de Lacey Sheryl
Research Centre for Reproductive Health and Repromed, Department of Obstetrics and Gynaecology, The University of Adelaide, South Australia 5005.
Hum Reprod. 2005 Jun;20(6):1661-9. doi: 10.1093/humrep/deh831. Epub 2005 Mar 10.
Many patients prefer to donate unused embryos when surveyed. However, it is a source of frustration and curiosity that clinical audits of embryo outcomes show the majority changed their minds. In many clinics, the number of recipients continues to outweigh the number of donors. To plan effective counselling practices, it is important to understand the dynamics of decision-making for patients when determining outcomes for unused embryos.
Twelve couples and nine women (n = 33) who had discarded unused embryos were interviewed using a narrative structure and various interview techniques. Interview transcripts underwent qualitative analysis through which data were grouped thematically according to similarities. Differences were also examined.
Participants described their initial choice to donate embryos as an idealistic plan rather than a purposeful decision. Their change of mind was due to two factors: (i) a change in their standpoint from a childless couple to parents; and (ii) a change in the symbolism of the embryo from representing a chance to become pregnant to representing a 'virtual' child in cryo-storage. The meaning of embryo donation was likened to child relinquishment.
Counselling and social policy need to take account of the symbolism of the embryo and reform current practices.
许多患者在接受调查时表示愿意捐赠未使用的胚胎。然而，胚胎结局的临床审计显示大多数人改变了主意，这令人沮丧且好奇。在许多诊所，接受者的数量仍然超过捐赠者的数量。为了规划有效的咨询实践，了解患者在决定未使用胚胎的结局时的决策动态很重要。
采用叙事结构和多种访谈技巧，对12对夫妇和9名女性（共33人）进行了访谈，这些人曾丢弃未使用的胚胎。访谈记录进行了定性分析，数据根据相似性按主题分组，同时也研究了差异。
参与者将他们最初捐赠胚胎的选择描述为一个理想主义的计划，而非有目的的决定。他们改变主意有两个因素：（i）他们的立场从无子女夫妇转变为父母；（ii）胚胎的象征意义从代表怀孕的机会转变为代表冷冻储存中的“虚拟”孩子。胚胎捐赠的意义被比作孩子的放弃。
咨询和社会政策需要考虑胚胎的象征意义并改革现行做法。
