Institutionalizing Assisted Reproductive Technologies

Reproductive medicine has been very successful at developing new therapies in recent years and people having difficulties conceiving have more options available to them than ever before. These developments have led to a new institutional landscape emerging and this innovative volume explores how health and social structures are being developed and reconfigured to take into account the increased use of assisted reproductive technologies, such as IVF treatments. Using Sweden as a central case study, it explores how the process of institutionalizing new assisted reproductive technologies includes regulatory agencies, ethical committees, political bodies and discourses, scientific communities, patient and activists groups, and entrepreneurial activities in the existing clinics and new entrants to the industry. It draws on new theoretical developments in institutional theory and outlines how health innovations are always embedded in social relations including ethical, political, and financial concerns. This book will be of interest to advanced students and academics in health management, science and technology studies, the sociology of health and illness and organisational theory.

This innovative volume uses a Swedish case study to explore how health and social structures - including health services, regulatory bodies and patient groups - are being developed and reconfigured to take into account the increased use of assisted reproductive technologies, such as IVF treatments.

Reproductive medicine has been very successful at developing new therapies in recent years and people having difficulties conceiving have more options available to them than ever before. These developments have led to a new institutional landscape emerging and this innovative volume explores how health and social structures are being developed and reconfigured to take into account the increased use of assisted reproductive technologies, such as IVF treatments. Using Sweden as a central case study, it explores how the process of institutionalizing new assisted reproductive technologies includes regulatory agencies, ethical committees, political bodies and discourses, scientific communities, patient and activists groups, and entrepreneurial activities in the existing clinics and new entrants to the industry. It draws on new theoretical developments in institutional theory and outlines how health innovations are always embedded in social relations including ethical, political, and financial concerns. This book will be of interest to advanced students and academics in health management, science and technology studies, the sociology of health and illness and organisational theory.

Welcomed as liberation and dismissed as exploitation, egg freezing (oocyte cryopreservation) has rapidly become one of the most widely-discussed and influential new reproductive technologies of this century. In Freezing Fertility, Lucy van de Wiel takes us inside the world of fertility preservation—with its egg freezing parties, contested age limits, proactive anticipations and equity investments—and shows how the popularization of egg freezing has profound consequences for the way in which female fertility and reproductive aging are understood, commercialized and politicized. Beyond an individual reproductive choice for people who may want to have children later in life, Freezing Fertility explores how the rise of egg freezing also reveals broader cultural, political and economic negotiations about reproductive politics, gender inequities, age normativities and the financialization of healthcare. Van de Wiel investigates these issues by analyzing a wide range of sources—varying from sparkly online platforms to heart-breaking court cases and intimate autobiographical accounts—that are emblematic of each stage of the egg freezing procedure. By following the egg’s journey, Freezing Fertility examines how contemporary egg freezing practices both reflect broader social, regulatory and economic power asymmetries and repoliticize fertility and aging in ways that affect the public at large. In doing so, the book explores how the possibility of egg freezing shifts our relation to the beginning and end of life.

Assisted Reproductive Technologies in the Global South and North critically analyses the political and social frameworks of Assisted Reproductive Technology (ART), and its impact in different countries. In the context of a worldwide social pressure to conceive – particularly for women – this collection explores the effect of the development of ARTs, growing globalisation and reproductive medicalization on global societies. Providing an overview of the issues surrounding ART both in the Global South and North, this book analyses ART inequalities, commonalities and specificities in various countries, regions and on the transnational scene. From a multidisciplinary perspective and drawing on multisite studies, it highlights some new issues relating to ART (e.g. egg freezing, surrogacy) and discusses some older issues regarding infertility and its medical treatment (e.g. in vitro fertilisation, childless stigmatisation and access to treatment). This book aims to redress the balance between what is known about Assisted Reproductive Technologies in the Global North, and how the issue is investigated in the Global South. It aims to draw out the global similarities in the challenges that ARTs bring between these different areas of the world. It will appeal to scholars and students in the social sciences, medicine, public health, health policy, women’s and gender studies, and demography.

