[Artificial insemination with donor semen].
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A survey of Canadian providers of AID was conducted, along with a parallel survey of adoption workers. The questionnaire focused upon non-medical criteria for patient acceptance (for AID and adoption), including acceptance/rejection of single, lesbian, and common-law women, those economically or mentally unable to support children, and those who themselves have or whose partners have criminal records. Further questions concerned decision-making in patient selection, referral of unacceptable patients elsewhere, and the influence if any of legal advice. Most characteristics reflect great disagreement and lack of consensus within the profession. Attitudes towards characteristics may be influenced by the size and form (university vs private) of the practice, as well as by experience with patients with those characteristics. Systematic differences between AID and adoption providers are detailed and explored, as are implications of the study for the development of bioethical thinking and policy making.
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Twenty six couples with long standing infertility were treated by intrauterine AIH. Seminal and/or cervical factors were responsible for negative or poor coital test (PCT); retrograde ejaculation occurred in one case. A highly concentrated motile sperm suspension was obtained by swim-up procedure into fasting human serum and utilized for intrauterine insemination. Timing of ovulation was checked with the aid of ultrasound monitoring of follicular development. Totally, 120 cycles were treated. The pregnancy rate was 23.3%. Intrauterine AIH with motile sperm recovered by swim-up in human serum appears a valuable approach in the treatment of infertile couples with poor PCT as well as in cases of retrograde ejaculation.
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Findings from a national sample of 989 persons and an 'Opinion Leader' survey of 279 executive and ordinary members of 40 organizations identified as having an interest in AID showed that Australians overall approved of the procedure for helping infertile married couples, only 17% of the national sample unequivocally disapproving. Key variables in determining opinions on AID included age, education, country of origin, family status, religion and exposure to infertility. However only 15% of national respondents accepted that AID should be made available to any unmarried women on request although opinions were more evenly spread on its provision to unmarried women in a long-term relationship with a man. Over one-third of 'Opinion Leaders' believed that children should never be told of their AID conception, 13% that they should be given identifying and one third non-identifying information on the donor. A majority believed that AID should be directly carried out or supervised by doctors in hospital clinics. There was strong opposition to business or voluntary organization involvement. Suggestions for changes in the law, while emphasizing protection of donors, recipients, children, persons who ran AID programs and control over futuristic research activities, often showed a misunderstanding of the legal process. The major reasons for exclusion of donors were genetic defects and medical problems although many behavioural characteristics were mentioned. Views on recipients' rights to choose the sex of the AID child were marginally against the proposition.
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