INFERTILITY and ADOPTION

1. INFERTILITY and ADOPTION

3. Guidelines for the Reflection Paper 1 page Single space Prescribed format (can be downloaded from our website, www.famipop.weebly.com) Use at least 10 concepts learned in class when you write your essay. Underline those concepts.

4. One of the challenges that many couples face today is infertility. • The desire to have children is a human instinct. • Infertility…. the state of being unable to produce offspring; in a woman it is an inability to conceive; in a man it is an inability to impregnate.

5. Social Pressures to Have Children • Our society has a pronatalistbias. • Pressure to have children can come from the parents, the family, peers, and relatives and even the society in general. • Some societies have negative notions toward women who cannot bear a child. • Others will stigmatize men who cannot impregnate women, less masculine.

6. Socio-cultural understanding of infertility • Childless woman may be ostracized. • Ghana: One tribe calls infertile woman as Konowhich means barrenness, emptiness or worthlessness. • Kono is a derogatory term, outcast.

7. Infertility and death • In a tribe in Ghana, when a childless woman dies, they use some local medicine called anyato bury her. • Anya is like a leaf which is tied around her waist before burying her. This is done to convey a message that when she is coming back, she should not come back barren. (From an elder) Source: http://uir.unisa.ac.za/bitstream/handle/10500/9829/ajnm_v10_n1_a3.pdf?sequence=1

8. Consequences of Infertility • Children-Free • Adoption • Surrogate Motherhood

9. Primary infertility- No history of conception • Secondary infertility- Unable to conceive after a successful birth delivery.

10. Possible Causes of Infertility Female Factors • Infections: Vaginitis (see video) & Cervicitis – makes environment hostile to sperm. • Cervical Problems – can affect survival or mobility of sperm. Vagina [because of acidity] normally is a hostile environment for sperm.

12. Possible Causes of Infertility • Vaginitis

13. Possible Causes of Infertility • Cervicitis

14. Endometriosis – endometrial tissue grows outside uterine cavity.

15. Male Factors Primary Causes of Male Infertility: Impaired sperm production/mobility/delivery; Testosterone deficiency (hypogonadism). Can be congenital or acquired. Problems in Sperm Production • Average # deposited is 70 million/ml in 2-6 ml. • Sperm count 20 million or less in 2-6 ml. suggests inadequate production. Causes: • Infections - HPV, gonorrhea, chlamydia, epididymitis, testicular inflammation (orchitis) [mumps as adult] • High fever from prolonged elevation of scrotal temperature; can cause irreversible infertility if before puberty • Diseases; Testicular Cancer • Testosterone deficiency - disorder in hypothalamic-pituitary-gonadal axis . • Men with obesity, diabetes • Smoking and drinking and use of some drugs

16. The Sperm Analysis • You should get the sample to the lab within 30 minutes. • A laboratory specialist must look at the sample within 2 hours of the collection. • The earlier the sample is analysed, the more reliable the results. The following things will be evaluated: • How the semen thickens into a solid and turns to liquid • Fluid thickness, acidity, and sugar content • Resistance to flow (viscosity) • Movement of the sperm (motility)  • Number and structure of the sperm • Volume of semen • Source: http://www.nlm.nih.gov/medlineplus/ency/article/003627.htm

17. Combined Problems [Male/Female] – Sexual technique Sexual Technique/Timing - Provide counseling on: • Lay in bed for 10-15 mins. after the intercourse • Fertility best if intercourse timed around ovulation. • Infrequent intercourse: may lower sperm motility. • Frequent: may lower # mature sperm.

18. How to KNOW WHEN YOU ARE OVULATING? • Insert Video

20. Impacts of Infertility on Women (Women’s Health Queensland Wide, Inc.) • May feel angry for not being able to have children • Resentment towards other pregnant women • Feeling of guilt Infertility as a punishment (career) Previous termination • Feeling of inadequacy (dysfunctional self) • A diagnosis of infertility will often lead to feelings of grief associated with the loss of control over reproductive capabilities, plans and goals.

21. Impacts of Infertility on Women (Women’s Health Queensland Wide, Inc.) • Some may feel uneasy when surrounded with children • Withdrawal or social isolation

22. Impacts of Infertility on Men (Women’s Health Queensland Wide, Inc.) • If the couple’s infertility is a result of sperm dysfunction, the man may feel inadequate and feel that his sense of masculinity is challenged. • The strong societal link between fertility and virility causes many men to keep their infertility a secret, in turn increasing their feeling of isolation.

23. Impacts of infertility on marital relationship (Women’s Health Queensland Wide, Inc.) • Infertility can place great strain on a relationship, particularly where the diagnosis relates to only one partner. • The infertile partner may fear being left for another (fertile) person, while the fertile partner may blame or feel anger towards their partner.

24. Impacts of infertility on marital relationship (Women’s Health Queensland Wide, Inc.) • Differing levels of enthusiasm for pursuing treatment can occur, particularly in couples where one partner already has children. • Agreeing on what fertility tests to perform, which treatment options to pursue and when to stop treatment can all cause conflict. • If one partner does not want to begin or continue with treatment, the other partner may feel they are being denied the chance to have a child and become resentful.

25. Coming into terms with infertility • While some couples may not consider treatment, others may spend years pursuing treatment to have a child. • Infertility treatment is emotionally and financially demanding. • It is therefore important to come to an agreement, preferably before treatment will start, on the types of treatments, number of attempts, overall length of time and amount of money they will commit towards having a child. (Women’s Health Queensland Wide, Inc.)

