Kostenzer Johanna, Bos Annelies M E, Bont Antoinette de, Exel Job van
Erasmus University Rotterdam, Erasmus School of Health Policy and Management, Rotterdam, the Netherlands.
University Medical Centre Utrecht, Department of Reproductive Medicine and Gynaecology, Utrecht, the Netherlands.
Reprod Biomed Soc Online. 2020 Nov 9;12:32-43. doi: 10.1016/j.rbms.2020.09.009. eCollection 2021 Mar.
Preserving the option to conceive through egg freezing (oocyte cryopreservation) is surrounded by value conflicts and diverse viewpoints, particularly when non-medical or so-called 'social' reasons are involved. The debate is controversial and shaped by normative perceptions of the life course, including concepts regarding reproductive ageing, gender, motherhood and biomedicalization. To unravel the controversy and systematically identify the variety of viewpoints on egg freezing, a Q-methodology study was conducted in The Netherlands between December 2018 and October 2019. Thirty-four women of reproductive age participated in the study. They ranked 40 statements according to their level of agreement, and explained their ranking during follow-up interviews. Data were analysed using by-person factor analysis and interpreted using both quantitative and qualitative data. Four viewpoints, of which the fourth was bipolar, were identified: (1) cautious about egg freezing technology; (2) my body, my choice; (3) egg freezing is unnatural; and (4) have children and have them early. The distinct viewpoints illustrate different prioritizations of values and normative dimensions of biomedical innovations. By knowing more about the prevalent opinions on egg freezing and the surrounding controversy, policy makers and practitioners can make better informed decisions in terms of promoting and providing patient-centred infertility care. The findings furthermore stimulate continuing scholarly work on egg freezing and other innovations in reproductive medicine which may continue to disrupt normative standards.
保留通过卵子冷冻(卵母细胞冷冻保存)受孕的选择存在价值冲突和多种观点,尤其是当涉及非医学或所谓的“社会”原因时。这场辩论颇具争议,且受到对生命历程的规范性认知的影响,包括有关生殖衰老、性别、母亲身份和生物医学化的概念。为了厘清这场争议并系统地识别关于卵子冷冻的各种观点,2018年12月至2019年10月在荷兰进行了一项Q方法研究。34名育龄女性参与了该研究。她们根据认同程度对40条陈述进行排序,并在后续访谈中解释了自己的排序。使用个人因素分析法对数据进行分析,并运用定量和定性数据进行解读。识别出了四种观点,其中第四种是两极化的:(1)对卵子冷冻技术持谨慎态度;(2)我的身体,我的选择;(3)卵子冷冻是不自然的;(4)生育并尽早生育。这些不同的观点说明了生物医学创新在价值和规范性层面的不同优先次序。通过更多地了解关于卵子冷冻的普遍观点及周围的争议,政策制定者和从业者在推广和提供以患者为中心的不孕不育治疗方面可以做出更明智的决策。此外,这些研究结果还推动了关于卵子冷冻及生殖医学其他创新的持续学术研究,这些创新可能会继续颠覆规范性标准。