Process of becoming a mother in women receiving donated egg: Based on the grounded theory

Objective:To elucidate theoretically the safety and identity of mothers receiving egg and the process of becoming a mother.Methods:This study was conducted during 7 months from July 2018 to January 2019 by using a grounded theory approach.Infertile women at the gestational age who received oocyte were selected with purposive sampling method and then entered the study using theoretical sampling.Mothers who had not decided definitely to participate and had not started the treatment course yet were excluded from the study.The participating mothers were 28-44 years old with a mean age of(37.00±2.49)years.A total of 30 interviews were performed.Data were collected by unstructured deep interviews and field notes.The interview duration ranged between 19 to 74 min with a mean time of 40 min and they were performed individually.Results:Data analysis showed that"feeling of insecurity in personal and familial identity"formed in the context of"exposure to socio-cultural constraints"was the main problem of mothers receiving donated oocyte.This led to a set of coping strategies as"gradual acceptance","attempts to maintain the marital life","sensitivity in selecting donor","sensitivity in fetal care","seeking information and consultation","challenging the internal restlessness",and"treatment follow-up",all indicating the concept of"protection of personal and familial identity"as the core variable.Conclusions:The challenge faced by Iranian mothers receiving donated oocyte in the constrained sociocultural context forms a multilateral and all-inclusive insecurity.

Can DNA fragmentation of neat or swim-up spermatozoa be used to predict pregnancy following ICSI of fertile oocyte donors？

This study compared the potential of assessing sperm DNA fragmentation （SDF） from neat semen and the subsequent swim-up （SU） procedure to predict pregnancy when conducting ICSI of fertile donor oocytes. Infertile females （n=81） were transferred embryos resulting from intracytoplasmic sperm injection （ICSI） of their partner＇s spermatozoa and proven donor oocytes. This model normalized the impact of female factor in putative sperm DNA repair. Semen was blindly assessed for SDF using Halosperm immediately following ejaculation （NS） and after swim-up at the time of ICSI fertilisation. There was a decrease in SDF values of the ejaculated semen sample following the swim-up protocol （P=0.000）. Interestingly, pregnancy could be equally predicted from SDF values derived from either neat or swim-up semen samples. Receiver operator curves and the derived Youden＇s indices determined SDF cutoff values for NS and SU of 24.8% and 17.5%, respectively. Prediction of pregnancy from NS SDF had a sensitivity of 75% and a specificity of 69%, whereas for SU SDF was 78% and 73%, respectively. While increased levels of SDF negatively impact reproductive outcome, we have shown that a reduction in SDF following sperm selection using ICSI with proven donor oocytes is not mandatory for achieving pregnancy. This suggests that a certain level of DNA damage that is not detectable using current technologies could be impacting on the relative success of assisted reproductive technology （ART） procedures. Consequently, we propose a modification of the so called ＇iceberg model＇ as a possible rationale for understanding the role of SDF in reproductive outcome.