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Papers by Zeynep Gurtin

Reproductive Biomedicine and Society Online, 2020

To the authors' knowledge, this is the first UK-based study to analyse the marketing of elective ... more To the authors' knowledge, this is the first UK-based study to analyse the marketing of elective egg freezing (EEF) by fertility clinics. Analyses were based on the websites of the top 15 UK clinics, which together provided 87.8% of all egg freezing cycles in the UK between 2008 and 2017 inclusive. The analyses included three phases: content analysis; systematic cost analysis and comparison ; and quality analysis examining the information available on egg freezing and its adherence to the guidelines of the Human Fertilisation and Embryology Authority (HFEA). The results show that clinics frame EEF according to four main themes: as a new and exciting technology; as a solution to (a modern woman's) life circumstances; as a means to gain control, freedom and more reproductive options; and as a means to avoid the reproductive risks of ageing. This study also found that most clinics are not sufficiently clear and transparent about the 'true' cost of an EEF cycle, present an unbalanced view of EEF, and do not provide satisfactory data or information. Most importantly, none of the clinics adhere adequately to the HFEA guidelines regarding advertising and the provision of information. As the EEF market continues to grow, offered exclusively by private clinics, these findings require urgent attention. Clinics must improve the type and quality of EEF information on their websites such that potential patients can make informed choices, and this article provides 10 basic criteria which can be used as a checklist. It is suggested that the time may have come to grant greater economic regulatory powers to HFEA to avoid over commercialization of the fertility industry.

Anthropology & Medicine, 2019

Reproductive BioMedicine Online, 2018

ABSTRACT Research question: What can we learn from 5 years of egg-freezing practice in the UK? Wh... more ABSTRACT
Research question: What can we learn from 5 years of egg-freezing practice in the UK? What are the different categories of egg freezing, and what are the social and demographic characteristics of patients, and their decisions regarding subsequent storage or thawing?
Design: A retrospective analysis of clinical and laboratory data of all 514 cycles of ‘own’ egg freezing conducted at the London Women’s Clinic in the 5-year period from the start of 2012 to the end of 2016.
Results: This analysis, the first of its kind, develops a clearer picture of egg-freezing trends in the UK and fills in the details behind the Human Fertilisation and Embryology Authority’s national figures. Four different categories
of egg freezing are identified and the appropriate category allocated to each of the 514 cycles undertaken by 352 patients. To the established categories of ‘medical’ and ‘social’ already discussed in the literature, we add the two new categories of ‘clinical’ and ‘incidental’ egg freezing. We show how each of these categories presents a distinct egg-freezing patient profile, and discuss the similarities and differences between them across variables such as age, relationship status, number of eggs frozen, number of egg-freezing cycles undertaken, and the current status of frozen eggs.
Conclusions: The data require a reconceptualization of the phenomenon of egg freezing, and argue for the importance of clearly and accurately differentiating between different categories of egg-freezing practice in clinical and national data collection in order to adequately inform future practice, regulation and the decision-making processes of patients considering these procedures.

Anthropology and Medicine, Special Issue, Forthcoming (Winter 2018)

Sociological Research Online Special Section, Vol 22. Issue 2.

This article compares the use of assisted reproductive technology (ART) and resultant kinship for... more This article compares the use of assisted reproductive technology (ART) and resultant kinship formations in four Middle Eastern settings: the Sunni Muslim Arab world, the Sunni Muslim but officially 'secular' country of Turkey, Shia Muslim Iran and Jewish Israel. This four-way comparison reveals considerable similarities, as well as stark differences, in matters of Middle Eastern kinship and assisted reproduction. The permissions and restrictions on ART, often determined by religious decrees, may lead to counter-intuitive outcomes, many of which defy prevailing stereotypes about which parts of the Middle East are more 'progressive' or 'conservative'. Local considerations – be they social, cultural, economic, religious or political – have shaped the ways in which ART treatments are offered to, and received by, infertile couples in different parts of the Middle East. Yet, across the region, clerics, in dialogue with clinicians and patients, have paved the way for ART practices that have had significant implications for Middle Eastern kinship and family life.

