Knowledge and Attitude of patients about the use of surrogacy as treatment method of infertile couples - Mostafa Khomeini hospital in 2016

Authors

1 Instructor, Department of Health and Social Medicine, Mother and Child Health, Faculty of Medicine, Shahed University, Tehran, Iran.

2 Associate Professor, Department of Health and Social Medicine, Faculty of Medicine, Shahed University, Tehran, Iran.

3 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Shahed University, Tehran, Iran.

4 Medical student, Faculty of Medicine, Shahed University, Tehran, Iran.

Abstract

Introduction: Infertility threatens the mental health of infertile couples. Society should have sufficient knowledge of the implanted embryo resulted of in vitro fertilization in the surrogacy as a therapy method. This study was performed with aim to determine the knowledge and attitude of patients in Mostafa Khomeini hospital on the use of surrogacy as a treatment method.
Methods: This cross-sectional and analytic study was performed on 216 patients referred to Mostafa Khomeini Hospital in 2016. Data collection tool was a researcher-made questionnaire consisting of two parts: the first part was demographic questions and the second part included the questions about knowledge and attitude. Data were analyzed by SPSS software (version 16) and statistical tests of correlation test, independent t-test, Mann-Whitney, Kruskal wallis and ANOVA. PResults: 185 subjects (85.6%) stated that they have information about surrogacy. While according to the results, only 31 subjects (14.8%) had good and very good knowledge of surrogacy. 99 subjects (43.5%) had no religious perception about this method. 90 (41.7%) had negative attitude to the priority of surrogacy from family and friends. 144 (66.7%) agreed about insurance protection. Independent t-test showed that the mean attitude of men and women was not different. ANOVA showed a significant difference between the attitudes of subjects in different educational groups (P=0.04).
Conclusion: Most people had negative attitude toward emotional, legal, and religious issues of surrogacy, but they had positive attitude to solve problems and financial costs and insurance support.

