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Research Framework: The concept of personal origins is constantly evolving as the ways in which families are formed diversify. In France, parents who have recourse to sperm donation are now encouraged to pass on to their child the circumstances of their birth. These narratives are particularly important for single mothers: they are supposed to give the donor a part in the family history, without compensating for the absence of a second parent.Objectives: This article aims to analyze how narratives about origins – in this case about donors – are constructed by single mothers.Methodology: As part of a doctoral thesis, eighteen biographical interviews were carried out with single women who had become mothers through sperm donation, both abroad and in France. These interviews were complemented by the analysis of an online group, which was a productive field of investigation for observing family intimacies.Results: Revealing one’s history gives rise to a variety of practices and narrative strategies, based on a moral norm of dual responsibility for single mothers. Investigating these narratives reveals the place assigned to the donor. He embodies a symbolic figure in family history, that is unrelated to kinship or filiation. His place is constructed in a feminine group that includes other single mothers, and is then negotiated with the close family. Furthermore, these narratives are materialized through the creation of various supports (books, images, films, etc.), testifying to single mothers’ desire to assert their family model.Conclusion: The creation of the origin story is part of the narrative work of single mothers, aimed at their children and their relatives, and contributes to family memory.Contribution: This article contributes to a better understanding of the experience of single mothers, and more generally of the place given to a donor in the history of families born of donation.

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The law (No.40/2004) stipulates that consent to Medically Assisted Procreation (MAP) remains irrevocable post ovum fertilization. Cryopreservation introduces complexities, enabling embryo implantation requests after a couple’s separation and the dissolution of the original parenthood plan. Constitutional Court Ruling No.161 in 2023 affirmed that the prohibition of revoking consent to MAP aligns with the Italian Constitution and the jurisprudence of the European Court of Human Rights. This delicate equilibrium of conflicting interests upholds human freedom, allowing consent revocation prior to ovocyte fertilization. Permitting revocation until implantation could inflict more significant harm: the infertile woman can in fact miss the opportunity to become a mother, impacting her psychophysical well-being and freedom of self-determination. Moreover, the embryo loses the chance to live, remaining in cryopreservation, which violates its dignity. Addressing this issue requires thorough communication by medical profession-als to inform couples about the limitations on consent revocation. An element of objectivity in terms of standards and evidence-based guidelines, from which norms must originate, is of utmost importance. Relying on broadly shared rules, especially at the international level, is vital in light of the unremitting scientific advances in MAP, as in other areas of medicine, which will open up new opportunities for which current legal/regulatory frameworks are inadequate. [ABSTRACT FROM AUTHOR]

Parmi les questions médicales, scientifiques et éthiques suscitées par la fécondation in vitro (FIV), celles concernant la santé à moyen et à long terme des enfants et des jeunes adultes ainsi conçus sont primordiales. Quarante-cinq ans après la naissance du premier enfant et alors que plus de 8 millions de personnes dans le monde ont été conçues par FIV, l'Académie nationale de médecine a consacré un rapport sur ce thème en appuyant notamment sa réflexion sur l'analyse des résultats des très nombreuses études internationales. Les résultats publiés sont plutôt rassurants mais ils ne sont pas toujours concordants et de nombreuses incertitudes demeurent. L'Académie de médecine appelle à approfondir les études épidémiologiques et cliniques dans des populations mieux caractérisées et à des âges plus avancés de la vie. Elle recommande aussi de développer les recherches fondamentales pour mieux renseigner les effets potentiels de la FIV. Among the medical, scientific and ethical questions raised by in vitro fertilization (IVF), those concerning the medium and long-term health of children and young adults thus conceived are essential. Forty-five years after the birth of the first child and while more than 8 million people in the world have been conceived by IVF, the National Academy of Medicine has devoted a report to this theme, mainly analysing the results of numerous international studies. The published results are rather reassuring but they are not always consistent and many uncertainties remain. The Academy of Medicine calls for further epidemiological and clinical studies in better characterized populations and at later ages of life. The Academy also recommends developing basic research to better explain the potential effects of IVF. [ABSTRACT FROM AUTHOR]

Copyright of Ruch Prawniczy, Ekonomiczny i Socjologiczny (0035-9629) is the property of Adam Mickiewicz University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Studia Iuridica Toruniensia is the property of Nicolaus Copernicus University in Torun, Faculty of Law & Administration and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The purpose of the publication is to answer the question whether, on the basis of the Act on Infertility Treatment, the minister in charge of health, as the central authority of government administration with the most extensive competences in the field of health, mainly realises, as assumed in the literature, normative competences, or whether he also undertakes other types of activities within the scope of the tasks set out by this Act. Its realisation, therefore, required an analysis of the competences of the minister in charge of health related to the organisation of the provision of health services in the field of medically assisted procreation, as defined by the aforementioned Act. This analysis was carried out using the dogmatic-legal method supported by scientific views. The analysis made it possible to establish, that this minister exercises two basic groups of competences: normative and competences to apply the law, which include the competences to: control, supervision, issue administrative decisions, as well as the competences to perform factual actions, including material-technical ones, and socialorganizational actions. Thus, a conclusion can be drawn that it has been equipped with a whole range of forms of activity that allow the realisation of the values assumed by the legislator, among which the type of activity such as issuing normative acts taking the form of universally binding regulations plays an important role. [ABSTRACT FROM AUTHOR]