26. For couples who can afford, the option is in-vitro fertilization. Step 1. Stimulation or super ovulation (fertility drug) Step 2. Egg Retrieval (Follicular aspiration, a minor surgery)..If cannot produce, donation is the option.

27. For couples who can afford, the option is in vetro infertilization. Step 3. Insemination and Fertilization----intracytoplasmic sperm injection (ICSI) Step 4. Embryo Culture (when the egg divides) Step 5. Embryo Transfer- Embryos are placed into the woman’s womb 3 - 5 days after egg retrieval and fertilization…The doctor inserts a thin tube containing the embryos into the woman’s vagina, through the cervix, and up into the womb.

28. Cost • In the United States, a cycle of in vitro fertilization costs approximately $10,000 to $15,000.

30. Insert VIDEO • IVF

31. “The idea behind the underwear is that tests of men with fertility problems tend to "be naturally warmer by an average of over one degree Celsius". That little number adds up to a big difference and by lowering temperature in the precious area can improve the motility of the sperm.” “The Snowballs underwear is made from organic cotton and cools with freezable gel packs in a wedge shape made of Carboxymethyl Cellulose Sodium.” Source: http://sploid.gizmodo.com/this-tingly-cold-pair-of-underwear-will-make-your-sperm-1497544777

32. Cultural Practices (Other Remedies)

34. Other Remedies • Herbal Medicine • Spiritual means if they think infertility is caused by evil spirits. • Massage (Lingam Massage for Erectile Dysfunction)…a sensual massage • Acupuncture • Yoga

35. Adoption • This is an alternative to infertility treatment. • By definition (DWSD), “this refers the socio-legal process of providing a permanent family to a child whose parents have voluntarily or involuntarily relinquished parental authority over the child.”

36. Who usually adopts? • Homosexual parents • Parents who cannot produce offspring • Parents who just want to have children but do not want to engage in sexual relationships • Altruistic reasons

37. Jason Hanna And Joe Riggs, Texas Gay Fathers, Denied Legal Parenthood Of Twin Sons • “In order to grant a second-parent adoption it has to be between two married people,” Jason explained. “And so, considering we’re not legally married in the eyes of Texas, they don’t have to grant that second-parent adoption because they don’t recognize our marriage…It’s up to the judge’s discretion on whether or not to grant it.”

38. Adoption is a process • Adoption is not time bound. • Adoption involves people, the adoptees, the adoptive parents, and the birth parents.

39. Types of Adoption • Public Adoption: An adoption that occurs through licensed public agencies (DSWD) • Private Adoption: An adoption arranged directly between adoptive parents an the biological birth mother, usually with the assistance of an attorney

40. Transracial Adoptions • Single-Parent Adoptions • Adoptions by Gays and Lesbians • International Adoptions

41. Closed and Open Adoptions Closed Adoption: An adoption where identifying information is sealed and unavailable to all parties Open Adoption: A type of adoption that involves direct contact between the biological and adoptive parents

42. International Adoptions (U.S.) • About 18,000 adoptions in 2000 were of children from outside the country. • 48% of all children who have been adopted from overseas by American parents were from Asia, 33% percent from Latin America, and 11% from Europe.

43. UK adoption today • In the UK today there are 4 main areas of adoption: • Adoption of step-children • Babies and children with disabilities • Children who have been removed from their families • Babies and young children from overseas

44. Components of Adoption (DSWD) The following are components of adoption: • Recruitment of potential adoptive families who may provide a home to a child; • Development of adoptive applicants as parents to a particular child in need of a home; • Selection of a family who can best contribute to the total development of a particular child; • Preparation of the child and family prior to placement to insure acceptance and readiness for the new relationship;

45. Components of Adoption (DSWD) The following are components of adoption: • Supervision of trial custody for at least six months to facilitate the child’s adjustment in the family prior to the completion of adoption; • Preparation for removal of the child from the adoptive home if the placement disrupts while alternative plans are being worked out; • Finalization of adoption and termination of service with issuance of the final decree of adoption and amended birth certificate; • Organization of groups of adoptive parents as part of support system; and • Post-legal adoption counselling when adoptive family and adoptee need further counselling related to information about adoptee’s background and search for his/her biological parents.

46. Homosexual Adoptive Parents • Do children under homosexual families grow differently? • A study by Farr, Forssell, and Patterson (2010) reveals that gender orientation is not really significant to cause children’s adjustment. • What matters most according to them is parental relationship, parenting, and parenting stress.

47. Impacts of Adoption on Birth Parents ( Child Welfare Information Gateway , 2013) • It is a traumatic experience • Thinking about the child • Guilt and shame • Identity issues • Effect on other relationships

48. Insert VIDEO • Beautiful Woman

49. Legal Instrument • Republic Act 8552 Domestic Adoption Act of 1998 • Republic Act 8043 Inter-Country Adoption Act of 1995.

50. RA 8552 [1]Birth certificates, marriage certificate, proof of financial capacity (like ITR, bank deposit, etc), clearances (barangay, police, NBI, fiscal, court), and others as proof of good moral character, good health, etc.[2] Upon payment of the filing or docket fee, the petition is raffled to a Family Court (of the city nearest the place where the petitioner resides). [3]Newspaper Publication