Nordic and Infertile. A study of options and decisions.
Year: 2012
Type: dissertation
Abstract: Aim: The aim of this thesis was to obtain an overview over the options of Nordic infertile couples regarding assisted reproduction treatment, and to follow couples’ arguments and decision-making process to make relevant decisions about these options. Methods: Quantitative and qualitative methods were used. The study design was inspired by Ecological systems theory, where data was gathered from laws and regulations (macro-level), fertility clinics (meso-level) and the couples using these options (micro-level). Study I consists of results from a review of the legislations in the five Nordic countries and results from a questionnaire that was sent to all fertility clinics to gather information about available options. Papers II and III present the findings of the interviews with 22 Nordic couples, after their first appointment with a specialist at the fertility clinic. The couples came from Denmark (3), Finland (6), Iceland (3), Norway (4) and Sweden (6). Study IV presents the findings of follow-up interviews with the same couples approximately three years later. For the qualitative study the tools of Grounded Theory were used. Findings: In Study I it was found that Nordic couples generally have good access to assisted reproductive technology treatments (ART), although it is not evenly distributed and there are restrictions related to certain criteria, such as age. There are national differences in the legislations, especially regarding gamete donation. These differences open up for cross-border reproductive care, andmore than one third of the fertility clinics offered treatment to people from other countries. Study II describes the decision-making process of the couples when determining the “right time” to try for a child. The couples mention the need to feel prepared for parenthood; such as a stable social situation, and once they felt prepared they became more susceptible to decision-making catalysts, such as influence from friends and family. Fear of infertility made the couple accelerate their decision regardless of preparation. In Study III the decision-making process of seeking medical help is illustrated. The core category was “negotiation and re-negotiation”. The process of decision-making is first to accept that they have a problem in common, secondly that they need knowledge and finally to take action and get help. Study IV deals with the decision-making process during treatments. Of 22 couples, 17 had succeeded at becoming parents after approximately three years, three couples were still trying and two had not decided how to continue. The core category was “maintaining control in an uncertain situation”. The couples tried to keep focus on the goal and to learn to deal with the new world with various methods. Conclusions:The structure of and the access to service for infertile couples differ between the Nordic countries. Some of the differences, e.g. regarding subsidy systems and waiting time, affected the decision making process since they could mean a delay in the treatment process or whether a private or public clinic was chosen. Additionally, a couple consists of two individuals with independent decision-making processes, which makes joint decision-making difficult and time-consuming. The couples have to negotiate their way to a consensus and are constantly confronted with new choices they need to re-negotiate on. The decision-making process, when dealing with infertility, is not a straight line, but rather a chain of small decisions affected by feelings, context and situation
Author: Helga Sól Ólafsdóttir
Language: English
Subfield: Reproductive Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2095992919