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Demarquette CF, Rivet-Danon D, Ly A, Ogouma-Aworet L, Prades M, Berthaut I, Bachelot G, Kolanska K, Bardet L, Lévy R, Sermondade N, Dupont C. Medically assisted reproduction (MAR) with sperm donation: comparison of the profiles and medical pathways of unmarried women and women in heterosexual couples. J Gynecol Obstet Hum Reprod 2024:102848. [PMID: 39243887 DOI: 10.1016/j.jogoh.2024.102848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 08/08/2024] [Accepted: 09/04/2024] [Indexed: 09/09/2024]
Abstract
RESEARCH QUESTION The legislation allowing unmarried women to undergo medically assisted reproduction (MAR) with sperm donation was adopted in France on August 2, 2021. This major advancement, and its impact on French society, led us to a closer examination of the requests made by unmarried women and the outcomes of ART attempts. DESIGN A retrospective single center cohort study was conducted in a fertility center in Paris, France. All unmarried women and women in heterosexual couple seeking for MAR using sperm donation between September 2021 and October 2022 were included. Medical and socio-demographic data, as well as details and outcomes of MAR attempts were analyzed until October 31, 2023. RESULTS Two hundred seventy-two unmarried women and 76 women in heterosexual couple were included. Results were compared between the two groups. Unmarried women were significantly older, with a significant decrease in anti-Müllerian hormone (AMH) and antral follicle count (AFC). They also exhibited a higher prevalence of gynecological pathologies associated with infertility, such as endometriosis. Unmarried women were more likely to work in intermediate occupations, whereas women in heterosexual couple more often had employee status. Among unmarried women who had undergone at least one MAR attempt by October 31, 2023, significantly lower cumulative early and ongoing pregnancy rates were observed. CONCLUSIONS Female age appears to play a major role in the likehood of pregnancy and live birth. It is therefore crucial to inform women initiating the process of MAR with sperm donation that success is not guaranteed.
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Affiliation(s)
- C Farabet Demarquette
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP. Sorbonne-Université, Paris, France; Sorbonne Université, Faculté de Santé, Paris, France
| | - D Rivet-Danon
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP. Sorbonne-Université, Paris, France
| | - A Ly
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP. Sorbonne-Université, Paris, France
| | - L Ogouma-Aworet
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP. Sorbonne-Université, Paris, France
| | - M Prades
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP. Sorbonne-Université, Paris, France
| | - I Berthaut
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP. Sorbonne-Université, Paris, France; Sorbonne Université, INSERM UMR 938, Centre de Recherche St-Antoine, CRSA, Paris, France
| | - G Bachelot
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP. Sorbonne-Université, Paris, France; Sorbonne Université, INSERM UMR 938, Centre de Recherche St-Antoine, CRSA, Paris, France
| | - K Kolanska
- Sorbonne Université, INSERM UMR 938, Centre de Recherche St-Antoine, CRSA, Paris, France; Service de Gynécologie Obstétrique et Médecine de la Reproduction, Hôpital Tenon, AP-HP, Sorbonne Université, 4 Rue de la Chine, 75020, Paris, France
| | - L Bardet
- Sorbonne Université, INSERM UMR 938, Centre de Recherche St-Antoine, CRSA, Paris, France; Service de Gynécologie Obstétrique et Médecine de la Reproduction, Hôpital Tenon, AP-HP, Sorbonne Université, 4 Rue de la Chine, 75020, Paris, France
| | - R Lévy
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP. Sorbonne-Université, Paris, France; Sorbonne Université, INSERM UMR 938, Centre de Recherche St-Antoine, CRSA, Paris, France
| | - N Sermondade
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP. Sorbonne-Université, Paris, France; Sorbonne Université, INSERM UMR 938, Centre de Recherche St-Antoine, CRSA, Paris, France
| | - C Dupont
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP. Sorbonne-Université, Paris, France; Sorbonne Université, INSERM UMR 938, Centre de Recherche St-Antoine, CRSA, Paris, France.
