Veerle Provoost

Ghent University | UGhent · Bioethics Institute Ghent, Department of Philosophy and Moral Sciences

Background Obesity in adolescents is a growing public health issue. Bariatric surgery is an effective, yet controversial treatment option for adolescents. The moral acceptability of this procedure by health-care professionals as well as the general public can be influenced by its portrayal in the news media. Our objective was to analyze how newspap...

Background: This is the first qualitative study to investigate how researchers, who do empirical work in bioethics, relate to objectives of empirical research in bioethics (ERiB). We explore reasons that make some objectives more acceptable, while others are deemed less acceptable. Methods: Using qualitative exploratory study design, we intervie...

IVF treatment involving donated eggs increases yearly. Numerous technical and commercial transformations have reshaped how eggs are retrieved, stored and managed. A key transformation is vitrification; a ‘fast freezing’ method that allows efficient preservation of eggs, and therefore more flexibility in use, giving rise to new commercial possibilit...

Background During the last decade, the possibility for women to cryopreserve oocytes in anticipation of age-related fertility loss, also referred to as social egg freezing, has become an established practice at fertility clinics around the globe. In Europe, there is extensive variation in the costs for this procedure, with the common denominator th...

The use of third-party eggs now forms an integral part of a global reproductive bioeconomy. In order to meet clinics' growing need for donors, they employ a range of recruitment strategies including adverts for donors via their publicly facing websites. Such websites are also key sites for the articulation and popularisation of culturally specific...

Social egg freezing has become an expanding clinical practice and there is a growing body of empirical literature on women's attitudes and the sociocultural implications of this phenomenon. Yet, its impact remains subject to ethical controversy. This article reports on a qualitative study, drawing on 18 interviews with women who had elected to init...

Given the controversial nature of research into in-vitro gametogenesis (IVG), this study set out to investigate the current attitudes towards IVG in the general Belgian population in order to anticipate potential future barriers and misunderstandings. A questionnaire was developed and incorporated into a web-based online survey and sent out to Belg...

Study question How do Indian healthcare professionals describe their clinical experience with and perspectives on AMH testing in Indian women seeking fertility treatments including fertility preservation? Summary answer The HCPs cautioned against AMH testing as a screening tool in presumed fertile Indian women due to its anticipated impact on wome...

Study question How do Indian healthcare professionals describe their clinical experience with and perspectives on AMH testing in Indian women seeking fertility treatments including fertility preservation? Summary answer The HCPs cautioned against AMH testing as a screening tool in presumed fertile Indian women due to its anticipated impact on wome...

Study question How do fertility clinics’ websites of the UK, Belgium and Spain present the medical risks of egg donation and incentives? Summary answer Spanish and UK websites typically included more incentives to recruit egg donors compared to the Belgian websites. OHSS was overall the most discussed risk. What is known already People commonly t...

Study question What are the moral perceptions and views of women considering social egg freezing? Summary answer Participants did not perceive egg freezing as a morally problematic solution to societal problems but addressed concerns about relationship formation and wanted more social efforts. What is known already Central to the social egg freez...

Study question What are the moral perceptions and views of women considering social egg freezing? Summary answer Participants did not perceive egg freezing as a morally problematic solution to societal problems but addressed concerns about relationship formation and wanted more social efforts. What is known already Central to the social egg freez...

Background During the last decade, the possibility for women to cryopreserve oocytes in anticipation of age-related fertility loss, also referred to as social egg freezing, has become an established practice at fertility clinics around the globe. In Europe, there is extensive variation in the costs for this procedure, with the common denominator th...

Recently, Petersen provided in this journal a critical discussion of individualisation arguments in the context of social egg freezing. This argument underlines the idea that it is morally problematic to use individual technological solutions to solve societal challenges that women face. So far, however, there is a lack of empirical data to context...

Introduction International policy imperatives for the public and patient involvement in the governance of health data coexist with conflicting cross-border policies on data sharing. This can challenge the planning and implementation of participatory data governance in healthcare services locally. Engaging with local stakeholders and understanding h...

Patient access to electronic health records gives rise to ethical questions related to the patient-doctor-computer relationship. Our study aims to examine patients’ moral attitudes toward a shared EHR, with a focus on autonomy, information access, and responsibility. A de novo self-administered questionnaire containing three vignettes and 15 statem...

Background Up to 2018, the Belgian law stated that transgender people who wanted to change their legal sex had to undergo physical gender affirming treatment. This included gonadectomy to a medically possible and justified extent, which entailed that they had to accept the fact that they could no longer reproduce. However, research has shown that m...

Study question: Can risks associated with novelties in assisted reproduction technologies (ARTs) be assessed in a systematic and structured way? Summary answer: An ART-specific risk assessment tool has been developed to assess the risks associated with the development of novelties in ART (EuroGTP II-ART). What is known already: How to implemen...