Law n. 40/2004 regulated Medically Assisted Procreation (MAP) in Italy. The case described in this article is part of the many judicial cases that have affected this legislation. Following the marital separation process, the former husband withdrew consent to the implantation of already formed embryos in the uterus of his former wife who turned to the judiciary to obtain permission to initiate such a procedure. This paper consists of an analysis of this judicial process and deals with medical-legal and bioethical issues. In contrast to what is stated in Law n. 40/2004, the subsequent Law n. 219/2017 about informed consent, establishes the general principle of the withdrawal of consent until the healthcare procedure is carried out. Another issue concerns the difficult balance between the guarantee of personal freedom and the embryo's life protection, considering that although the embryo is already formed, it is not a person yet. In light of the existence of previous conflicting judicial sentences, the careful and separate assessment of the case under discussion, together with potential future events, is essential to reach a balanced conclusion, that can resolve disputes in the Italian constantly changing society. [ABSTRACT FROM AUTHOR]

Due to the constant development of medicine and biotechnology, including the in vitro procedure, more and more infertile couples can fulfil their desire to have a child. Traditional rules of family law concerning the determination of status familiae of such children have then turned out to be insufficient. The situation is even more complicated when IVF procedure assumes the use of donated genetic material or the involvement of a surrogate mother. Therefore in the field of family law the intention to "create" a child starts to play quite an important role. Family law is then undergoing far-reaching transformations, especially in those countries where same-sex couples are eligible to start IVF procedures (Great Britain, USA, Germany, Austria). [ABSTRACT FROM AUTHOR]

Due to the constant development of medicine and biotechnology, including the in vitro procedure, more and more infertile couples can fulfil their desire to have a child. Traditional rules of family law concerning the determination of status familiae of such children have then turned out to be insufficient. The situation is even more complicated when IVF procedure assumes the use of donated genetic material or the involvement of a surrogate mother. Therefore in the field of family law the intention to "create" a child starts to play quite an important role. Family law is then undergoing far-reaching transformations, especially in those countries where same-sex couples are eligible to start IVF procedures (Great Britain, USA, Germany, Austria). [ABSTRACT FROM AUTHOR]

The promulgation of the law of 2 August 2021 on bioethics was followed by a significant number of requests for AMP from female couples and unmarried women (17,000 in 1 year), but also proposals for sperm donations (nearly 600 in 2021, i.e. twice as many as in 2019). The stocks of donor sperm straws built up to date (nearly 90,000 straws) are sufficient to meet the demand from all groups. The observed lengthening of the duration of the AMP with donation process, from 12 to 13.9 months, reveals that the supply of care is not yet sized to meet the impacts of the law. It is not linked to the insufficiency of sperm stocks but rather to the organisation of these courses within a limited number of authorised centres (around thirty). For the months and years to come, the challenge is twofold in terms of the management of donor sperm stocks in order to respond to legislative changes on access to origins and the requests of the persons concerned: i) concerted management to limit the number of straws that will be destroyed and ii) the constitution of a sufficient stock of straws from donors who have consented to their identity being transmitted to the persons born from their donation, if they so request. The work of the Bioethics Law Monitoring Committee, led by the Agence de la biomédecine, by encouraging continuous exchange between all the stakeholders, and also the support of the centres by the institutional players, aims to facilitate the adequacy of the supply of care to the expectations of users and professionals. [ABSTRACT FROM AUTHOR]

Introduction: infertility is a real public health problem. Medically Assisted Procreation (MAP) with donor gametes is one of the possible solutions. In Benin, despite a well-defined legislative framework (children's code), MAP using donated gametes has not been studied. The purpose of this study was to assess knowledge, attitudes and perceptions of students at the Faculty of Health and Medical Sciences in Cotonou about the donation of gametes. Methods: we conducted a cross-sectional and descriptive study among second or third-year medical students at the Faculty of Health and Medical Sciences (FHMS) in Cotonou. Results: the surveyed sample consisted of 236 students, of whom 54% (n=127) were male and 46% (n=109) were female; the representative age range was between 18 and 24 years (87%). The knowledge of MAP using donated gametes was 90.6% (n=214). The possibility that this treatment might be performed in Benin was known to be 55.6% (n=131). More that eighty-eight percent (n=209) of respondents were unaware of the existence of legislation in force since 2015 on this matter and 69.5% (n=164) refused to donate gametes. Among the reasons mentioned, the ethical reason dominated. Conclusion: in Benin, students' knowledge about MAP using donated gametes is adequate but there is a widespread refusal to donate their gametes among them, mainly because of ethical issues. [ABSTRACT FROM AUTHOR]

After more than a quarter of a century of the practice of medically assisted procreation (MAP) in Morocco in the absence of a legal framework, the Moroccan legislator passed Law 47-14, in April 2019, to make up for the considerable delay in the field of medically assisted procreation. Through this research work, we aim to explore the field of application of this law and demonstrate its contributions to the lives of couples aspiring to motherhood and fatherhood in order to achieve their parenthood project within the couple. From a methodological point of view, this research is based on the qualitative analysis of semi-directive interviews conducted with infertile couples having recourse to (AMP) and practitioners of this medical technique. One of the key findings of this work is that there are major differences between the provision of medically assisted reproduction services in the public and private sectors, and between insured and uninsured couples.

