Reproductive Donation Research Articles

P-342 Improving consent procedures to increase oocyte donation rates

Abstract Study question Can consent procedures for donation of surplus frozen oocytes be changed to improve donation rates? Summary answer Obtaining informed consent for donation of oocytes after freezing could be improved by adapting new consent procedures used in genomic biomedical research for ART contexts. What is known already The widespread adoption of oocyte cryopreservation has led to a rapid accumulation of oocytes in cryostorage, since the number of people who return to use their eggs remains low. Previous studies show that many people intend to donate their surplus cryopreserved oocytes, but few people actually donate them. Increased rates of donation are required to address chronic shortages of eggs available for both reproductive and research purposes. Study design, size, duration This paper examines whether advances in consent procedures in genomic research and biobanking, such as Dynamic Consent interfaces, could be utilised within the ART context to improve patient experience and oocyte donation rates. Ethical issues with dynamic consent are considered as well as the possible benefits of such a system for potential donors and recipients of oocytes. Participants/materials, setting, methods This paper undertakes ethical analysis of the procedures used for obtaining informed consent in egg freezing for donation of surplus eggs. We consider whether these could be improved and argue that adapting advances in consent procedures, such as dynamic consent interfaces, may help to facilitate donation, with benefits to both donors and recipients. Main results and the role of chance While people freezing eggs often express an intent to donate eggs surplus to their own needs at the start of the freezing process, in few cases does this translate to actual donation. Current processes seek consent for donation at limited times throughout the cryostorage period. Further, some countries such as Australia require that eggs be donated to specific active research projects at the time that eggs are to be relinquished from storage. Factors such as these impede donation and fail to facilitate the initial expressed intent to donate surplus eggs. We hypothesise that consent processes can be improved in ways that may boost rates of donation while still satisfying the requirements of informed consent. Dynamic consent allows continuous review of consent decisions through an online interface. Adaptation of this approach to the context of egg cryopreservation and donation may have several benefits, as continuous communication and review opportunities encourage patient engagement. It may enhance understanding of the need for eggs and increase knowledge of opportunities to donate surplus eggs. While dynamic consent may benefit both potential donors and recipients, careful implementation would be required to ensure compatibility with counselling requirements and other ethical standards for reproductive donation in particular. Limitations, reasons for caution We consider the potential benefits to donors and recipients but do not analyse the costs of implementing such a system of consent for clinics. Further, specific clinics may have consent procedures that differ from the model we use here and may be constrained by regulatory contexts Wider implications of the findings Recent research suggests that cryopreserved oocytes are rarely used or donated. Improving procedures for obtaining informed consent promises to increase rates of donation and improve patient experience. Dynamic consent tools have been widely used in biobanking and genomics research to positive effect but would be novel within the ART context. Trial registration number Not Applicable

A Sense of Connectedness in Reproductive Donation. Contrasting Policy With Donor and Donor Kin Lived Experience

This article asks how well new developments in family life are reflected in law and policy, with a particular focus on donor conception. There has been an unprecedented ‘opening up’ of family life in recent decades; this increased diversity is, at least in part, linked to developments in reproductive technologies, including gamete donation. In family lives touched by donation, genetic relations with ‘donor connections’ take genetic connectedness beyond traditional notions of kinship. There is not yet an established social script for how to understand what constitutes meaningful connectedness in reproductive donation. Focussing on the UK context specifically, where assisted conception is highly regulated, this article examines on the one hand, how UK law and policy portray meaningful connectedness in the context of donation, and, on the other hand, how well this fits with connectedness as experienced within egg and sperm donor communities. Drawing on original data from UK law and policy analysis, and empirical interview data with egg and sperm donors and their kin, our analysis shows important disparities between law and policy, and the empirical evidence, suggesting a need for an overhaul of UK donor conception law and policy.