The word “mother” traditionally meant a woman who bears and nurtures a child. In recent decades, changes in social norms and public policy as well as advances in reproductive technologies and the development of markets for procreation and care have radically expanded definitions of motherhood. But while maternity has become a matter of choice for more women, the freedom to make reproductive decisions is unevenly distributed. Restrictive policies, socioeconomic disadvantages, cultural mores, and discrimination force some women into motherhood and prevent others from caring for their children. Reassembling Motherhood brings together contributors from across the disciplines to consider the transformation of motherhood as both an identity and a role. It examines how the processes of bearing and rearing a child are being restructured as reproductive labor and care work change around the globe. The authors examine issues such as artificial reproductive technologies, surrogacy, fetal ultrasounds, adoption, nonparental care, and the legal status of kinship, showing how complex chains of procreation and childcare have simultaneously generated greater liberty and new forms of constraint. Emphasizing the tension between the liberalization of procreation and care on the one hand, and the limits to their democratization due to race, class, and global inequality on the other, the book highlights debates that have emerged as these multifaceted changes have led to both the fragmentation and reassembling of motherhood.

Since the first "test tube baby" was born over 40 years ago, In Vitro Fertilization and other Assisted Reproductive Technologies (ARTs) have advanced in extraordinary ways, producing millions of babies. An estimated 20% of American couples use infertility services to help them conceive, and that number is growing. Such technologies permit thousands of people, including gay and lesbian couples and single parents, to have offspring. Couples can now transmit or avoid passing on certain genes to their children, including those for chronic disease and, probably sometime soon, height and eye color as well. Prospective parents routinely choose even the sex of their future child and whether or not to have twins. The possibilities of this rapidly developing technology are astounding-especially in the United States, where the procedures are practically unregulated and a large commercial market for buying and selling human eggs is swiftly growing. New gene-editing technology, known as CRISPR, allows for even more direct manipulation of embryos' genes. As these possibilities are increasingly realized, potential parents, doctors, and policy-makers face complex and critical questions about the use-or possible misuse-of ARTs. Designing Babies confronts these questions, examining the ethical, social, and policy concerns surrounding reproductive technology. Based on in-depth interviews with providers and patients, Robert Klitzman explores how individuals and couples are facing quandaries of whether, when, and how to use ARTs. He articulates the full range of these crucial issues, from the economic pressures patients face to the moral and social challenges they encounter as they make decisions which will profoundly shape the life of their offspring. In doing so, he reveals the broader social and biological implications of controlling genetics, ultimately arguing for closer regulation of procedures which affect the lives of generations to come and the future of our species as a whole.

In the UK and beyond, Down’s syndrome screening has become a universal programme in prenatal care. But why does screening persist, particularly in light of research that highlights pregnant women’s ambivalent and problematic experiences with it? Drawing on an ethnography of Down’s syndrome screening in two UK clinics, Thomas explores how and why we are so invested in this practice and what effects this has on those involved. Informed by theoretical approaches that privilege the mundane and micro practices, discourses, materials, and rituals of everyday life, Down’s Syndrome Screening and Reproductive Politics describes the banal world of the clinic and, in particular, the professionals contained within it who are responsible for delivering this programme. In so doing, it illustrates how Down’s syndrome screening is ‘downgraded’ and subsequently stabilised as a ‘routine’ part of a pregnancy. Further, the book captures how this routinisation is deepened by a systematic, but subtle, framing of Down’s syndrome as a negative pregnancy outcome. By unpacking the complex relationships between professionals, parents, technology, policy, and clinical practice, Thomas identifies how and why screening is successfully routinised and how it is embroiled in both new and familiar debates surrounding pregnancy, ethics, choice, diagnosis, care, disability, and parenthood. The book will appeal to academics, students, and professionals interested in medical sociology, medical anthropology, science and technology studies (STS), bioethics, genetics, and/or disability studies.