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Abstract Objective Among medically assisted procreation (MAP) patients, the prevalence of eating disorders (ED), clinical or subclinical, current or past, is considerable. In addition to metabolic repercussions, the literature suggests that these patients present with more sexual dysfunction, leading to anxiety. This quantitative research on a population of women consulting a MAP department for unexplained or ovulatory infertility proposed to study the sexuality of this population by comparing the sexuality of patients suffering from or having suffered from an ED to the sexuality of the non‐ED group. Method Patients (n = 61) filled out the Eating Disorder Examination Questionnaire (EDE‐Q), the Brief Index of Sexual Functioning for Women (BISF‐W), the ED Whole Life Research Questionnaire, the Hospital Anxiety and Depression Scale (HADS) and the Kansas Marital Satisfaction Scale (KMSS). Results We found a prevalence of 54% of ED, current or past. Even though these patients reported the same prevalence of sexual intercourse, they had significantly more physical problems (e.g., anorgasmia, vaginismus, headache) affecting their sexuality (p = .01) than the non‐ED group, after adjusting for depression. Approximately 10% of the study population reported no intravaginal intercourse during the last month. Discussion This study provides evidence for the existence of more sexual dysfunction in patients who have a fertility disorder and have ED or a history of ED. Future research should evaluate the results of psychological or sexological care that may be more suitable for the infertility of these patients.

Copyright of Przeglad Sejmowy is the property of Kancelaria Sejmu and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

En pratique quotidienne, l'impression clinique suggère une surreprésentation des enfants issus de l'Assistance médicale à la procréation (AMP) dans la population consultant en pédopsychiatrie. Se pose alors la question de la réalité de cette surreprésentation et de l'impact de l'AMP sur le développement psychique de l'enfant. Il s'agit d'une étude transversale descriptive sur une population de 262 familles dont l'enfant est suivi au Centre Alfred-Binet (Centre médico-psychologique [CMP]), à Paris. Après estimation du taux d'incidence d'enfants issus d'AMP dans la population générale, la différence entre le taux attendu et le taux réel dans la file active du CMP a été évaluée. Les enfants issus d'AMP sont significativement plus représentés dans la population du CMP entre 1997 et 2015 (p < 0,05) et entre 2006 et 2015 (p < 0,0001). Il existe d'autres différences significatives entre les patients issus d'AMP et les enfants conçus naturellement avec respectivement un taux de prématurés plus important (43,7 % vs 3,7 %), un âge moyen plus jeune (4,8 ans vs 9,76 ans) et une surreprésentation de familles monoparentales (25 % vs 6,1 %). Les résultats de cette étude sont importants mais présentent certaines limites. Tout d'abord, il s'agit d'une étude unicentrique. Ensuite, les cofacteurs identifiés ne suffisent pas à expliquer l'impact réel de l'AMP sur le développement psychique de l'enfant. Il existe une surreprésentation des enfants issus d'AMP dans la population du Centre Alfred-Binet. Cependant, elle ne permet pas d'expliquer un développement psychique spécifique. Des études complémentaires multicentriques, quantitatives et qualitatives permettraient d'étayer ces résultats. In daily practice, the clinical impression suggests an over-representation of children from medically assisted procreation (MAP) in the population consulting in child psychiatry. This raises the question of the reality of this over-representation and the impact of the MAP on the psychic child's development. Based on the different reflections that have been carried out in the case of adoption, the study presented here attempts to provide a reflection on the current state of families and how the MAP comes to upset our representations. This is a non-interventional descriptive cross-sectional study including a population of 262 families whose children are followed at the Alfred Binet Center, a child psychiatry consulting center in Paris. The main outcome measure is the over-representation of children from MAP in the Alfred Binet Center active queue. The secondary judgment criteria is: whether or not the consulting physicians know the MAP birth status of their patients. This criterion was measured by evaluating a difference between the two methods of collecting information (consulting physicians vs questionnaires) as well as by describing the population of children from Alfred Binet Center MAP, by comparing it to the population of children of ordinary conception. Children from MPA were significantly more represented in the Alfred Binet Center population between 1997 and 2015 (p <0.05) and between 2006 and 2015 (p <0.0001). There are other significant differences between MAP patients and naturally conceived children with a higher rate of prematurity respectively (43.7% vs 3.7%), a younger average age (4.8 years vs 9.76 years) and an over-representation of single-parent families (25% vs 6.1%). The results of this study are important but have certain limitations. Firstly, it is a unicentric study. Secondly, the cofactors identified are insufficient to explain the real impact of the MPA on the child's psychic development. There is an overrepresentation of children from MAP in the population of the Alfred Binet Center. However, these results do not explain a specific psychic development. Additional multicentric, quantitative and qualitative studies are necessary to support these results. In this perspective, research is underway at the Alfred Binet Center on the development and the future of children born from MAP. [ABSTRACT FROM AUTHOR]