Whilst studies of ‘Parenting Culture’ and ‘Assisted Reproductive Technologies’ (ARTs) are now wel... more Whilst studies of ‘Parenting Culture’ and ‘Assisted Reproductive Technologies’ (ARTs) are now well-established areas of social science scholarship, so far, the potential connections between the two fields have not been significantly explored. Responding to calls for a more ‘processual’ approach to studying reproduction (Almeling, 2015) in order to make clearer contributions to sociological theory more broadly, we begin a dialogue between these mutually relevant bodies of literature, highlighting connections and crosscutting findings. We focus on four interlinked themes – Reflexivity, Gender, Expertise and Stratification – and promote a more holistic approach to understanding how children are conceived and cared for within the current ‘Euro-American’ reproductive landscape. By way of conclusion, we draw attention to the contemporary context of ‘anxious reproduction’ and propose directions for future research.

This article constructs an explanatory history of the introduction, growth and social regulation ... more This article constructs an explanatory history of the introduction, growth and social regulation of IVF in Turkey, labelling it a form of ‘patriarchal pronatalism’. Based on sociological research between 2006 and 2010, including analysis of regulatory and media materials as well as an in-depth clinical ethnography and interviews with IVF patients and practitioners, the paper contextualizes Turkey’s ‘IVF boom’ within the wider and governmental contexts of reproductive politics. Examining both the legal framework and the surrounding rhetoric, it highlights how the nationally pertinent tensions between Islam and secularism unfold in this particular field, and traces how the rise of neo-conservatism and the expansion of the role of religious organizations and discourses has led to the promotion and development of assisted reproduction, but only within strictly enforced conjugal confines. This work contributes not only to the significant sociological and anthropological scholarship on the globalization, localization and repro-national character of assisted reproductive technologies around the world, but also to the growing scholarship examining the contours of reproductive citizenship, gender relations and family formation in contemporary Turkey.

Globalized Fatherhood, edited by Marcia C. Inhorn, Wendy Chavkin & José-Alberto Navarro

The Changing World Religion Map, edited by Stanley Brunn. Springer (forthcoming).

Clinical Ethics, 7: 183-192., 2012

This paper reports the results of a survey study examining the knowledge, motivations and concern... more This paper reports the results of a survey study examining the knowledge, motivations and concerns of egg-share donors and recipients, and assesses the clinical and policy implications of these findings. The survey, combining quantitative and qualitative items, was completed by 48 donors and 38 recipients who took part in an egg-sharing scheme at the London Women's Clinic between 2007 and 2009. Although the most important motivation for all egg-sharers was to have a baby, both donors and recipients displayed multiple motivations, including elements of self-interest and altruism. Many viewed egg-sharing as a reciprocal process in which two women with different needs help one another. The results are reassuring from an ethical and policy perspective: they suggest that if information about egg-sharing was more widely available (especially through general practitioners), more women may consider becoming egg-share donors, gaining swift access to their own treatment and reducing the UK's egg donor shortage.

FVV in OBGYN, MONOGRAPH, 24-29., 2012

This paper discusses the social, religious, and resource considerations around infertility and th... more This paper discusses the social, religious, and resource considerations around infertility and the provision of assisted reproductive technologies in the Muslim Middle East. Demonstrating the social need for IVF by millions of invol- untarily childless Muslim men and women, as well as the religious permissibility of the technique according to Islam, we provide the positive examples of Turkey and Egypt regarding how resource concerns may be tackled and access to ARTs broadened. We end the paper by making a call for ARTs and infertility treatments to be incorporated into comprehensive reproductive care regimes, and for reproductive rights to encompass the facilitation as well as the control of fertility.