Keywords


  1. Milanifar AR, Akhondi MM, Ardekani ZB, Abdolahzadeh A. Issuing birth certificates and ID cards for newborns following a surrogate birth and the legal and ethical responsibilities of the medical team. J Reprod Infertil 2008; 9(1):82-8. (Persian).
  2. Salehi K, Shakour M, Pashaei Sabet F, Alizadeh S. The opinion of Iranian students about the society's perception on using surrogacy as an infertility treatment in the future community. Sex Reprod Healthc 2015; 6(1):19-22.
  3. Asghari F. Ethical issues in surrogate motherhood. J Reprod Infertil 2008; 9(1):30-5. (Persian).
  4. Akhondi MM, Ardekani ZB. Surrogacy and the necessity for its application in infertility treatment. J Reprod Infertil 2008; 9(1):7-13. (Persian).
  5. van den Akker OB. Functions and responsibilities of organizations dealing with surrogate motherhood in the UK. Hum Fertil 1998; 1(1):10-3.
  6. Yousefi H, Ghahari S. Perspectives and challenges of surrogacy in Iran. J Reprod Infertil 2008; 9(2):137-43. (Persian).
  7. Callman J. Surrogacy–a case for normalization. Hum Reprod 1999; 14(2):277-8.
  8. Ardakani ZB, Akhondi MM, Yaghmaie F, Milanifar AR. Consultations and health assessments in surrogacy. J Reprod Infertil 2008; 9(2):107-41. (Persian).
  9. Ziaee T, Gobadi KH, Ziaee F. Positive and negative effects of surrogacy from the view of married people in Gorgan. J Gorgan Facul Nurs Midwifery 2007; 12:45-9. (Persian).
  10. Minai J, Suzuki K, Takeda Y, Hoshi K, Yamagata Z. There are gender differences in attitudes toward surrogacy when information on this technique is provided. Eur J Obstet Gynecol Reprod Biol 2007; 132(2):193-9.
  11. Schuiling KD, Likis FE. Women's gynecologic health. Massachusetts: Jones & Bartlett Publishers; 2011.
  12. Gardner DK. In vitro fertilization: a practical approach. Florida: CRC Press; 2006.
  13. Covington SN, Burns LH. Infertility counseling: a comprehensive handbook for clinicians. Cambridge, UK: Cambridge University Press; 2006.
  14. Balen AH. Infertility-epidemiology, diagnosis, counseling. Infertility in practice. New York: Informa Healthcare, Churchill Livingstone; 2008. P. 1-114.
  15. Pashmi M, Ahmadi SA, Tabatabaie SM. The need for counseling surrogate mothers before practicing surrogacy. J Reprod Infertil 2009; 9(4):361-72. (Persian).
  16. Kiyarash A. Ethical assessment of monetary relationship in surrogacy. J Reprod Infertil 2008; 9(1):36-42. (Persian).
  17. Rao KA, Brinsden PR, Sathananthan AH. Infertility manual. New York: Mcgraw-Hill; 2008.
  18. Seifi G. Third party rights in surrogate mother contracts. J Reprod Infertil 2008; 9(1):65-81. (Persian).
  19. Brinsden PR. Gestational surrogacy. Hum Reprod Update 2003; 9(5):483-91.
  20. Braude P, Muhammed S. Assisted conception and the law in the United Kingdom. BMJ 2003; 327(7421):978-81.
  21. Qasemzadeh SM. Surrogacy contracts in the Iranian law. J Reprod Infertil 2008; 9(2):182-94. (Persian).
  22. Rahimi HA. Civil responsibility in surrogacy. J Reprod Infertil 2008; 9(2(:165-81. (Persian).
  23. MacCallum F, Lycett E, Murray C, Jadva V, Golombok S. Surrogacy: the experience of commissioning couples. Hum Reprod 2003; 18(6):1334-42.
  24. Asghari F. Ethical issues in surrogate motherhood. J Reprod Infertil 2008; 9(1):30-5. (Persian).
  25. Imrie S, Jadva V. The long-term experiences of surrogates: relationships and contact with surrogacy families in genetic and gestational surrogacy arrangements. Reprod Biomed Online 2014; 29(4):424-35.
  26. Akhondi MM, Ardekani ZB. Surrogacy and the necessity for its application in infertility treatment. J Reprod Infertil 2008; 9(1):7-13. (Persian).
  27. Sohrabvand F, Jafarabadi M. Knowledge and attitudes of infertile couples about assisted reproductive technology. Iran J Reprod Med 2009; 3(2):90-4.
  28. Rahmani A, Sattarzadeh N, Gholizadeh L, Sheikhalipour Z, Allahbakhshian A, Hassankhani H. Gestational surrogacy: viewpoint of Iranian infertile women. J Hum Reprod Sci 2011; 4(3):138.
  29. Kian EM, Riazi H, Bashirian S. Attitudes of Iranian infertile couples toward surrogacy. J Hum Reprod Sci 2014; 747(1):47-51.
  30. Fereydouni S, Fereydouni B, Solimani H. Attitude of male and female subjects towards oocyte donation in Shiraz. J Reprod Infertil 2009; 10(1):51-7. (Persain).
  31. Jadva V, Murray C, Lycett E, MacCallum F, Golombok S. Surrogacy: the experiences of surrogate mothers. Hum Reprod 2003; 18(10):2196-204.
  32. Ragoné H. Surrogate Motherhood. Boulder: Conception in the Heart Boulder, CO: Westview; 1994.
  33. Latifnejad R, Jafari J, TaghipurA KN, Ebrahimzadeh S. The association of religious beliefs in infertile couples’ attitude towards donation procedures and its selection as a therapeutic approach to infertility. J Mashhad Univ Med Sci 2007; 16(44):1-10.
  34. Abbasi-Shavazi MJ, Nasrabad HB, Ardekani ZB, Akhondi MM. Attitudes of infertile women towards gamete donation: a case study in Tehran. J Reprod Infertil 2006; 7(2):139-48. (Persian).
  35. Drabiak K, Wegner C, Fredland V, Helft PR. Ethics, law, and commercial surrogacy: a call for uniformity. J Law Med Ethics 2007; 35(2):300-9.
  36. Galbraith M, McLachlan HV, Swales JK. Commercial agencies and surrogate motherhood: a transaction cost approach. Health Care Anal 2005; 13(1):11-31.
  37. Stöbel-Richter Y, Goldschmidt S, Brähler E, Weidner K, Beutel M. Egg donation, surrogate mothering, and cloning: attitudes of men and women in Germany based on a representative survey. Fertil Steril 2009; 92(1):124-30.
  38. Suzuki K, Hoshi K, Minai J, Yanaihara T, Takeda Y, Yamagata Z. Analysis of national representative opinion surveys concerning gestational surrogacy in Japan. Eur J Obstet Gynecol Reprod Biol 2006; 126(1):39-47.
  39. Ahmari Tehran H, Jafarbagloo E, Zia Sheikholeslami N, Abedini Z, Heidarpoor A. Surrogacy: infertile women's attitude. Iran J Med Ethics Hist Med 2010; 4(1):62-70. (Persian).
  40. Kazemifard Y, Jafarian J, Zahedi R, Mosala Nezhad H. Attitude of rural infertile women towards surrogacy in Jahrom town. Iran J Obstet Gynecol Infertil 2013; 15(33):26-32. (Persian).
  41. Bruce-Hickman K, Kirkland L, Ba-Obeid T. The attitudes and knowledge of medical students towards surrogacy. J Obstet Gynaecol 2009; 29(3):229-32.
  42. Saito Y, Matsuo H. Survey of Japanese infertile couples' attitudes toward surrogacy. J Psychosom Obstet Gynecol 2009; 30(3):156-61.
  43. Chliaoutakis J, Koukouli S, Papadakaki M. Using attitudinal indicators to explain the public´s intention to have recourse to gamete donation and surrogacy. Hum Reprod 2002; 17(11):2995-3002.
  44. Poote AE, van Den Akker OB. British women attitudes to surrogacy. Hum Reprod 2009; 24(1):139-45.
  45. Fasouliotis SJ, Schenker JG. Social aspect in assisted reoroduction. Hum Repord Update 1999; 5(1):26-39.
  46. Reilly DR. Surrogate pregnancy: a guide for Canadian prenatal health care providers. CMAJ 2007; 176(4):483-5.
  47. Jones HW Jr. Commentary on ACOG committee opinion number 88, November 1990--“Ethical issues in surrogate motherhood. Woman Health Issues 2000; 1(3):138-9.