The first birth from a donated egg was reported in Australia in 1984, ushering in a new era of possibilities for the treatment of infertility (1). Since then egg donation has undergone a number of technical, regulatory and commercial transformations. Its use by a growing and diverse range of social groups and more recently the dawn of advanced free...

Online spaces are increasingly important for our collective consciousness and provide an opportunity to document changing ideas, subjectivities and experiences surrounding new reproductive technologies. This paper reports on the first study of egg donation and online discussion boards in UK-based forums. Using thematic analysis, we investigated how...

Objective: The aim of this study is to explore whether specific ethical questions arise with the use of a shared electronic health record (EHR) system, based on the daily experience of primary care physicians (PCPs). Methods: In this qualitative research project, we conducted 14 in-depth semistructured interviews with PCPs in a tertiary hospital...

Background: Reasonable disagreement about the role awarded to gamete donors in decision-making on the use of embryos created by gamete donation (EGDs) for research purposes emphasises the importance of considering the implementation of participatory, adaptive, and trustworthy policies and guidelines for consent procedures. However, the perspective...

Introduction Belgian legislation allows only strictly anonymous gamete donation and known donation (donation to a recipient known by the donor). Recently, an amendment of the legislation was proposed to grant donor offspring, as of 18 years old, the right to claim identifying information about their donor. Purpose The aim is to explore the attitud...

Purpose The aim of this study is to assess the attitude of heterosexual female students towards sperm donation by their partners and towards sperm donation in general. Methods The method is an online anonymous survey of 1525 female students. Results The majority of the women had a positive attitude towards sperm donation in general, but only 37%...

How do women who provide eggs for use in fertility treatment perceive practices related to the use, storage and distribution of eggs?

Introduction: A lot of attention has been given to the quest of parents, children and donors to find donor siblings (= half siblings who share the same donor gametes but who are born in different families). However, literature is scarce about the use of the same sperm donor for subsequent children in the same family. Methods: This study included 68...

The way in which heterosexual couples manage information about infertility and donor insemination within their social networks has not yet been explored in-depth. This study focuses on how parents and aspiring parents manage information about infertility and donor insemination within their social networks. Fifteen Belgian couples were interviewed a...

This case provides an illustration of the importance of drawing relationality into healthcare. It will do so by exemplifying how a bioethics approach that merely protects the rights and interests of individuals is inapt as it comes to capturing the full picture of how decisions— in this case related to reproduction and reproductive medical treatmen...

How do professionals working in pre-implantation genetic diagnosis (PGD) reflect upon their decision making with regard to ethical challenges arising in everyday practice? Two focus group discussions were held with staff of reproductive genetic clinics: one in Utrecht (The Netherlands) with PGD-professionals from Dutch PGD-centres and one in Prague...

Background: This paper reports the process and outcome of a consensus finding project, which began with a meeting at the Brocher Foundation in May 2015. The project sought to generate and reach consensus on standards of practice for Empirical Bioethics research. The project involved 16 academics from 5 different European Countries, with a range of...

Objective: Finding out whether patients would be motivated by reciprocity when considering donating oocytes to others. Study design: This is a prospective monocentric study in the CECOS of the Centre Hospitalier Universitaire (CHU) of Rennes (France) on the opinion of patients regarding reciprocity. Couples who had a child with donor sperm were...

Background: A review of literature published a decade ago noted a significant increase in empirical papers across nine bioethics journals. This study provides an update on the presence of empirical papers in the same nine journals. It first evaluates whether the empirical trend is continuing as noted in the previous study, and second, how it is ch...

PurposeThe aim of this article is to study attitudes about sperm donation and willingness to donate sperm in students who have never shown an interest in sperm donation. Methods The method used in this study is an electronic survey of 1012 male students. ResultsOnly one third of the respondents (34.3%) would consider donating sperm. Overall, 85.7%...

Background: The use of empirical research methods in bioethics has been increasing in the last decades. It has resulted in discussions about the 'empirical turn of bioethics' and raised questions related to the value of empirical work for this field, methodological questions about its quality and rigor, and how this integration of the normative an...

Objective: To study the motivation and attitudes of a candidate sperm donor population in Belgium. Design: Anonymous survey. Setting: Tertiary referral infertility center. Patient(s): One hundred candidate sperm donors applying to the center for a first semen analysis between April 2013 and March 2016. Intervention(s): Invitation to comple...

Although qualitative research about couples and families is becoming increasingly widespread, the aspect of data analysis remains largely underrepresented in the literature. In this methodological paper, we outline one specific approach to data analysis in the context of multi family member interview studies. Inspired by Interpretative Phenomenolog...