Legal regulation of gamete and embryo donation: global and national trends (literature review)

While the assisted reproductive technologies have been available for several decades, there still exists a great divergence in legal frameworks regulating reproductive donation. 
 The article discusses legal regulations on embryo and gamete (sperm and oocytes) donation in Europe, Americas, Canada and Australia. The search for publications was carried out in all available bibliographic and abstract databases (RSCI, Scopus, Web of Science, CyberLeninka, eLibrary, PubMed) containing reports on the subject of the article. The main search restrictions were the language of publications (English and Russian) and the date of reports (not earlier than 2000). We seek to chart global trends and identify major legislative “gaps”; the latter emerge because each type of reproductive donation causes specific conflicts and calls for specific regulations. There is a visible trend towards open gamete donation across the globe as more and more governments insist on deanonymization of donors. Legislators intend to protect children’s interests and to secure their right to identify their biological parents. Financial remuneration is perceived differently, and regulations diverge across the globe. Many governments permit reimbursements, but do not allow any commercial payoffs. Yet, issues of parenthood and donor-recipient obligations remain quite controversial, which results in divergent legal frameworks. Sperm donation is the least controversial and safest procedure; therefore, it is legal in all countries and is allowed in non-medical setting. On the other hand, informal sperm donation requires targeted legal regulations. Parenthood and anonymity in sperm donation also cause concern and require specific legislation. In some countries, oocyte donation is illegal while in others it is under severe limitations. Currently medical treatment and observation of oocyte donors after ART cycles is not yet legally regulated, which leaves women unprotected from post-donation health issues. Embryo donation hinges on the status of the embryo. Specific definition will determine the consequences including from adoption to research use. There remains a problem of authority over embryo’s future in cases of a spouse’s death or divorce.

Student views on recognition and payment options for gamete donation in New Zealand.

Demand for donor gametes in New Zealand significantly outweighs the number of willing donors. Payment for donation has been suggested as a viable solution to increase the supply and attract more donors in acknowledging the time, effort and inconvenience associated with donation. Internationally, university students are a commonly targeted group for paid gamete donation. This study aims to explore the views of university students in New Zealand to gauge their support and concerns relating to a range of options to recognise donors, including payment. Two hundred and three tertiary students completed a questionnaire exploring their views on various forms of recognition for donation and concerns relating to payment. Participants indicated the greatest support for reimbursement for expenses directly related to the donation process. Payment constituting explicit financial advantage was regarded least favourably. Participants held concerns that payment would attract people donating for the 'wrong' reasons and lead to donors concealing relevant histories. Further concerns included payment increasing costs for recipients and causing disparities in access to gametes. The findings of this study suggest that within a New Zealand context a culture of gift-giving and altruism are strongly held principles towards reproductive donation, including among the student population. This highlights the need to consider alternative strategies to commercial models to overcome donor shortages which are in line with the cultural and legislative context of New Zealand.

Whose autonomy, whose interests? A donor-focused analysis of surrogacy and egg donation from the global South.

This article provides a donor-focused analysis of how transnational reproductive donation intersects with issues central to bodily autonomy of surrogates and egg donors from the global South. Little is known about the autonomy of surrogates and egg donors, especially among those from the global South. This article addresses this gap by examining two key issues on surrogacy and egg donation-conflict of interest and recruitment market. With these issues, this paper presents contexts of the reproductive body as a space of contestation for autonomy. Analysis reveals that bodily autonomy is not an absolute entitlement available for surrogates and egg donors from the global South. Having bodily autonomy is a privileged disposition rather than a universal liberty for reproductive donors. The discussions in this work encourage further examination to understand the multi-layered experiences of reproductive donors from the global South, towards deeper interrogation of the processes of reproductive industry.

Reproductive birth control after the coronavirus pandemic

Changes in measures and instruments of birth control are one of the consequences of the coronavirus pandemic in all countries with increased significance of reproductive components, i.e. concerning physiological capabilities of conception, gestation and childbirth. Pandemic-associated measures had diverse impacts on restrictive (aimed at reducing fertility) and expansionary (aimed at increasing fertility) methods of reproductive regulation: it did not take methods of pregnancy prevention and artificial termination of pregnancy long to adapt to the new conditions without changing the established trends, while assisted reproductive technologies, following administrative bans of the first days of mass lockdowns, demonstrated new development directions upon removal of bans. Against the background of the progress in the medical component, increasingly bringing in- vitro fertilization closer to natural conception, the scale of state funding and the number of free of charge programs for patients have increased, however, due to anti-epidemic control, cross-border reproductive care or fertility tourism, relevant for surrogacy and reproductive donation, has become more complicated. In Russia, this has intensified public discussions and contributed to further elaboration of reproductive legislation.

