Perception of Key Ethical Issues in Assisted Reproductive Technology (ART) by Providers and Clients in Nigeria

Son Preference among Infertile Couples at the Fertility Clinic of Two Tertiary Hospitals in Enugu, Nigeria

BACKGROUND

Son preference is known to be prevalent in developing countries and has dire consequences for the family, particularly girls and women. It is speculated that the prevalence of son preference may be high among fertility clinic attendees, and that son preference may be the reason for seeking fertility care in Nigeria.

OBJECTIVES

To determine the prevalence and risk factors for son preference among fertility seekers in Enugu, Nigeria.

MATERIALS AND METHODS

Questionnaire-based cross-sectional study of fertility clinic attendees from the University of Nigeria Teaching Hospital Ituku-Ozalla Enugu and the Pink Petals Fertility Clinic Enugu from April 1 to September 30, 2023. Eligible and consenting participants were interviewed. Data collection was with a pretested interviewer-administered questionnaire, which contained three sections: biodata, obstetrics and gynecological data and 3-point son preference questions. The proportion of those who scored 3 (son preference) was documented. The analysis was both descriptive and inferential using IBM SPSS statistics for Windows, version 22.0 Armonk, NY, USA: IBM Corp.

RESULTS

Of the 422 participants interviewed, 416 (98.6%) completed the study with a nonresponse rate of 6 (1.4%). The overall prevalence of son preference was 10.1% (42/416) and all 42 (10.1%) were in the clinic to have a male baby. The risk factors for son preference were less than tertiary education (P < 0.001, adjusted odds ratio [AOR] = 6.46, confidence interval [CI] 2.79-14.98) and family pressure to have a male baby (P = 0.03, AOR = 3.41, CI 1.72-7.13).

CONCLUSIONS

One in 10 couples who attend an infertility clinic in Enugu, Nigeria, has a preference for son, and having a male child is the sole purpose of such a visit. Being under family pressure and not having tertiary education were the predictive risk factors for son preference in the study population.

'It's like donating blood': Ghanaian university students' knowledge and attitudes towards egg and sperm donation

There is anecdotal evidence that third-party reproduction, in particular gamete donation, is on the rise in Ghana. This is not surprising, considering the country has adopted assisted conception through the use of reproductive technologies for the past three decades. These technologies primarily aid infertile couples in Ghana in fulfilling their procreative responsibilities within the Ghanaian family and society. Potential donors' opinions regarding gamete donation have received minimal attention in the Ghanaian discourse on assisted reproductive technology (ART) usage. This study explores the knowledge and attitudes of undergraduate university students regarding gamete donation. The study utilized a qualitative methodology, which included 21 in-depth telephone interviews with students who were potential gamete donors. The data were thematically analyzed. The results of the study show that the participants knew that gamete donation was performed in Ghana. Positive sentiments about the technique were motivated by altruism, whereas negative attitudes were motivated by the urge to adhere to cultural norms that stigmatize incest and children conceived by artificial means. The decision to donate or decline egg or sperm donation was significantly influenced by one's religious convictions.

Who's your daddy? An ethical argument for disclosure to donor conceived children

To our knowledge, there have been few discussions in the andrology literature regarding the ethics of disclosure to donor conceived children. Our goal in this paper is to summarize the main reasons in favor of disclosure to engender more conversations about the ethics of donor conception in andrology circles. Specifically, we argue (1) transparency regarding gamete donation upholds the ethical principle of beneficence by improving the psychological health of donor conceived children; and (2) based on the ethical principle of autonomy, donor conceived children should have the right to know their donor status.