Research has shown that the recipients of donor sperm can experience difficulties finding appropriate language to refer to the donor. Based on two qualitative analysis techniques, namely word count and empirical discourse analysis, we studied the words used to refer to the donor in heterosexual and lesbian (aspiring) parents and in donor conceived...

Although intra‐familial egg donation has been practiced for more than 15 years in several countries, little is known about family relationships in this family type. Framed within the new kinship studies, this article focuses on the experiential dimension of kinship in sister‐to‐sister egg donation families: how is kinship ‘unpacked’ and ‘reconstruc...

Objective: To describe the decisions lesbian couples make when creating a family through donor insemination [DI] and to explore the negotiations between the biological and the non-biological mother. Methods: We included 18 lesbian parents (9 biological and 9 non-biological mothers) with at least one child (7-10 years old) conceived through anony...

Over the years, connection websites and speed dating events have increasingly attracted singles and couples who cannot have a child in the ‘traditional’ way. These initiatives bring together candidate gamete providers and recipients with the promise of offering more freedom of choice than fertility centres or sperm banks currently do. Depending on...

Objective: This study aimed to gain an in-depth understanding of the experiences of genetic ties in intrafamily oocyte donation families. Background: Previous research has shown that most mothers have a good and stable relationship with their donor. Little is known about the meaning of the difference in genetic ties for parents who conceived throug...

In literature, disclosure of donor conception in lesbian families has been considered an obvious and straightforward event. However, little is known about the ways in which donor conception is discussed in planned lesbian co-mother families. This study focuses on the process of parent-child communication about the donor conception on a within-famil...

Although children from lesbian families appear to make a distinction between a residential father and a donor, defining these two concepts seems to be a challenge. They need to appeal to more familiar concepts such as the hetero-normative concept of 'mother' to give a definition of the unfamiliar concepts they are confronted with. The study is base...

The aim of this qualitative study was to explore how recipients viewed payment of sperm donors. The study was conducted in Belgium, where, as in many countries, sperm donors receive recompense for their time and expenses. Face-to-face semi-structured interviews were conducted with 34 heterosexual and lesbian couples who, at the time of data collect...

In the literature, relatively little attention has been paid to the meaning of donor involvement in the intimate couple dyad. The current study aimed to enrich our understanding of couples' meaning-making regarding the anonymous sperm donor and how they dealt with the donor involvement. Semi-structured interviews were conducted with nine couples, w...

This paper aims to provide a description of how authors publishing in medical ethics journals have made use of empirical research data in papers on the topic of gamete or embryo donation by means of references to studies conducted by others (secondary use). Rather than making a direct contribution to the theoretical methodological literature about...

This editorial begins, perhaps unusually, with a personal anecdote from Ives, one of the editors of this special edition, which sets the scene for the edition and, to some extent, explains why the debates presented in these pages are needed:When I was first starting out as a Ph.D. student in 2004, I submitted a paper to a philosophy journal that di...

In this qualitative study, we explore how lesbian recipients view and experience the selection of their anonymous sperm donor. The study was conducted in Belgium, where fertility centres follow a legal protocol that severely restricts personal choice in donor selection. While previous studies have shown that recipients want greater control and inpu...

In this qualitative study of 10 lesbian couples who built their families through anonymous donor conception, we explore how lesbian parents experience communication about the donor conception within the family. While for these families "disclosure" of donor conception is often seen as evident, the way parents and children discuss this subject and h...

Objective: In this qualitative study, we investigate how lesbian couples experience and deal with the difference in genetic relatedness in their family. Background: Previous research showed that lesbian couples handle the difference with regard to genetic relatedness by, for instance, creating a narrative about physical resemblances or by focusing...

Assisted reproduction challenges and reinforces traditional understandings of family, kinship and identity. Sperm, egg and embryo donation and surrogacy raise questions about relatedness for parents, children and others involved in creating and raising a child. How socially, morally or psychologically significant is a genetic link between a donor-c...

This Task Force document discusses ethical issues arising with requests for medically assisted reproduction from people in what may be called ‘non-standard’ situations and relationships. The document stresses that categorically denying access to any of these groups cannot be reconciled with a human rights perspective. If there are concerns about th...

Over the past years, a growing number of countries have legislated open-identity donation, in which donor-conceived offspring are given access to the donor’s identity once they’ve reached maturity. It is held that donor anonymity creates identity problems for such children similar to the ‘genealogical bewilderment’ described within the adoption con...

This Task Force document discusses some relatively unexplored ethical issues involved in preimplantation genetic diagnosis (PGD). The document starts from the wide consensus that PGD is ethically acceptable if aimed at helping at-risk couples to avoid having a child with a serious disorder. However, if understood as a limit to acceptable indication...