O-104 Providing accurate information – impact of ancestry testing

Abstract Providing information to patients and, or donors at the ART clinic is essential but challenging, especially in the case of reproductive donation. Recent developments in direct-to-consumer genetic testing combined with social media have increased the degree of difficulty. Concepts such as donor anonymity, secrecy and disclosure have to be revisited and totally re-thought as the anonymity of donors, their relatives and also of the children born through donation is no longer guaranteed. This potentially has significant effects on everyone involved: to donors who donated under the assumption that their donation was completely anonymous, to recipients who were under the impression that they could keep donor conception a secret and to donor offspring who were unaware of their donor-assisted conception. It is also effectively retrospective affecting everyone who has, is or might participate. Providing the correct information to donors, ART couples and donor-conceived offspring is the key, and advise for such information provision will be presented in line with the recently published ESHRE good practice recommendations for information provision for those involved in reproductive donation. Trial registration number

Good practice recommendations for information provision for those involved in reproductive donation†.

STUDY QUESTIONWhat information and support should be offered to donors, intended parents and donor-conceived people, in general and in consideration of the availability of direct-to-consumer genetic testing and matching services?SUMMARY ANSWERFor donors, intended parents and donor-conceived offspring, recommendations are made that cover information needs and informed consent, psychosocial implications and disclosure.WHAT IS KNOWN ALREADYTrends indicate that the use of donor-assisted conception is growing and guidance is needed to help these recipients/intended parents, the donors and offspring, navigate the rapidly changing environment in which donor-assisted conception takes place.STUDY DESIGN, SIZE, DURATIONA working group (WG) collaborated on writing recommendations based, where available, on evidence collected from a literature search and expert opinion. Draft recommendations were published for stakeholder review and adapted where relevant based on the comments received.PARTICIPANTS/MATERIALS, SETTING, METHODSPapers retrieved from PUBMED were included from 1 January 2014 up to 31 August 2020, focusing on studies published since direct-to-consumer genetic testing has become more widespread and accessible. The current paper is limited to reproductive donation performed in medically assisted reproduction (MAR) centres (and gamete banks): donation outside the medical context was not considered.MAIN RESULTS AND THE ROLE OF CHANCEIn total, 32 recommendations were made for information provision and support to donors, 32 for intended parents and 27 for donor-conceived offspring requesting information/support.LIMITATIONS, REASONS FOR CAUTIONThe available evidence in the area of reproductive donation is limited and diverse with regards to the context and types of donation. General conclusions and recommendations are largely based on expert opinion and may need to be adapted in light of future research.WIDER IMPLICATIONS OF THE FINDINGSThese recommendations provide guidance to MAR centres and gamete banks on good practice in information provision and support but should also be considered by regulatory bodies and policymakers at a national and international level to guide regulatory and legislative efforts towards the protection of donors and donor-conceived offspring.STUDY FUNDING/COMPETING INTEREST(S)The development of this good practice paper was funded by European Society of Human Reproduction and Embryology (ESHRE), covering expenses associated with the WG meetings, the literature searches and dissemination. The WG members did not receive any payment. The authors have no conflicts of interest to declare.DISCLAIMER This document represents the views of ESHRE, which are the result of consensus between the relevant ESHRE stakeholders and where relevant based on the scientific evidence available at the time of preparation. The recommendations should be used for informational and educational purposes. They should not be interpreted as setting a standard of care, or be deemed inclusive of all proper methods of care nor exclusive of other methods of care reasonably directed to obtaining the same results. They do not replace the need for application of clinical judgement to each individual presentation, nor variations based on locality and facility type. †ESHRE pages content is not externally peer reviewed. The manuscript has been approved by the Executive Committee of ESHRE.

