Abstract

Abstract Study question How do young adults in the four Eastern European countries (North Macedonia, Slovenia, Kosovo and Albania) perceive and understand infertility issues and the MAR techniques? Summary answer Overall, young participants in the study in the four countries acknowledged that they are not familiar with MAR techniques available and technical processes involved. What is known already There is little comprehensive research about perceptions, knowledge, and concerns among young people about MAR and infertility, and even less in these four countries. The unfamiliarity about MAR and infertility demonstrates that there is little understanding of medical issues and little understanding about the success rates. Study design, size, duration Part of the European Project B²-InF team conducted a multi-country qualitative study in Albania, Kosovo, Slovenia and North Macedonia with young adults (18-30) in 2021 assessing sociocultural, gender and legal perspectives related to MAR and information provided by the MAR clinics. Between 10-15 interviews were conducted in each country. Data was collected in native language, transcribed and translated in English. Participants/materials, setting, methods The B²-InF team carried out and analyzed a total of 50 interviews with young people living in these 4 European countries. A thematic analysis was performed using Atlas.ti software. The study used purposive sampling technique in order to capture heterogeneity of young participants (gender, age, residence, marital status/relationship, sexual orientation, education and religion) Main results and the role of chance Young adults perceive infertility as a topic that is not discussed very much in public. The individuals affected by it tend to keep it private, reluctant to discuss it within their social environment which contributes to the taboo of infertility and may limit access to MAR techniques. Despite this, many individuals, male and female, face infertility problems, including data n these countries. In all four countries, young people agree that infertility imposes great pressure on both males and females. In certain countries, religion affects the use of MAR techniques, whereas LGBT people are faced with stigmatization while using MAR techniques. Young interviewees reported general knowledge about MAR treatments and specifically, certain techniques they are familiar with, such as in vitro fertilization or artificial insemination. In addition, surrogacy was a process that many participants were familiar with. However, all young interviewed participants claim that more information about MAR is needed and they are not confident about where they should search for it. Limitations, reasons for caution This study is first of its kind in the MAR research body and its results are useful for policy-makers dealing with (in)fertility. However, information provided by the young participants in these 4 countries would serve as an overview of gaps and concerns about MAR techniques. Wider implications of the findings The results of this study are used to develop National Guidelines aimed for policy makers and MAR clinics to improve information about infertility among young people. Trial registration number not applicable

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