The development of techniques of medically assisted procreation (hereinafter MAP) -- above all the ability to form an embryo outside a woman's body and surrogacy procedures -- has generated heated international debate involving doctors, geneticists, biologists, psychologists, sociologists, philosophers, bioethicists, feminists, and legal experts. This long list of protagonists might yet grow as MAP affects one of the two most important symbolic aspects of human life: the beginning and the end. Reflecting on the issue of birth (the beginning of life) means asking questions about sexuality and conception which relate directly to the female body. This article highlights the decisive impact of MAP techniques on the new social imaginaries of the body, sexuality, and conception. The new symbols and myths which emerge tell of sexless, de-eroticised, and empty male and female bodies: the horizon of the imaginary now features the 'androgynous' woman and the 'gynandrous' man, while conception occurs in a relational vacuum. [ABSTRACT FROM AUTHOR]

Despite the troubling data that points to population imbalance, more precisely, increased number of born males in many countries, the issue of sex selection for non-medical reasons was not addressed adequately from the human rights protection perspective. Sex selection is also complex ethical issue. One of the most common arguments used in favor of non-medical sex selection, is that the ban of sex selection will simply limit reproductive freedom. Many supporters of non-medical sex selection defend the practice by relying on the reason of 'family balancing'. However, this reason does not seem to be eligible to justify selection. Problem of reproductive tourism is also present, due to the different approaches of the countries in regulating non-medical sex selection. More precisely, people are traveling to countries where respect for individual autonomy plays dominant role. In addition, there is a simple option to send samples for analysis to companies that advertise genetic testing over internet. In the context of human rights protection, only the Convention on Human Rights and Biomedicine has ban on sex selection for non-medical purposes, however, this ban applies only to specific, less practiced technique of selection. When it comes to other techniques of selection, Article 5 (a) of the Convention on the Elimination of All Forms of Discrimination against Women might be helpful to some extent. The issue of non-medical sex selection was in the focus of interest of the United Nations, Council of Europe and European Union to some extent, however insufficiently.

Research framework : The study focuses on the right to know the origins of the adopted child from a comparative law perspective. Objectives : The objective of the research is to provide an analysis of the French system, dating from January 22, 2002, and the one reformed in 2017 in Quebec, both of which provide access to access for adopted persons. identity of their original parents. Methodology : This study mainly uses a positivist methodology of legal research analyzing legislation, jurisprudence and doctrinal work, as well as comparative law (France / Quebec). Results : Research shows that France and Quebec have sought to reconsider the place of the history of the adopted child by substituting the principle of secrecy on origins for a logic favoring transparency. However, the balance between the child and the birth parents is often tilted in favor of the latter who can prevent the release of the secret, sometimes even until after death. Conclusions : The relaxation of the law towards more transparency is a step in the right direction, but the exercise seems incomplete as long as the question of the right to identity (including origins) - recognized in particular in the UN Convention rights of the child - adopted persons and those conceived through assisted reproduction, will not be discussed as part of a comprehensive law reform. Contribution : By analyzing the positive law in force in France and Quebec on access to the origins of adopted persons, this text helps to understand the issues relating to this question and the difficult opens up reflection on access to the origins of people conceived by medically assisted procreation. Research Framework : T he study focuses on the right to know one's origins of the adopted child from a comparative law perspective. Objectives : The objective of the research is to provide an analysis of the French law, dating from January 22, 2002, and the 2017 law in Quebec, both of which provide adopted people access to the identity of their parents of origin. Methodology : This study mainly uses a positivist methodology of legal research analyzing legislation, case law and legal literature, as well as comparative law (France / Quebec). [ABSTRACT FROM AUTHOR]

Research framework: The article analyzes the relationship to origins in lesbian-parent families in two countries (Italy and Belgium) characterized by different laws regarding the recognition of biogenetic and intentional origins. Objectives: The objective is to understand the relationship to the origins of families, depending on the treatment of lesbian parenthood in the country, as well as the generation and reproductive path of the interlocutors. The article is based on two local studies carried out between 2016 and 2020 on a corpus of 16 families. Methodology: The method used includes participatory observation of family practices, biographical interviews, informal conversations, construction of kinship patterns and analysis of the legal context. Results : The trajectories of families belonging to different generations and countries show that the relationships at the origins are built over time without necessarily breaking with the past or with the local culture of kinship, despite the weight of external conditions and context. Conclusions: The study testifies to a progressive multiplication and indeterminacy of the border between kin and non-kin, the result of an often incomplete negotiation, a constant redefinition and multiple interpretations between the different actors, leading to practices sometimes contradictory. Contribution to research: The article shows that kinship takes different forms depending on the actors, the dimensions at play (legal, social or even experience), but also on the generation of mothers. [ABSTRACT FROM AUTHOR]

Research framework: New figures are emerging within the links created by medically assisted procreation with third-party donors: people from the same donation. Objectives: Based on an anthropological survey of adults conceived by sperm donation in the United Kingdom and France, the article analyzes the distinctions that are made between people from the same donation, brothers and sisters. sisters and children of the donor in order to better understand what is involved in sharing "origins" when one has been conceived thanks to the same donor. Methodology: The analysis is based on in-depth semi-structured interviews conducted between October 2017 and December 2019 with 17 adults conceived by sperm donation who identified at least one person conceived by the same donor in the United Kingdom and in France. Results: In the light of relationships with brothers and sisters, connections between people from the same donation first appear as a paradoxical bodily bond that materializes through the sharing of genes between strangers. The distinctions between the donor's children and people conceived by donation then underline that beyond the genetic dimension, it is the donation event that specifies the links between people from the same donation. More than a progenitor, they share the circumstances of their conception, from which flow a shared narrative and common experiences. Finally, if the relationships that are established are characterized by their flexibility and their elective dimension, they nonetheless give rise to new norms and hierarchies. Conclusions: The study of the links between people resulting from the same donation suggests the constitution of a new relational category at the borders of kinship. Contribution: The article proposes to approach assisted procreation with a third-party donor through the collateral relationships that it produces. It contributes to the reflection on the content of the links created by the "origins". [ABSTRACT FROM AUTHOR]

