Disposition Decisions by Couples with Frozen Embryos

描述(申请人提供)：这项定性研究的目标是更好地了解接受体外受精的不孕不育夫妇如何决定如何处理他们多余的冷冻胚胎。由于胚胎的潜在用途和处置的多样性和差异使这个问题变得复杂，例如，夫妇可以在进一步尝试受孕时使用胚胎，将其“捐赠”给其他希望生育孩子的不育夫妇，用于干细胞研究，或者无限期储存、丢弃或销毁，有限的可用数据表明，夫妇在处理这一决定时会有相当大的不确定性和矛盾心理。这项为期48个月的人种学研究将是第一次深入研究夫妇如何看待他们的冷冻胚胎，并制定他们的处置决定。这项研究将在一年的时间里纵向研究100对夫妇，每隔六个月分别和一起对夫妇进行三次深度访谈，调查对象是冷冻胚胎储存了一到十年的参与者。然后，定性数据分析将分七步进行。这项研究的具体目的是：(1)考察女性和男性赋予胚胎的意义；(2)了解女性和男性对胚胎的看法与家庭观念的关系；(3)探索女性和男性对胚胎概念化的差异和相似之处；(4)描述女性和男性在考虑处理冷冻胚胎时所参与的过程，以及他们对应该做什么的看法是否会随着时间的推移而改变。对冷冻胚胎处置决定的探讨不仅将加深我们对关于家庭意义的文化观念变化的理解，还将为目前深陷模棱两可、不确定和争议的公共卫生政策的几个具体领域提供信息，例如试管受精诊所的责任和义务、使用冷冻胚胎进行干细胞研究，以及“捐赠”或“收养”冷冻胚胎。

DESCRIPTION (provided by applicant): The goal of this qualitative research is to better understand how infertile couples who have undergone in vitro fertilization decide what to do with their surplus frozen embryos. Because this question is complicated by the variety and disparity of the embryo's potential uses and dispositions, e.g., they can be used by the couple in further attempts to conceive, "donated" to other infertile couples who wish to have a child, used in stem cell research, or stored indefinitely, discarded, or destroyed, the limited available data suggests that couples address this decision with considerable uncertainty and ambivalence. This 48-month ethnographic study would be the first in-depth examination of how couples think about their frozen embryos and formulate their disposition decision. The research will study 100 couples longitudinally over a one-year period, using three in-depth interviews of husbands and wives separately and together at six-month intervals, inducting participants who have frozen embryos in storage for between one and ten years. Qualitative data analysis will then proceed in a seven-step progression. The specific aims of this research are: (1) to examine the meanings that women and men attach to embryos; (2) to understand how women and men think about embryos in relation to concepts of the family; (3) to explore differences and similarities in how women and men conceptualize embryos; and (4) to describe the process women and men engage in as they consider the disposition of their frozen embryos, and whether their views of what should be done change over time. An exploration of the frozen embryo disposition decision would not only deepen our understanding of changing cultural notions about the meaning of family, but would inform several specific areas of public health policy that are currently mired in ambiguity, uncertainty, and controversy, e.g., the responsibilities and obligations of IVF clinics, the use of frozen embryos for stem cell research, and the "donation" or "adoption" of frozen embryos.