Informal Sperm Donation in Russia

Rising infertility across the globe has created a growing demand for assisted reproductive technologies (ART). In recent years, apart from sperm donation in formal settings such as fertility clinics, informal donation practices have emerged and spread across Russia. These reproductive donation practices have become possible due to the development of social networks and private online platforms. We conducted a pilot study (eleven semi-structured interviews) of the informal sperm donation in Russia and analyzed donor-recipient interactions, donors’ expectations and experiences of finding recipients online. We focus on donors' motivations and on the meanings, which donors invest in this practice that consumes significant resources on their part (medical tests and artificial insemination costs, travel and accommodation expenses, sometimes mutually agreed financial support of future offspring). We interpreted the practices that coalesced around informal donation from the perspective of symbolic interactionism, because it allowed us to showcase how actors reflected on and formulated the meanings of their actions in the absence of externally imposed rules (legal regulations, established moral conventions). Since informal donation practices do not fit into the traditional schemes of interpretation, such research requires the actors involved in informal donation either to create their own schemes or to modify the existing conceptual frames in creative ways. The study shows that informal donors do not only provide their genetic material but also spend time and invested considerable resources to ensure their procreation, including eventual financial support of the child. At the same time, these men are not interested in marital relations or paternal relations with their offspring. Thus, the informal sperm donors do not associate the parental project with traditional family and its values. We conclude that ART engendered a new phenomenon, which might be described as extramarital reproduction. Assisted reproduction outside marriage ­gains footing in Russia and requires more detailed further study.

Indirect Strategies for Disclosing the Genetic/Gestational Origins of Children Conceived by Means of Reproductive Donation (Spain)

This article is based on ethnographic research carried out in Spain, with families who have conceived their children using third-party intervention. It focuses on an aspect of these parents’ strategies regarding disclosure (or non-disclosure) of their children’s origins which has received very little attention in the research in this field: the indirect strategies implemented in contexts beyond the parents-children dyad. The parents use these strategies to establish an environment in which the child can create an image of her or himself as normal and non-exceptional, for which they intervene in their social networks mainly by controlling the information circulating through them and that, therefore, can reach the child. Three main contexts in which the parents implement these strategies have been identified: the extended family, the school, and family associations. The analysis of disclosure (or non-disclosure) strategies in these contexts provides some suggestions to improve professional intervention in this area.

СОЦИАЛЬНО-ДЕМОГРАФИЧЕСКИЕ ОСОБЕННОСТИ ПРОКРЕАТИВНОГО ПОВЕДЕНИЯ В УСЛОВИЯХ РУТИНИЗАЦИИ ВСПОМОГАТЕЛЬНЫХ РЕПРОДУКТИВНЫХ ТЕХНОЛОГИЙ

The article describes the first results of an electronic survey of Moscow and Novosibirsk university students and postgraduates in April-May 2021. The analysis of 106 questionnaires showed that 74.7 % of the respondents (among whom 67.9 % are aged from 18 to 20 years, ⅔ are female, ¾ live in cities, 92.9 % are not married) want to have children, and every fifth of them — three ones. 91.8 % of the respondents believe that their individual health will not prevent them from implementing these plans, and they consider assisted reproductive technologies to be «a chance for people who are not able to have a child naturally to become parents». Awareness of specific ART programs varies: 81.2 % know about surrogacy, 75.3 % — about sperm donation, but only 55.3 % — about egg donation, 51.8 % — about cryopreservation of reproductive material, 49.4 % — about ICSI, while only 31.8 % — about long-used artificial insemination and 28.2 % — about the relatively new technology of embryo donation. For the majority of the respondents this is «abstract» knowledge since ¾ of them have not heard of real cases of applying assisted reproduction among their relatives and acquaintances. 56.5 % of the respondents are ready to use in vitro fertilization themselves if natural pregnancy and childbirth turn out to be contraindicated or physically impossible. However, ⅔ of the respondents deny the possibility of using more «morally complex» programs related to reproductive donation and surrogacy. These results allow us to speak of new sociocultural procreative norms due to the fundamental possibility of medicalization of reproductive processes. However, this makes the conception and gestation procedures dependent on organizational resources and the stability of the public health system.