Advances in reproductive biotechnologies raise questions regarding what is possible and what is desirable. These questions stem from the numerous possibilities for disruption that these technologies create. Disruptions in origin: a child may be the result of sperm, oocyte, or embryo donation, or of surrogate gestation, thus involving serial disruptions in filiations. Disruptions in gender and difference: procreation within female couples or by single women, in male couples or by single men, or procreation by transgender people. Disruptions in prediction: through advances in genomics, a link will be increasingly made possible between procreation and prediction, a link which could occupy an ever more important place in the conception of children. Will we eventually be able to predict the child? What will be the place left to chance, to the unexpected? Beyond any temptation to conservatism, there is a need to be prepared to accompany increasingly novel modes of procreation, in a world that is being invented faster than our ability to follow it. [ABSTRACT FROM AUTHOR]

Sociological studies have not been very interested in the study of emotions. Sociological reflection has dealt with the existing literature, but there are few empirical studies. This document aims to present the analysis of data related to a small section of the research "Medically Assisted Procreation and Surrogacy: the new social imaginaries". The research has taken place at the end of 2017 to 360 subjects (24-43 years old) residing in the Italian regions: Veneto, Emilia-Romagna, Campania. The aim of the research was to understand whether or not there was a new social imaginary related to the techniques ofPMA. In the survey there were some questions to investigate the emotional state of women who use PMA or who ask a surrogate mother for help. The data showed that the emotional area of the self emerges with high values in case the woman decides not to have children to prioritize her professional career. The data show that people involved in medically assisted procreation techniques experience very different emotions. The emotions they feel depend on their motivations and goals. [ABSTRACT FROM AUTHOR]

Lesbian mothers and gay fathers cannot conceal the existence of a third party for reproduction purposes: a sperm donor, an egg cell donor or a surrogate mother, all of whom have contributed, without being a parent as such, to the birth of their child. This article focuses on what is said about these third parties and what the child is told about his or her conception, by lesbian mothers who used sperm donation, either through the means of MAP or with the help of a known donor, outside the medical field. The inquiry, both qualitative and quantitative, uses a sample of 118 female couples to whom a child was born in France between 2011 and 2013. Analysis shows that the mothers employ different terms by which they wish to be known by their child and by which to refer to a donor according to whether he is known or not. The study exposes not only a common structure to most of the conception stories but also certain variations revealing four types of narratives. The narratives produced by couples who have used a known donor insist less on the love story between the two mothers. The entirety of these narratives, however, offer the chance to reconcile a transgressive family model with society: to normalise and valorise the family set‐up. [ABSTRACT FROM AUTHOR]

Objective: We decided to conduct a study based on these multidisciplinary team (MDT) in order to investigate their impact at the University Hospitals of Strasbourg and look for ways to improve this MDT., Methods: This is a retrospective study of the 682 patients presented to endometriosis MDT from its inception in March 2017 to December 2020., Results: The MDT decision was different from that initially proposed by the patient's referent for 406 patients (60%). Surgery was chosen for 417 patients (61%) and assisted reproduction for 261 patients (38%). A review of the MRI by a referring radiologist was carried out for 348 cases (51%), with a modification of the results for 255 patients (73%). Initial underestimation of lesions was noted in 198 cases., Conclusion: Our study has shown the importance of MDT in endometriosis since the therapeutic proposal was modified in 60% of cases. In addition, we supported the importance of radiologists specializing in this field since they made a modification in two-thirds of the MRIs reread. These results show the importance of collegial discussions, which can modify the decisions of medical teams. This underlines the importance of setting up endometriosis networks., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Abstract: The law (No.40/2004) stipulates that consent to Medically Assisted Procreation (MAP) remains irrevocable post ovum fertilization. Cryo-preservation introduces complexities, enabling embryo implantation requests after a couple's separation and the dissolution of the original parenthood plan. Constitutional Court Ruling No.161 in 2023 affirmed that the prohibition of revoking consent to MAP aligns with the Italian Constitution and the jurisprudence of the European Court of Human Rights. This delicate equilibrium of conflicting interests upholds human freedom, allowing consent revocation prior to ovocyte fertilization. Permitting revocation until implantation could inflict more significant harm: the infertile woman can in fact miss the opportunity to become a mother, impacting her psychophysical well-being and freedom of self-determination. Moreover, the embryo loses the chance to live, remaining in cryopreservation, which violates its dignity. Addressing this issue requires thorough communication by medical profession-als to inform couples about the limitations on consent revocation. An element of objectivity in terms of standards and evidence-based guidelines, from which norms must originate, is of utmost importance. Relying on broadly shared rules, especially at the international level, is vital in light of the unremitting scientific advances in MAP, as in other areas of medicine, which will open up new opportunities for which current legal/regulatory frameworks are inadequate.