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Frydenrejn Funderskov K, Konge Nielsen M, Boe Danbjørg D, Juel Rothmann M, Werner A. Preparing solo mothers for childbirth and parenthood - The importance of being with like-minded women. SEXUAL & REPRODUCTIVE HEALTHCARE 2024; 40:100968. [PMID: 38574597 DOI: 10.1016/j.srhc.2024.100968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/23/2024] [Accepted: 03/26/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVES Denmark and many high-income countries have seen an increase in the number of single women getting pregnant through medical assisted reproduction (MAR). These women are also named solo mothers. According to the Danish Health Authorities, they should, as all other pregnant women, be offered antenatal education. The aim of this study was to explore solo mothers' needs in order to prepare them for childbirth and parenthood. METHODS This qualitative study was set to investigate solo mothers' experiences and requirements during pregnancy toprepare them for childbirth and parenting. Semi-structured interviews were conducted by telephone or face-to-face. A systematic text condensation and interpretation was used to analyse data. RESULTS 38 interviews were conducted before and after pregnancy. Twenty solo mothers participated in the study. Three themes emerged from the analysis: 'Confrontation with the normative pregnancy', 'Mirroring and network' and 'Using formal and informal sources to gain information'. CONCLUSION The conventional antenatal packages offered by the healthcare system did not meet the solo mothers' needs. The women called for content and information tailored to single parents. Solo mothers may benefit from structured antenatal classes in small groups. Being with like-minded women was essential for preparing for childbirth and parenting.
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Affiliation(s)
- Karen Frydenrejn Funderskov
- Department of Anaesthesiology, Pain and Respiratory Support, Neuroscience Centre Rigshospitalet, Copenhagen, Denmark.
| | - Marie Konge Nielsen
- Department of Nursing, University College Absalon, Slagelse, Denmark; Department of Design, Media and Educational Science, University of Southern Denmark, Denmark; User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | | | - Mette Juel Rothmann
- Department of Clinical Research, University of Southern Denmark, Denmark; CIMT, Centre for Innovative Medical Technology, Odense University Hospital, Denmark; Steno Diabetes Center Odense, Odense University Hospital, Denmark
| | - Anette Werner
- Department of Clinical Research, University of Southern Denmark, Denmark; Department of Gynecology and Obstetrics, Odense University Hospital, Denmark
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Perceived social support in solo women seeking treatment with donor gametes and in women in heterosexual couples seeking IVF-treatment with own gametes. Sci Rep 2023; 13:2733. [PMID: 36792663 PMCID: PMC9931690 DOI: 10.1038/s41598-023-29441-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 02/06/2023] [Indexed: 02/17/2023] Open
Abstract
Solo motherhood is a family constellation that is becoming increasingly common in high income countries. The demographic characteristics of solo women entering treatment with donated sperm or embryo have been shown to be different from that of cohabiting women. The general importance of perceived social support is frequently amplified when health and quality of life are concerned, and positively affects mental health status, experienced stress, perceived self-efficacy during the transition to parenthood and during parenthood itself. The objective of the present study was to compare demographic characteristics, social network and perceived social support among solo women and cohabiting women awaiting fertility treatment. This objective was explored with a study-specific demographic and background questionnaire as well as through questions on access to practical support and the Multidimensional Scale of Perceived Social Support (MSPSS) assessing different sources of support. This study is a part of a longitudinal prospective multicenter study of solo women who awaited donation treatment in six Swedish public and private fertility clinics and a comparison group of women who were cohabiting/married to male partner and awaited in vitro fertilization (IVF) treatment with the couple's own gametes. A total of 670 women were invited and 463 accepted participation (69% response rate); 207 solo women (study group) and 256 cohabiting women (comparison group). The results show significant differences in age, education, and employment between the groups. Solo women were on average 3.6 years older, had a higher level of education, a higher-income profession, and were more frequently working full time. Solo women perceived an equally high degree of social support from their families, significantly higher levels of support from friends and significantly lower support from a significant other compared to cohabiting women. Solo women expected their mother to be the most supportive person in future parenthood, while cohabiting women most often stated their cohabiting partner to fill that role. The study adds to the body of knowledge of solo women as a sociodemographic distinct group going at motherhood alone, stating a high degree of currently perceived and expected social support. The previously studied negative impact that lack of a co-parent might have, may be attenuated by the expected and perceived social support from family and friends.