Delegation of parenthood and language of reproduction: experts and patients on the birth of ART-children

While understanding their positions on various ethical issues in the field of reproductive technologies, IVF patients form their own special language, not scientific, but rather vernacular, based on real experience. A group of women actively seeking procreation with modern biotechnologies remains somewhat conservative, focused on a traditional family. New concepts and terminology are particularly well-formed in their disputes over the use of reproductive donation. In general, what they articulate and advocate is consistent with concepts of bioethics that are also controversial – for some, the priority of genetic connectivity is unusually strong, while others deny its significance. The study bases on examining perceptions of reproductive donation by bioethics specialists presented in the literature and their comparison with the views of ART patients communicating on the Internet. The author uses qualitative discourse analysis and studies thematic discussions on the Probirka.ru website, which are devoted to the preferences of their participants in relation to reproductive donation, its acceptance or rejection. The study shows that patients’ positions are somewhat more extreme than the views of bioethics. For example, some participants practically deny the existence of genes, while others talk about the advantage of finding a child without using one’s own body. The author reveals different groups of patients, and more traditionally oriented women prefer to delegate the genetic part of parenthood to third parties and cannot refuse to bear pregnancy as they see it as a central part of female identity, while more modernized prefer to keep genetic connection if it is possible to refuse childbearing.

Recent trends in embryo disposition choices made by patients following in vitro fertilization.

To assess longitudinal trends in in vitro fertilization (IVF) patients' choices for disposing of cryopreserved embryos. This is a retrospective cohort study of embryo disposition forms submitted between January 2000 and February 2020 at a university-based fertility clinic. Primary outcome was disposition decision. Binary and multivariable logistic regression were performed to determine odds ratios (OR) for decisions according to female age, education, race, religion, state of residence, area deprivation index based on zip code, and IVF pregnancy history. We also assessed disposition year, storage duration, and number of stored embryos. Forms were reviewed from 615 patients; 50.6% chose to discard embryos, 45.4% donated to research, and 4.1% chose reproductive donation. In the regression model, two factors were significantly associated with donation to research: female listing "no preference" or declining to list religious preference (OR 2.56, 95%CI 1.44-4.54) and live birth of multiples after IVF (OR 1.58, 95%CI 1.05-2.36). Before 2012, females younger than age 30 at storage were equally likely to choose to donate embryos to research as discard them. However, between 2013 and 2020, females younger than 30 were significantly more likely to discard than donate embryos for research (OR 2.87, 95%CI 1.13-7.28). Since 2013, the majority of patients younger than 30 at storage have chosen to discard cryopreserved embryos. Before then, patients were more likely to donate embryos for research. To ensure sufficient embryos are available for research, young patients, who are most likely to have cryopreserved embryos, should be counseled about options for donation.

Review of International Research on Ethical and Psychological Barriers to Reproductive Donation

Review of International Research on Ethical and Psychological Barriers to Reproductive Donation

The relationship of sociocultural beliefs and infertile couples' attitude toward reproductive donation: A descriptive-correlational study.

BackgroundThere are controversial views on accepting a reproductive donation in the world.ObjectiveThis study aimed to determine the relationship between the sociocultural beliefs and infertile couples' attitude toward reproductive donation in Mashhad, Iran.Materials and MethodsThis descriptive correlational study was conducted out on 115 infertile couples visiting Milad Infertility Center in Mashhad, Iran with using convenience sampling. The research instruments were valid and reliable sociocultural beliefs and attitude questionnaires, which were completed by the respondents on a self-report basis.ResultsThe mean score of attitude toward reproductive donation in infertile women and men was 58.3 12.6 and 57.8 12.0, and the mean score of sociocultural beliefs in infertile women and men was 67.7 11.5 and 67.6 12.4, respectively. There was a direct correlation between sociocultural beliefs and attitude toward reproductive donation in infertile women (p 0.001) and men (p 0.001), that is, women and men with a higher score of sociocultural beliefs had a higher score of attitude as well. A direct correlation was also seen between sociocultural beliefs and infertile women and men's public attitude, their attitude towards genetic bound between parents and children, their attitude regarding the issue of confidentiality of the donation process, as well as attitude in relation to oocyte donation, embryo donation, and surrogacy (p 0.001).ConclusionThe findings suggest that sociocultural beliefs that surround reproductive donation could influence infertile couple's attitude toward accepting these therapeutic alternatives in infertile couples. It is therefore recommended to take steps to incorporate sociocultural beliefs into the routine care of infertile couples with the help of social media to give them ability for making more pragmatic decision in relation to their chosen options.