Depuis plusieurs années en France, des enfants dont le père est transgenre (né fille) sont issus par procréation médicalement assistée (PMA) avec don de sperme. Le développement de ces enfants est mal connu. Bon nombre d'interrogations participent aux polémiques concernant ce type de parentalité dont l'identité même de la famille constituée. Afin d'apprécier s'il y avait une différence de représentation repérable de l'identité sexuée chez ces enfants, nous avons demandé à 47 enfants (74,5 % de garçons) âgés de 3 à 14 ans de réaliser « le dessin d'une famille » (Corman, 1964). Les 24 enfants nés de père transgenre ont été comparés à 23 enfants nés de parents cisgenres et conçus par rapports sexuels. La recherche a été approuvée par le comité d'éthique de l'université Paris V. L'analyse en aveugle des différents dessins ne nous a pas permis de distinguer de différence ou de particularité qualitatives qui indiqueraient le groupe d'appartenance de l'enfant. Nous avons pu, après la levée de l'aveugle, réaliser une analyse descriptive des dessins et observer que les marqueurs de genre au sein des dessins évoluent, en partie et comme attendu, en fonction de l'âge des enfants mais ne sont pas liés à un effet du groupe d'appartenance. Nous avons également pu apprécier comme attendu d'après les précédentes recherches ayant utilisées le dessin de famille des différences à travers certains éléments qualitatifs en lien avec la représentation familiale, et ce, dans les deux groupes. L'enfant né de père transgenre et mère cisgenre avec recours à la PMA projette dans le dessin d'une famille des états internes en tous points proches de ceux d'enfants du même âge et du même sexe mais nés de parents cisgenres et rapport sexuel. Il serait pertinent de pouvoir évaluer à nouveau, la cohorte des plus jeunes au moment de l'adolescence où l'identité sexuée est remaniée du fait de la puberté. For several years in France, children whose father is transgender (born female) are conceived through Medically assisted procreation (MAP). The development of these children is poorly known. Many interrogations have contributed to a controversy regarding this type of parenthood, including the very identity of the family constitution. In order to assess whether there were noticeable differences in the gender identity representations for these children, we invited 47 children (74.5% of boys) aged between 3 and 14 years old to make a "drawing of a family" (Corman, 1964). 24 children whose father is transgender were compared to 23 children born of cisgender parents, conceived by sexual intercourse. The research was approved by the University of Paris V ethics committee. The blind analyses of the different drawings did not allow us to distinguish any qualitative difference or particularity that would indicate in which group the child belongs. After the lifting of the blind, we were able to carry out a descriptive analysis of the drawings and observe that the gender markers in the drawings did evolve, in part and as expected, according to the age of the children but are not related to an effect of the home group. We have also been able to appreciate as expected from the previous researches that used the family drawing of the differences through certain qualitative elements related to the family representation, and this, in both groups. The children born with MAP from a cisgender mother and a transgender father projects internal states in the "drawing of a family" in all points close to those of children of the same age and of the same sex but born of cisgender parents and conceived by sexual intercourse. It would be relevant to reevaluate the cohort of the youngest children at the time of their adolescence when the sexual identity is reshaped by puberty. [ABSTRACT FROM AUTHOR]

Obesity impacts at multiple levels on the female reproductive functions. Weight loss is associated with improved ovulation and pregnancy rate after assisted reproductive technique (ART). Bariatric surgery allows for greater weight loss than with lifestyle modifications. It is associated with a reduction in the prevalence of polycystic ovarian syndrome, as well as an increase in the rate of spontaneous pregnancies. To date, no data shows an improvement of ART pregnancy rates after bariatric surgery, and the decrease in AMH levels observed postoperatively implies for caution for women whose infertility is not related to a polycystic ovarian syndrome. Bariatric surgery could thus be interesting in obese infertile women by allowing the weight loss necessary to restore spontaneous ovulation, allow access to AMP and limit maternal comorbidities during pregnancy. The objectives nutritional care should be discussed early in the process, taking into account the age of the patients who play a predominant role after 35 years, and the time between bariatric surgery and pregnancy. [ABSTRACT FROM AUTHOR]

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This paper aims to analyze the Italian law on medically assisted procreation (Law n. 40 of 2004) and particularly the prohibition of surrogacy under Article 12. This procedure is in fact prohibited in Italy's legal system; anyway, there have been cases in which many couples (heterosexual and homosexual) went to the States where this practice is allowed to access the procedure, in violation of the limitation of international public order. In this context, there is the problem of the legal recognition of the foreign birth certificate. However, the issue of surrogacy raises a series of problems relating to the legal qualification of the interested parties, also in consideration of the necessity to respect the relationship of parent with the child. [ABSTRACT FROM AUTHOR]

Le rapport parlementaire propose la « procréation sans sexe pour tous », laquelle passe par l'assistance médicale à la procréation pour les couples de femmes et les femmes seules, la procréation post mortem et le double don de gamètes. The parliamentary report proposes "non-sexual procreation for all", which goes through medically assisted procreation for couples of women and single women, post-mortem procreation and dual gamete donation. [ABSTRACT FROM AUTHOR]