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Temmesen CG, Faber Frandsen T, Svarre-Nielsen H, Petersen KB, Clemensen J, Andersen HLM. Women's reflections on timing of motherhood: a meta-synthesis of qualitative evidence. Reprod Health 2023; 20:30. [PMID: 36755286 PMCID: PMC9909900 DOI: 10.1186/s12978-022-01548-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 12/11/2022] [Indexed: 02/10/2023] Open
Abstract
INTRODUCTION Fertility declines with increasing age, especially in women. In recent decades women's age at the birth of their first child has risen markedly in many countries, and an increasing number of women do not establish a family until their late-twenties to mid-thirties. Although there can be various reasons that couples experience fertility problems, advanced maternal age is the most frequent cause for difficulties with achieving pregnancy. OBJECTIVE In this meta-synthesis, we investigated reflections on timing of motherhood in women who have not yet had children. METHODS A systematic literature search of six electronic databases and manual searches of reference lists identified eight qualitative studies published between 2011 and 2018 that focused on women's reflections on timing of motherhood. The studies were assessed with the Critical Assessment Skills Programme (CASP) quality appraisal tool. The results were synthesized using Noblit and Hare's meta-ethnographic approach as described by Malterud. FINDINGS An overall theme of 'Timing of motherhood' and four overlapping subthemes were identified: Making a life-changing decision, The right time, Fear of regret, and Plan B. The dilemmas associated with timing of motherhood leave women of reproductive age balancing their priorities and values against a biological deadline for having children naturally or through assisted reproductive technology. CONCLUSIONS Women of reproductive age are aware that they must make a life-changing decision as to if or when to have children, but they consider having children at 'the right time' to be important. Simultaneously, while some women are reluctant to have children for various reasons, they express fear that waiting too long could result in their regretting not having children later in life. Although women of reproductive age express concern about their ability to achieve pregnancy, they have limited focus on the medical risks associated with postponing motherhood. There is a need to establish preventive health initiatives to support women of reproductive age in their considerations regarding timing of motherhood. TRIAL REGISTRATION NUMBER PROSPERO: CRD42020175151.
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Affiliation(s)
- Camilla Gry Temmesen
- Department of Nutrition, Rehabilitation and Midwifery, University College Absalon, Sdr. Stationsvej 30, 4200, Slagelse, Denmark. .,Clinical Institute, University of Southern Denmark, Odense, Denmark.
| | - Tove Faber Frandsen
- grid.10825.3e0000 0001 0728 0170Department of Design and Communication, University of Southern Denmark, Kolding, Denmark
| | - Henriette Svarre-Nielsen
- grid.5254.60000 0001 0674 042XDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark ,grid.411905.80000 0004 0646 8202Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | | | - Jane Clemensen
- grid.10825.3e0000 0001 0728 0170Department of Children, Hans Christian Andersen Children’s Hospital, University of Southern Denmark, Odense, Denmark
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Volgsten H, Schmidt L. Exploring Swedish single women's decision to choose motherhood through medically assisted reproduction - a qualitative study. HUM FERTIL 2021:1-12. [PMID: 34933655 DOI: 10.1080/14647273.2021.2017026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
New legislation was introduced in Sweden in 2016, giving single women access to medically assisted reproduction (MAR). While Swedish single women's characteristics and motivations for choosing motherhood through MAR were assessed in our previous pilot survey, their experience of considering and making the decision to undergo MAR has not been assessed through a qualitative approach. Thus, the aim of this study was to explore Swedish single women´s experience of making the decision to choose motherhood through MAR. The study design was a qualitative method with a semi-structured interview guide used for individual face-to-face interviews. Sixteen single women accepted for MAR were interviewed individually during their waiting time to start treatment. Qualitative content analysis was used to analyse the data. The data analyses resulted in three main categories: (i) longing and belonging; (ii) social exclusion and support; and (iii) evaluation and encounter. The overarching theme reflects the decision to become a single mother by choice: motherhood through MAR - an emotional and ambivalent decision to make on your own. In conclusion, to reach motherhood, by giving birth to one's child and not deviating from the norm as childless, was considered important among these women when making the decision to become a single mother by choice.
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Affiliation(s)
- Helena Volgsten
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Lone Schmidt
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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