Human Reproduction, 27(6): 1690-1701., 2012

BACKGROUND: This paper presents finding from a study of the emotional and relational aspects of ... more BACKGROUND:
This paper presents finding from a study of the emotional and relational aspects of egg-sharing, exploring egg-share donors' and recipients' thoughts and feelings about each other, about each other's treatment outcome and any resulting children, as well as their attitudes towards disclosure of donor origins and contact between donors and donor offspring in the future. It is the first study of this population since the removal of donor anonymity in 2005.
METHODS:
A paper or online questionnaire was completed anonymously by 48 donors and 38 recipients who took part in egg-sharing between 2007 and 2009. Data were obtained on a range of measures-including demographics, family circumstances, motivations and anxieties, feelings about egg-sharing, retrospective assessments and views on regulation-and analysed to facilitate cross-group and within-group comparisons of donors and recipients.
RESULTS:
This study found very few differences between donors and recipients, as well as between successful and unsuccessful egg-share participants. Donors and recipients expressed sentiments of goodwill towards one another, and displayed attitudes of openness regarding disclosure decisions and future contact among donors and donor-conceived offspring. While some donors and recipients wanted to know the outcome of their donor's/recipient's treatment, others preferred not to.
CONCLUSIONS:
Most significantly, concerns voiced regarding the potential psychological harm to donors, particularly those whose own treatment ends unsuccessfully, were not borne out by the data.

Reproductive BioMedicine Online, Ethics, Bioscience and Life 24: 698-708., 2012

Egg-sharing schemes involve a woman sharing a portion of her eggs with another in exchange for fr... more Egg-sharing schemes involve a woman sharing a portion of her eggs with another in exchange for free or reduced-cost fertility treatment and have been regulated in the UK since 1998. However, while being perceived as a unique anomaly (within the UK system) such schemes have caused considerable debate. Some critics have been concerned that the benefit-in-kind (i.e. fertility treatment) offered in exchange for donating eggs might compromise the consent of potential donors, particularly those who have no other means to access treatment, and lead to exploitation and the commodification of gametes. This article reports empirical findings that engage directly with these concerns. First, data on the demographic characteristics, circumstances and treatment outcomes of donors and recipients are presented, followed by data on egg sharers' own retrospective assessments of egg-sharing and their opinions regarding its ethics and regulation. This study shows that, contrary to some expectations, there are very few differences in the characteristics, experiences and opinions of egg-sharing donors and recipients, and also highlights the overwhelmingly positive assessment of egg-sharing by women who have taken part in such schemes.

Appears in M. Inhorn and S. Tremayne. (eds.) Islam and Assisted Reproductive Technologies: Sunni and Shia Perspectives. New York: Berghahn., 2012

Appears in M. Richards, J. Appleby & G. Pennings (eds.) Reproductive Donation: Bioethics, Policy and Practice. Cambridge: Cambridge University Press., 2012

Reproductive Biomedicine and Society Online, 2020

To the authors' knowledge, this is the first UK-based study to analyse the marketing of elective ... more To the authors' knowledge, this is the first UK-based study to analyse the marketing of elective egg freezing (EEF) by fertility clinics. Analyses were based on the websites of the top 15 UK clinics, which together provided 87.8% of all egg freezing cycles in the UK between 2008 and 2017 inclusive. The analyses included three phases: content analysis; systematic cost analysis and comparison ; and quality analysis examining the information available on egg freezing and its adherence to the guidelines of the Human Fertilisation and Embryology Authority (HFEA). The results show that clinics frame EEF according to four main themes: as a new and exciting technology; as a solution to (a modern woman's) life circumstances; as a means to gain control, freedom and more reproductive options; and as a means to avoid the reproductive risks of ageing. This study also found that most clinics are not sufficiently clear and transparent about the 'true' cost of an EEF cycle, present an unbalanced view of EEF, and do not provide satisfactory data or information. Most importantly, none of the clinics adhere adequately to the HFEA guidelines regarding advertising and the provision of information. As the EEF market continues to grow, offered exclusively by private clinics, these findings require urgent attention. Clinics must improve the type and quality of EEF information on their websites such that potential patients can make informed choices, and this article provides 10 basic criteria which can be used as a checklist. It is suggested that the time may have come to grant greater economic regulatory powers to HFEA to avoid over commercialization of the fertility industry.