Despite the troubling data that points to population imbalance, more precisely, increased number of born males in many countries, the issue of sex selection for non-medical reasons was not addressed adequately from the human rights protection perspective. Sex selection is also complex ethical issue. One of the most common arguments used in favor of non-medical sex selection, is that the ban of sex selection will simply limit reproductive freedom. Many supporters of non-medical sex selection defend the practice by relying pn the reason of [family balancing'. However, this reason does not seem to be eligible to justify selection. Problem of reproductive tourism is also present, due to the different approaches of the countries in regulating non-medical sex selection. More precisely, people are traveling to countries where respect for individual autonomy plays dominant role. In addition, there is a simple option to send samples for analysis to companies that advertise genetic testing over internet. In the context of human rights protection, only the Convention on Human Rights and Biomedi-cine has ban on sex selection for non-medical purposes, however, this ban applies only to specific, less practiced technique of selection. When it comes to other techniques of selection, Article 5 (a) of the Convention on the Elimination of All Forms of Discrimination against Women might be helpful to some extent. The issue of non-medical sex selection was in the focus of interest of the United Nations, Council of Europe and European Union to some extent, however insufficiently. [ABSTRACT FROM AUTHOR]

• Infertile patients are at risk for developing sexual difficulties and this study is the first to assess sexual difficulties by clinical interview. • Infertile women commonly faced sexual interest/arousal disorder and associated genital-pelvic pain disorder. • Infertile men reported higher presence of delayed ejaculation and erectile dysfunction than men in the general population. • For optimal care, clinicians must assess sexual function in those undergoing medically assisted procreation , particularly in men. A mixed-methods study was conducted to investigate sexual function among infertile patients undergoing medically assisted procreation for the first time. The study employed an interview and content analysis approach, involving 45 infertile patients prior to their medically assisted procreation procedures. The findings revealed that infertile patients are a group at risk for sexual distress. Furthermore, patients with sexual dysfunctions exhibited lower levels of sexual activity, potentially diminishing their chances of achieving pregnancy. Participants faced challenges in openly discussing their sexual problems and demonstrated limited knowledge of sexual functioning. Among infertile women with sexual dysfunctions, the most frequently reported issues were sexual interest/arousal disorders, with a majority also experiencing pain during sexual activity and associated genital-pelvic pain disorders. In contrast, delayed ejaculation and erectile disorder seem to be more common in infertile men, while sexual desire and excitement disorders and premature ejaculation disorders appeared to be as common as in the general population. While the relationship between infertility and sexuality is complex, our study suggests that sexual dysfunctions or the absence of sexual activity may explain infertility. Therefore, it is imperative for clinicians to evaluate the sexual functioning of both men and women undergoing medically assisted procreation treatment, to increase their chances of procreation and offer them sexological support if needed. Future studies should expand their scope to include a larger sample size and delve into the potential etiological factors associated with sexual dysfunctions. [ABSTRACT FROM AUTHOR]

Background and objectives: To explore the ethical and legal complexities arising from the controversial issue of surrogacy, particularly in terms of how they affect fundamental rights of children and parents. Surrogacy is a form of medically-assisted procreation (MAP) in which a woman “lends” her uterus to carry out a pregnancy on behalf of a third party. There are pathological conditions, such as uterine agenesis or hysterectomy outcomes, that may prevent prospective mothers from becoming pregnant or carry a pregnancy to term; such patients may consider finding a surrogate mother. Many issues relating to surrogacy remain unresolved, with significant disagreements and controversy within the scientific community and public opinion. There are several factors called into play and multiple parties and stakeholders whose objectives and interests need to somehow be reconciled. First and foremost, the authors contend, it is essential to prioritize and uphold the rights of children born through surrogacy and heterologous MAP. Materials and methods: To draw a parallel between Italy and the rest of the world, the legislation in force in twelve European countries was analyzed, eleven of which are part of the European Union (France, Germany, Italy, Spain, Greece, Netherlands, Belgium, Denmark, Lithuania, Czech Republic and Portugal) and three non-members of the same (United Kingdom, Ukraine and Russia), as well as that of twelve non-European countries considered exemplary (United States, Canada, Australia, India, China, Thailand, Israel, Nigeria and South Africa); in particular, legislative sources and legal databases were drawn upon, in order to draw a comparison with the Italian legislation currently in force and map out the evolution of the Italian case law on the basis of the judgments issued by Italian courts, including the Constitutional and Supreme Courts and the European Court of Human Rights (ECHR); search engines such as PubMed and Google Scholar were also used, by entering the keywords “surrogacy” and “surrogate motherhood”, to find scientific articles concerning assisted reproduction techniques with a close focus on surrogacy. Results: SM is a prohibited and sanctioned practice in Italy; on the other hand, it is allowed in other countries of the world, which leads Italian couples, or couples from other countries where it is banned, to often contact foreign centers in order to undertake a MAP pathway which includes surrogacy; in addition, challenges may arise from the legal status of children born through surrogacy abroad: to date, in most countries, there is no specific legislation aimed at regulating their legal registration and parental status. Conclusion: With reference to the Italian context, despite the scientific and legal evolution on the subject, a legislative intervention aimed at filling the regulatory gaps in terms of heterologous MAP and surrogacy has not yet come to fruition. Considering the possibility of “fertility tourism”, i.e., traveling to countries where the practice is legal, as indeed already happens in a relatively significant number of cases, the current legislation, although integrated by the legal interpretation, does not appear to be effective in avoiding the phenomenon of procreative tourism. Moreover, to overcome some contradictions currently present between law 40 and law 194, it would be appropriate to outline an organic and exhaustive framework of rules, which should take into account the multiplicity of interests at stake, in keeping with a fair and sustainable balance when regulating such practices.

