Artificial fertilization with donor gametes : a medical social work perspective

Abstract

English: Artificial fertilization with donor gametes is becoming more popular amongst infertile couples as an alternative to childlessness. It allows the couple the opportunity to experience a pregnancy and the birth of their child, who is fifty percent blood-related. This form of treatment involves various medical, legal, ethical-moral, religious and psycho-social aspects, and couples requesting this form of treatment usually have limited knowledge of these aspects, are unable to make an informed decision and are unaware of the possible long-term implications. Applied and developmental research was implemented in this study. The research designs were exploratory and descriptive and the nature of this research was both quantitative and qualitative. The research population of 30 respondents were all included in this study. The hypotheses for this study were formulated as follows: Hypothesis 1: When couples request artificial fertilization with donor gametes, they have limited knowledge of all the medical, legal, ethical-moral, religious and psycho-social aspects related to this treatment. Hypothesis 2: If couples are prepared for artificial fertilization with donor gametes by means of a holistic preparation session, they will gain more knowledge regarding all the aspects related to this treatment. Hypothesis 3: If couples undergo artificial fertilization with donor gametes, they will experience long-term psycho-social implications. vi The aims of this study included: Aim 1: To develop, implement, evaluate and describe a guideline for the holistic preparation of couples for artificial fertilization with donor gametes. Aim 2: To do a longitudinal study of the same respondents to determine the long-term psycho-social implications of successful or unsuccessful artificial fertilization with donor gametes. Aim 3: To provide a medical social work guideline for the counselling of couples undergoing artificial fertilization with donor gametes. These aims were all met by means of this study. In the first empirical study, the preparation session which was developed in this study, was implemented over a half-day session, individually with each couple using the A-B-A single system design and a questionnaire. A pre-test prior to and post-test after completion of the session was conducted. These respondents' knowledge on all the aspects related to this form of treatment, which was limited in the pre-test, had increased after completion of the session in the post-test. The session was evaluated to be of high value on the short-term, as it had increased their knowledge and provided them with a thorough perspective, supporting hypothesis 1 and 2. The second empirical study was conducted with the same respondents 7 years later, by means of a longitudinal survey, using personal interviews and a questionnaire. Respondents had either donor, adopted or own biological children or were childless and had experienced successful long-term psycho-social implications as a result of or unsuccessful artificial fertilization with donor gametes, supporting hypothesis 3. Respondents valued the preparation session highly on the long-term, as it had increased their knowledge and enabled them to make an informed decision. A preparation session was recommended as a necessity for all couples undergoing this form of treatment, as well as a need for long-term counselling. Recommendations included a preparation session being a prerequisite for all couples undergoing this form of treatment and the need for long-term counselling. A guideline was provided for this purpose.

Afrikaans: Kunsmatige bevrugting met donor gamete, word steeds gewilder by onvrugbare egpare, as alternatief tot kinderloosheid. Dit bied 'n egpaar die geleentheid om 'n swangerskap en die geboorte van hulle kind, wat vyftig persent bloedverwant is, te ervaar. Hierdie soort behandeling behels verskillende mediese, wetlike, eties-morele, godsdienstige en psigososiale aspekte en egpare wat hierdie soort behandeling versoek, dra gewoonlik slegs beperkte kennis van hierdie aspekte, is nie daartoe instaat om 'n ingeligte besluit te neem nie en is onbewus van die moontlike langtermyn implikasies. Toegepaste en ontwikkelingsnavorsing is in hierdie studie aangewend. Die navorsingsontwerpe was verkennend en beskrywend en die aard van die navorsing was sowel kwantitatief as kwalitatief. Die universum van 30 respondente is in hierdie studie ingesluit. Die hipoteses vir die studie is as volg geformuleer: Hipotese 1: Wanneer egpare kunsmatige bevrugting met donor gamete versoek, het hulle slegs beperkte kennis van al die mediese, wetlike, etiesmorele, godsdienstige en psigososiale aspekte wat verband hou met hierdie behandeling. Hipotese 2: Indien egpare deur middel van 'n holistiese voorbereidingsessie vir kunsmatige bevrugting met donor gamete voorberei word, sal hulle meer kennis opdoen ten opsigte van al die aspekte wat verband hou met die behandeling. Hipotese 3: Indien egpare kunsmatige bevrugting met donor gamete ondergaan, sal hulle langtermyn psigososiale implikasies ervaar. Die doelstellings van die studie het die volgende ingesluit: Doelstelling 1: Om 'n riglyn vir die holistiese voorbereiding van egpare vir kunsmatige bevrugting met donor gamete te ontwikkel, implementeer, evalueer en beskryf. Doelstelling 2: Om 'n longitudinale studie van dieselfde respondente te onderneem, om die langtermyn psigososiale implikasies van suksesvolle of onsuksesvolle kunsmatige bevrugting met donor gamete te bepaal. Doelstelling 3: Om 'n geneeskundige maatskaplikewerk-riglyn vir die berading van egpare wat kunsmatige bevrugting met donor gamete ondergaan, te verskaf. Hierdie doelstellings is almal deur middel van hierdie studie bereik. In die eerste empiriese studie is die voorbereidingsessie individueel met elke egpaar oor 'n half-dag geimplementeer en die A-B-A enkelstelselontwerp en 'n vraelys is benut. 'n Voortoets asook 'n natoets is ui tgevoer, voor en na vol tooiing van die sessie. Die respondente het v66r die voorbereidingsessie, oor beperkte kennis van al die aspekte wat met die behandeling verband hou beskik, en het na die sessie vermeerderde kennis getoon. Die sessie is van hoe waarde beskou op die korttermyn, want hulle kennis is aangevul en 'n deeglike perspektief is voorsien, wat hipoteses 1 en 2 ondersteun het. Die tweede empiriese studie is sewe jaar later met dieselfde respondente ui tgevoer, deur middel van 'n longi tudinale opname, met gebruikmaking van persoonlike onderhoude en 'n vraelys. Die respondente het donor, aangenome, of eie biologiese kinders gehad, of was kinderloos en het langtermyn psigososiale implikasies ervaar as gevolg van suksesvolle of onsuksesvolle kunsmatige bevrugting met donor gamete. Hipotese 3 is deur hierdie bevindinge ondersteun. 'n Hoe waarde is aan die sessie geheg met die langtermyn evaluasie van die voorbereidingsessie, omdat dit hulle met kennis toegerus het, en hulle in staat gestel het om 'n ingeligte besluit te neem. Aanbevelings het sowel die voorbereidingsessie as vereiste vir alle egpare wat hierdie behandeling ondergaan, ingesluit, asook die behoefte aan langtermyn berading. 'n Riglyn is vir hierdie doel voorsien.