This Task Force document explores the ethical issues involved in the debate about the scope of genetic screening of gamete donors. Calls for expanded donor screening arise against the background of both occasional findings of serious but rare genetic conditions in donors or donor offspring that were not detected through present screening procedures...

What meanings do lesbian couples construct regarding their sperm donor? For some parents, the donor was increasingly presented as a person, whereas for other parents, the donor was seen as an instrument from the moment they received the sperm donation. Few studies specifically focus on how lesbian couples deal with the issue of third-party anonymou...

The precise delineation of the research phase is a recurrent subject of debate: When is the evidence base firm enough to decide that a new technology or treatment no longer needs to be regarded as 'experimental'? We propose a framework that distinguishes between three instead of two types of treatment and describes a continuum from experimental ove...

Study question It's a preliminary report to clarify motivations of intended surrogate mothers and ?experienced? surrogates and, taking into consideration their background, specify if their main motive is an altruistic wish to help childless people to become parents, either it's all about money, or the surrogates are driven by combination of differe...

Study question What are the UK public's views on the social and ethical impact of making mitochondria replacement techniques (maternal spindle transfer and pronuclear transfer) available to patients? Summary answer The majority of people consider that, if these techniques are proven safe to use, the benefits associated with them outweigh the possi...

The 2013 ESHRE guideline on the management of women with endometriosis Dr Gerard A.J. Dunselman (Chair Guideline Development Group) Endometriosis is defined as the presence of endometrial-like tissue outside the uterus, which induces a chronic, inflammatory reaction. Women with endometriosis can experience painful symptoms and/or infertility, whil...

Study question In this study, we will look back on the decision about who will be the biological mother (and thus on the internal distribution of social and genetic parenthood) in lesbian couples ten years after treatment: what decisions did they make and how do they talk about them now? Summary answer Agreements about who would gestate the child...

Study question How do lesbian parents discuss the donor conception with their school-age children? How is this dialogical process between parents and children described by the parents? Summary answer Some lesbian parents participating in this study seem to wait for their children to ask questions about their conception. This guarantees them that t...

This paper aims to gain in-depth understanding of why some donor-conceived offspring want to know the identity of their sperm donor. Step-by-step inductive thematic analysis was performed on first-hand quotes from donor-conceived offspring selected from a wide range of sources (including empirical studies and donor conception networks, registries a...

Study question: What information is shared on Dutch internet forums with regard to infertility treatment in Belgium? Summary answer: The online discussion mainly regards medical treatments, feelings and experiences, and financial implications. The general tone of the discussion on the forums about fertility treatment in Belgium is that Belgian c...

Abstract This study describes patients' satisfaction with the information they received regarding the disposition of supernumerary embryos in the context of their decision making, as well as partners' roles and the involvement of others. An anonymous mail questionnaire was sent to 412 female patients from the Department of Reproductive Medicine (Gh...

This paper describes a recently identified conception of the cryopreserved embryo as a symbol of one's relationship (SOR). A questionnaire was sent together with the embryo disposition decision (EDD) form to patients for whom embryos were cryopreserved at the department in Ghent, Belgium. We collected data on patient characteristics, their EDD atti...

Introduction In 2011 the UK Fertility Regulator – the Human Fertilisation and Embryology Authority (HFEA) – conducted a review on what a fair compensation scheme for egg and sperm donors should look like. The data collected during the review represents, what we believe is, a unique body of evidence on how different stakeholder groups in the UK appr...

This study examined the responses of patients of a Belgian fertility center to mailed requests to make or renew an embryo disposition decision (EDD), over a period of 15 years, to investigate trends in the decisions. A retrospective analysis was performed on a mailing program from 1992 to 2006, for patients, of the Department of Reproductive Medici...

OBJECTIVE: Cryopreservation of supernumerary embryos resulting from IVF treatment offers extra chances to conceive. The objective of this study is to describe patients' decisions to continue or discontinue storage of their embryos after a minimum storage period of 2 years. METHODS: Female patients who had embryos stored at the Infertility Centre of...

Empirical research into cross-border reproductive care is scarce and many facets of the phenomenon are unexplored. The objective of this study was to compare Belgian and Dutch patients regarding the way they perceived the treatment they received and regarding the embryo disposition decisions (EDDs) they made. A questionnaire was sent to patients fo...

To describe patients who at least once did not reply to correspondence of the center about embryo disposition. Anonymous questionnaire. Department of Reproductive Medicine, Ghent University Hospital (Belgium). Patients whose embryos were stored for at least 2 years. Mail survey. Patients' reply behavior, their characteristics, their embryo disposit...

Introduction: Third-party reproduction engages couples on a journey necessitating in-depth psychological adjustments, mainly the acceptance of sterility and of the donor's role in the procreation of a child. In countries requiring open-identity donors, disclosure to the offspring includes the possibility of a future meeting with the donor, reinfor...