The spread of medically assisted procreation (MAP) techniques promises to realise the previously denied human dream of planning and controlling one's progeny. The reproductive business market tends to fuel this dream, promising that technology can take over where nature falls short. Based on the spread of individualism and instrumental rationality, this promise modifies the social imaginary of procreation and generativity. The new social imaginary features a disproportionately greater freedom of choice and decision-making powers for adults (parents), along with increased risks of genetic determination also given the extremely rapid developments in genetics. At the same time, this demand is fuelled by the presence of a booming private reproductive market which often employs commercial marketing techniques by promising couples and women not only that they can achieve their desire for a child but can make the 'child of their desire' - they can have the children that they want, when and how they want them. This article presents the results of an exploratory study conducted with a sample of 360 subjects aged between 25 and 45 who may or may not have not used MAP and examines their responses to a questionnaire. In particular, what lies behind the idea that technology and private fee-based services can supplant nature and public services in areas that they cannot reach? How widespread is the idea? What are the ethical, social and cultural implications at the root of the concept? How can this idea modify the sense and meaning of procreation? What level of freedom and rights should the baby be granted? The results of the research show that the sample is divided almost equally on the issue of MAP between those who acknowledge its potential but are aware of its associated social and cultural risks and those who highlight its potential by referring to rights-based reasons and money-based reasons. [ABSTRACT FROM AUTHOR]

New treatments with direct-acting antivirals drugs for viral hepatitis C have changed the management of this disease. They provide viral hepatitis C cure in more than 95% of patients with a simplified care pathway. In France, since 2016, there is no limitation access to treatment. All MAP claimants' couples are screened for transmissible viruses. The safety profile of direct-acting antivirals drugs, the short duration of treatment, as well as the expected benefits in terms of the success of the MPA, the follow-up of pregnancy and the transmission of HCV from mother to child are in favor of HCV treatment before the completion of MAP. To date, due to lack of available data to confirm this hypothesis, observational studies must be performed. [ABSTRACT FROM AUTHOR]

Actually 90% of HIV-positive patients on treatment have a controlled viral load. In these patients, many studies have shown the absence of HIV transmission in serodiscordant couples. It is in the light of this scientific evidence that the expert group for the care of people living with HIV declared in 2017 that "Treatment as Prevention" (TasP) has now become the priority way of prevention. Medical assistance to procreation, which has played an important role for years to allow procreation without risk of viral transmission, is nowadays mainly indicated in cases of fertility disorders. The couple must however be accompanied by a multidisciplinary team to best lead the project of pregnancy desire. [ABSTRACT FROM AUTHOR]

Thesis. The Catholic Church, as an institution engaged in discussions on bioethical issues, is included in the public discourse on infertility and methods of its treatment. The position of the Church in these matters is much closer to Christian ethics than to natural ethics (which is related to biomedidne). The discussed concepts. The Church presents its position on the subject in the official documents of the institution, for example in encyclicals, apostolic letters, documents of the Congregation for the Doctrine of Faith or the Polish Episcopate Conference. It can also be found in unofficial documents, such as sermons. The author uses a method of discussing not individual concepts, tackles the topic problematically, dividing the structure of the article into the Church's position on the method of in vitro fertilization and prenatal tests. Results and conclusions. To sum up the presented position of the Catholic Church on in vitro and prenatal tests, one should consider a very sceptical and critical approach to the above-mentioned issues. The Church hierarchy's discourse seeks to encourage couples who do not have children to use other methods of dealing with infertility, such as, naprotechnology or child adoption. The Catholic Church presents a very restrictive and conservative approach to contemporary bioethical problems. Originality/cognitive value of the approach. The aim of the article is to systematize and bring the reader closer to the arguments of the Catholic Church in the matter of in vitro, infertility and prenatal tests. Extremely rapid technological progress enabling the treatment of many diseases, including infertility, is associated with ethical dilemmas in connection with the use of the in vitro procedure, freezing embryos, or performing prenatal and preimplantation tests. The article aims to synthetically present the position of the Catholic Church, which is a participant in the public debate on bioethical issues, drawing directly on official Church documents. [ABSTRACT FROM AUTHOR]

The practice of Medically Assisted Procreation has taken off since the end of the 1980s. Its advances, both technically and in terms of its expansion and diversity, face the analyst immersed in this practice to sensitive and difficult questions of an ethical, metapsychological and heuristic nature. It is a practice in an extreme situation, where access to parenthood makes the principles of pleasure and reality vacillate, upsets the organization of primal phantasies, and destabilizes the binding of the drives by creating permanent and unstoppable tensions between the biological, the individual, the cultural and the collective, both among the patients as well as among the various clinicians. As psychoanalysts working in close collaboration with a medico-technical team in Medically Assisted Procreation, we wish to show the peculiarity and the complexity of the clinical meetings – sometimes unique – as well as the psychotherapeutic follow-up with the patients: origins, filiations, transmissions, parenthood, identities and figures of identification seek to represent themselves and form a new family romance, enriching themselves during the process of MAP and subsequent perinatal period. [ABSTRACT FROM AUTHOR]

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