Nigeria; the impact of pandemic-related lockdowns and border closures on the movements of intended parents, reproductive assistors and reproductive material; and the impact of low-cost protocols on treatment access within the region. This scoping review provides insight into the relevant work on cross-border reproductive care in sub-Saharan Africa, where a unique combination of access factors, affordability, and sociocultural and geopolitical issues fashion individuals' and couples' cross-border reproductive travel within, to and from Africa.

A biosocial return to race? A cautionary view for the postgenomic era.

Recent studies demonstrating epigenetic and developmental sensitivity to early environments, as exemplified by fields like the Developmental Origins of Health and Disease (DOHaD) and environmental epigenetics, are bringing new data and models to bear on debates about race, genetics, and society. Here, we first survey the historical prominence of models of environmental determinism in early formulations of racial thinking to illustrate how notions of direct environmental effects on bodies have been used to naturalize racial hierarchy and inequalities in the past. Next, we conduct a scoping review of postgenomic work in environmental epigenetics and DOHaD that looks at the role of race/ethnicity in human health (2000-2021). Although there is substantial heterogeneity in how race is conceptualized and interpreted across studies, we observe practices that may unwittingly encourage typological thinking, including: using DNA methylation as a novel marker of racial classification; neglect of variation and reversibility within supposedly homogenous racial groups; and a tendency to label and reify whole groups as pathologized or impaired. Even in the very different politico-economic and epistemic context of contemporary postgenomic science, these trends echo deeply held beliefs in Western thinking which claimed that different environments shape different bodies and then used this logic to argue for essential differences between Europeans and non-Europeans. We conclude with a series of suggestions on interpreting and reporting findings in these fields that we feel will help researchers harness this work to benefit disadvantaged groups while avoiding the inadvertent dissemination of new and old forms of stigma or prejudice.

Medical Mistrust and Enduring Racism in South Africa.

In this essay, I argue that exploring institutional racism also needs to examine interactions and communications between patients and providers. Exchange between bioethicists, social scientists, and life scientists should emphasize the biological effects-made evident through health disparities-of racism. I discuss this through examples of patient-provider communication in fertility clinics in South Africa and the ongoing COVID-19 pandemic to emphasize the issue of mistrust between patients and medical institutions. Health disparities and medical mistrust are interrelated problems of racism in healthcare provision.

Assisted Reproduction: Politics, Ethics and Anthropological Futures.

Anthropological literature on Assisted Reproductive Technology (ART) has burgeoned in the forty years since IVF emerged as a potential solution to childlessness. A lexicon has consolidated, and key sets of debates have been identified. Chief among these are questions of kinship, the intersection of technologies and local moral worlds, and the circulation of gametes and technological know-how. The recent publication of five books in the Berghahn series on Fertility, Reproduction and Sexuality offers an opportunity to think about new affordances and futures for research. We review the texts and suggest several strands for research, concluding that anthropological objects do not become saturated by our knowledge of them and that ARTs will remain fertile ground for thought.

Making a Match: Curating Race in South African Gamete Donation.

What shapes would-be parents' choices of gamete donors for third-party IVF? Following extensive ethnographic fieldwork in South African fertility clinics and egg donor agencies, I explore the work of donor matching, a process in which translational figures mediate patient desires, donor biography and corporeality, and racial imaginaries to assist would-be parents. In doing so, these figures, or "matchers," draw upon both historical schemas and novel articulations to enact race, and certain forms of whiteness. I describe this through the concept of "curature," a post-apartheid technology of racialization that reflects a neoliberal shift to privatized sites of power.

Gendered bio-responsibilities and travelling egg providers from South Africa.

'Unsuspecting young South African women are heading overseas to donate their eggs to infertile couples and earn a free international holiday in the process. But, at what cost?' This was the voice-over during a news show in South Africa in 2016 that described the phenomenon of young white South African women going abroad to 'donate' their eggs. Through the media, medical professionals sought to warn 'naïve girls' about 'unscrupulous agencies' taking advantage of them, and in doing so putting them at grave medical risks in 'Third World' clinics. Yet owners of agencies and egg providers themselves countered this imagery; here, the egg provider becomes a far more complex biocitizen who finds an opportunity to combine an act of altruism with an opportunity to earn money and travel. Through interviews with travelling egg providers, doctors and egg agencies, and analysis of public and social media, we analyse these competing discourses critically by situating them within the specific context of egg provision in South Africa. We argue that travelling egg providers' defence of their involvement may challenge some gendered assumptions made by the media and medical staff, but at the same time reaffirm what we call 'gendered bio-responsibilities', or the gendered nature of the emphasis on (individual) responsibilization of biological citizens. By focusing on a relatively understudied aspect of the burgeoning literature on biocitizenship, we argue that the project of biocitizenship assists the expansion and normalization of new biomedical technologies, often without proper emphasis on the disproportionate obligations on the women involved.