Elective egg freezing and its underlying socio-demography: a binational analysis with global implications.

BACKGROUND: What are the underlying socio-demographic factors that lead healthy women to preserve their fertility through elective egg freezing (EEF)? Many recent reviews suggest that women are intentionally postponing fertility through EEF to pursue careers and achieve reproductive autonomy. However, emerging empirical evidence suggests that women may be resorting to EEF for other reasons, primarily the lack of a partner with whom to pursue childbearing. The aim of this study is thus to understand what socio-demographic factors may underlie women's use of EEF. METHODS: A binational qualitative study was conducted from June 2014 to August 2016 to assess the socio-demographic characteristics and life circumstances of 150 healthy women who had undertaken at least one cycle of elective egg freezing (EEF) in the United States and Israel, two countries where EEF has been offered in IVF clinics over the past 7-8 years. One hundred fourteen American women who completed EEF were recruited from 4 IVF clinics in the US (2 academic, 2 private) and 36 women from 3 IVF clinics in Israel (1 academic, 2 private). In-depth, audio-recorded interviews lasting from 0.5 to 2 h were undertaken and later transcribed verbatim for qualitative data analysis. RESULTS: Women in both countries were educated professionals (100%), and 85% undertook EEF because they lacked a partner. This "lack of a partner" problem was reflected in women's own assessments of why they were single in their late 30s, despite their desires for marriage and childbearing. Women themselves assessed partnership problems from four perspectives: 1) women's higher expectations; 2) men's lower commitments; 3) skewed gender demography; and 4) self-blame. DISCUSSION: The "lack of a partner" problem reflects growing, but little discussed international socio-demographic disparities in educational achievement. University-educated women now significantly outnumber university-educated men in the US, Israel, and nearly 75 other societies around the globe, according to World Bank data. Thus, educated women increasingly face a deficit of educated men with whom to pursue childbearing. CONCLUSION: Among healthy women, EEF is a technological concession to gender-based socio-demographic disparities, which leave many highly educated women without partners during their prime childbearing years. This information is important for reproductive specialists who counsel single EEF patients, and for future research on EEF in diverse national settings.

On the prevalence of population groups in the human-genetics research literature.

BACKGROUND: Population-specific human-genetics research has become commonplace but remains controversial, as its results can affect public and personal perceptions of the ethnic, national, and racial groups studied. Choice of populations for study has generally seemed a function of scientific, logistical, or economic factors. RESEARCH QUESTION: Has the identity of populations studied in the human-genetics research literature varied systematically, and, if it has, in what ways? METHODS: I searched the PubMed database for population-genetics reports, calculating for each a population score, a genetics score, and a mutation score. RESULTS: Some populations had been studied far more intensively than others. Many of the most frequently studied groups were ethnically defined and politically marginal in their home countries; some of these groups were involved in self-determination struggles. In the mutation-research literature, state-defined Muslim and Mediterranean populations prevailed. CONCLUSION: Study-population selection may in some cases be explained by, or may complicate, political predicament.

Donor insemination in Israel. Recipients' choice of donor.

OBJECTIVE: To study the physiognomic preferences of Israeli Jewish recipients of donor insemination. STUDY DESIGN: Donors were "scaled" by both their general popularity and their popularity among single women and married recipients. Following this procedure, the donors' physiognomic features were analyzed and interpreted in terms of Israel's sociopolitical system and the influences of the media. RESULTS: The preferred donor was an educated Ashkenazi Jew who was about 180 cm tall and weighed 72 kg, with straight, light-brown hair and light-colored eyes. This profile deviates from the average features of Israeli men, who are significantly shorter and heavier. The recipients' preferences were noticeably homogeneous, with relatively minor differences between Oriental and Ashkenazi recipients. CONCLUSION: The recipients' preferences reproduce Israel's class system, in which the Ashkenazi section is dominant. They also are influenced by the media and adopt prevailing body images.

State regulation of donor insemination: an Israeli case study.

Donor insemination (DI) in Israel is state regulated. The Ministry of Health dictates a policy of total medicalization and secrecy. In this paper we analyze the state regulations in reference to their historical and cultural contexts. Our main argument is that in Israel, having children and establishing a family are of supreme importance, owing to Biblical myths as well as the Zionist ethos. The state, as the provider of health care services, encourages fertility treatments in general. However, DI, while assisting conception, results in a somewhat non-traditional family. In contradiction to trends towards openness observed in Western countries, Israel's state policy is one of hiding and camouflaging. We attribute this policy to the strict support of the 'natural family' paradigm, which equally gives DI-assisted families a problem no less than a solution.

Secrecy among Israeli recipients of donor insemination.

Patterns of discretion and disclosure of fertility-related information among Israeli recipients of donor insemination (DI) are explored. Based on questionnaires completed by recipients in four sperm banks, we studied differences between married women and men. We found that most Israeli recipients conceal the treatment from their friends and relatives. Women and men, however, differ in their disclosure patterns: women are somewhat more open about the general fertility problem, but conceal the male factor; men are more discreet. However, men who disclose the fertility problem also tell about their own impairment. DI appears to be the most secretive issue in this context. Recipients who confided in anyone about their problem restricted it mostly to family relatives. The results are interpreted in terms of Israeli pronatalism, traditional concepts of the natural family, as well as elements of macho culture. Public education is highly recommended in order to open and "normalize" DI in Israel.

Discrimination against men in infertility treatment.

OBJECTIVE: To evaluate the scope of the medical effort invested in the study and treatment of male infertility, some of its sources and implications. STUDY DESIGN: The study reviewed the range of medical treatments of male and female infertility and their effectiveness. It also examined the funding policy in Ontario, Canada, as well as patients' responses to this policy. RESULTS: Male infertility therapy is relatively lacking and is not funded by the Ontario Health Insurance Plan. Neither professionals nor patients, however, challenge the unequal policy. CONCLUSION: The traditional association of infertility with the female partner prevails among professionals, policy makers and patients. It explains both the relative lack of therapy and the absence of public resentment. This traditional attitude hinders the prospects that infertile men will be assisted by biomedicine.

Maternal smoking during pregnancy: social, medical, and legal perspectives on the conception of a human being.

The social, medical, and legal aspects of maternal smoking during pregnancy are examined. Increasing social awareness of the fetus as a human being is described as emanating largely from modern prenatal screening technologies. Medical findings concerning the harms of maternal smoking to the fetus and developing child are then reviewed. The legal literature is considered within the context of women's rights. Two major trends are identified. The first is the prosecution of harmful maternal behaviors, and the second is extensive public education. It is asserted that despite repeated calls for action, actual attempts to help pregnant women quit smoking are meager. This finding is interpreted as resulting from the unclear status of both the fetus and smoking in general and from increased awareness of women's rights.