Marcas de identidad, atributos sociales deseables y fenotipos compartidos. Un análisis a partir de la donación de gametos en Uruguay

La gestión de gametos —óvulos y esperma— de donación para tratamientos de reproducción humana asistida involucra la captación de personas dispuestas a dar parte de su biología o fertilidad, una selección para definir quiénes ingresan efectivamente en el proceso de donación, el desarrollo de un “trabajo clínico” orientado a la producción de ese material reproductivo y, finalmente, la distribución los gametos entre personas o parejas receptoras. El proceso de selección que define quiénes ingresan efectivamente como donantes implica una valoración de la persona y de los gametos que puede aportar. Se ponen en juego en esta valoración atributos concebidos de modos diversos —capacidad reproductiva, características fenotípicas, características étnico-raciales, atributos genéticos, intelectuales, entre otros—, que hablan de la lectura que la sociedad hace del material biológico y de lo que se considera valorable para la reproducción de la sociedad en su conjunto y para el establecimiento de una relación filial específica. En este artículo analizo cómo se definen estos atributos y cuáles se privilegian al momento de gestionar la reproducción social y la producción de una relación social filial específica. No se trata de analizar la gestión de material reproductivo de donación para tecnologías de reproducción humana asistida en sí misma, sino como vía para entender cómo la sociedad uruguaya concibe las relaciones entre biología, identidad, filiación y reproducción.

The perspectives of adolescents conceived using surrogacy, egg or sperm donation.

STUDY QUESTIONWhat are the perspectives of adolescents conceived using surrogacy, egg or sperm donation regarding their conception and the third party involved?SUMMARY ANSWERThe majority of adolescents described feeling indifferent about their conception, and yet simultaneously reported an interest in the third party involved, or were in contact with them.WHAT IS KNOWN ALREADYThere is an assumption that children conceived through reproductive donation will feel negatively about their origins in adolescence. However, little is known about the views of adolescents who have been conceived through different types of reproductive donation.STUDY DESIGN, SIZE, DURATIONForty-four adolescents, all of whom had been told about their conception in childhood, participated in a semi-structured interview as part of the sixth phase of a longitudinal, multi-method, multi-informant study of assisted reproduction families in the UK.PARTICIPANTS/MATERIALS, SETTING, METHODSAll adolescents were aged 14 years, had been conceived using surrogacy (n = 22), egg donation (n = 13) or sperm donation (n = 9) to heterosexual couples, and varied in terms of their information about, and contact with, the third party involved in their conception. Semi-structured interviews were conducted in participants’ homes. Interviews were analysed qualitatively to determine adolescents’ perceptions of their conception, and their thoughts and feelings about the surrogate or donor involved.MAIN RESULTS AND THE ROLE OF CHANCEAdolescents were found to feel positive (n = 7), indifferent (n = 32) or ambivalent (n = 5) about their conception. Amongst adolescents not in contact with the surrogate or donor, most were interested (n = 16) in the surrogate or donor, and others were ambivalent (n = 4), or not interested (n = 6) in them. Adolescents in contact with the surrogate or donor expressed positive (n = 14), ambivalent (n = 1) or negative (n = 1) feelings about them.LIMITATIONS, REASONS FOR CAUTIONOf 56 adolescents invited to take part in the study, 47 consented to take part, giving a response rate of 84%. It was not possible to obtain information from adolescents who do not know about their conception.WIDER IMPLICATIONS OF THE FINDINGSThe findings contradict the assumption that children conceived through reproductive donation will feel negatively about their origins in adolescence and suggest that it may be helpful to draw a distinction between adolescents’ feelings about their conception in general, and their feelings about the surrogate or donor in particular.STUDY FUNDING/COMPETING INTEREST(S)This study was funded by the Wellcome Trust [097857/Z/11/Z]. The authors have no conflicts of interest to declare.

A longitudinal study of families formed through reproductive donation: Parent-adolescent relationships and adolescent adjustment at age 14.

The aim of the 6th phase of this longitudinal study was to establish whether children born through assisted reproduction involving reproductive donation were at risk for psychological problems following the transition to adolescence at age 14 and, if so, to examine the nature of these problems and the mechanisms involved. Eighty-seven families formed through reproductive donation, including 32 donor insemination families, 27 egg donation families, and 28 surrogacy families, were compared with 54 natural conception families. Standardized interviews, questionnaires, and observational assessments of the quality of parent-adolescent relationships and adolescent adjustment were administered to mothers, adolescents, and teachers. The mothers in surrogacy families showed less negative parenting and reported greater acceptance of their adolescent children and fewer problems in family relationships as a whole compared with gamete donation mothers. In addition, less positive relationships were found between mothers and adolescents in egg donation families than in donor insemination families as rated by both mothers and adolescents. There were no differences between family types for the adolescents themselves in terms of adjustment problems, psychological well-being, and self-esteem. Longitudinal analyses showed no differences between family types in negative parenting from age 7 to age 14, and a weaker association between negative parenting and adjustment difficulties for gamete donation than natural conception and surrogacy families. The findings suggest that the absence of a genetic link between mothers and their children is associated with less positive mother-adolescent relationships whereas the absence of a gestational link does not have an adverse effect.

Comunidades virtuales creadas en torno la donación reproductiva: ¿simulacros del contacto humano?

There is a large online presence of Spanish women participating in reproductive donation, creatiing different types of families through this process. This article addresses the following two questions regarding this phenomenon: First, why are assisted reproduction communities composed mainly, if not solely, of female participants? Second, what kind of relationships and roles do these communities prompt among their members? The paper then prsents hypotheses exploring the emergence and continuing existence of these online communities in the Spanish context. This context is defined as one with increasing participation in assisted reproduction, yet lacking in resources to support women throughout the assisted reproduction process.

ПРАВОВІ ТА ЕТИЧНІ АСПЕКТИ РОЗВИТКУ БІОМЕДИЧНИХ ТЕХНОЛОГІЙ ТА ЇХ ВПЛИВ НА ОРГАНІЗМ ЛЮДИНИ

he end of the twentieth century and the beginning of the twentyfirst century has begun the rapid development of scientific researches in the biological and medical fields. This process is associated with using of fundamentally new methods, which are primarily aimed at the disease prevention, as well as the introduction into the treatment of human diseases with the latest scientific and innovative technologies, methods and techniques of their application. These opportunities in the development of scientific technologies in the field of biology and medicine have led to the emergence of such a direction of scientific activity as "biotechnology". The proposed article notes that using of biomedical technologies has caused a number of new problems in the field of law and ethics. Legal arrangement in the field of the health protection have become much more complicated. Thanks to new opportunities, today these relations regulate rights and responsibilities of a fairly large number of people. Modern relations in the field of medical services and medical care lead to the emergence of new approaches to their regulation by both legal and ethical norms. In the past, relations in the field of the health protection were usually between two subjects, a doctor and a healthcare consumer. Nowadays, in a medical practice, relations in the field of the health protection involve: a health-care consumer, his family members (e.g., in the case of hereditary diseases diagnosis, blood and organ donation etc.) and third parties (e.g., organ donation, reproductive cell donation, surrogacy etc.). In the general doctrinal concept, biotechnology is the industrial use of living organisms or their parts (microorganisms, fungi, algae, plant and animal cells, cellular organs, enzymes etc.) for product producing or modifying, improving plants and animals, and in medical practice - in relation of the individual human organs (or body as a whole) functioning. These circumstances require improving the legal regulation of modern medicine public relations, bringing them into line with emerging realities. Moreover, the specifics of relations in this field determines the specifics of their legal regulation. The application of new medical technologiesin relation to human treatment has given rise to a significant number of moral and ethical problems that could not be solved within the framework of medical ethics and deontology alone. In connection with this, the way out of the current situation could be the consolidation of bioethics as an interdisciplinary field of knowledge, as a science, which makes it possible to explain moral, ethical and legal aspects of the medicine. This, for example, determines the allocation of medical law in an independent branch of law in some Western countries and Ukraine. The article focuses on biomedical ethics, which is a component of the medical activities system regulation. In the context of considering the levels of social regulation of medical activities, bioethics (biomedical ethics) is an interdisciplinary science that studies moral and ethical, social and legal problems of medical activities in the context of human rights protection. Bioethics should create a set of moral principles, norms and rules that are binding on all mankind and delineate the limits of scientific interference in the nature of the human body, the transition through which is unacceptable.