Anthropology & Medicine, 2019

Reproductive BioMedicine Online, 2018

ABSTRACT Research question: What can we learn from 5 years of egg-freezing practice in the UK? Wh... more ABSTRACT
Research question: What can we learn from 5 years of egg-freezing practice in the UK? What are the different categories of egg freezing, and what are the social and demographic characteristics of patients, and their decisions regarding subsequent storage or thawing?
Design: A retrospective analysis of clinical and laboratory data of all 514 cycles of ‘own’ egg freezing conducted at the London Women’s Clinic in the 5-year period from the start of 2012 to the end of 2016.
Results: This analysis, the first of its kind, develops a clearer picture of egg-freezing trends in the UK and fills in the details behind the Human Fertilisation and Embryology Authority’s national figures. Four different categories
of egg freezing are identified and the appropriate category allocated to each of the 514 cycles undertaken by 352 patients. To the established categories of ‘medical’ and ‘social’ already discussed in the literature, we add the two new categories of ‘clinical’ and ‘incidental’ egg freezing. We show how each of these categories presents a distinct egg-freezing patient profile, and discuss the similarities and differences between them across variables such as age, relationship status, number of eggs frozen, number of egg-freezing cycles undertaken, and the current status of frozen eggs.
Conclusions: The data require a reconceptualization of the phenomenon of egg freezing, and argue for the importance of clearly and accurately differentiating between different categories of egg-freezing practice in clinical and national data collection in order to adequately inform future practice, regulation and the decision-making processes of patients considering these procedures.

Anthropology and Medicine, Special Issue, Forthcoming (Winter 2018)

Sociological Research Online Special Section, Vol 22. Issue 2.

This article compares the use of assisted reproductive technology (ART) and resultant kinship for... more This article compares the use of assisted reproductive technology (ART) and resultant kinship formations in four Middle Eastern settings: the Sunni Muslim Arab world, the Sunni Muslim but officially 'secular' country of Turkey, Shia Muslim Iran and Jewish Israel. This four-way comparison reveals considerable similarities, as well as stark differences, in matters of Middle Eastern kinship and assisted reproduction. The permissions and restrictions on ART, often determined by religious decrees, may lead to counter-intuitive outcomes, many of which defy prevailing stereotypes about which parts of the Middle East are more 'progressive' or 'conservative'. Local considerations – be they social, cultural, economic, religious or political – have shaped the ways in which ART treatments are offered to, and received by, infertile couples in different parts of the Middle East. Yet, across the region, clerics, in dialogue with clinicians and patients, have paved the way for ART practices that have had significant implications for Middle Eastern kinship and family life.

Whilst studies of ‘Parenting Culture’ and ‘Assisted Reproductive Technologies’ (ARTs) are now wel... more Whilst studies of ‘Parenting Culture’ and ‘Assisted Reproductive Technologies’ (ARTs) are now well-established areas of social science scholarship, so far, the potential connections between the two fields have not been significantly explored. Responding to calls for a more ‘processual’ approach to studying reproduction (Almeling, 2015) in order to make clearer contributions to sociological theory more broadly, we begin a dialogue between these mutually relevant bodies of literature, highlighting connections and crosscutting findings. We focus on four interlinked themes – Reflexivity, Gender, Expertise and Stratification – and promote a more holistic approach to understanding how children are conceived and cared for within the current ‘Euro-American’ reproductive landscape. By way of conclusion, we draw attention to the contemporary context of ‘anxious reproduction’ and propose directions for future research.

This article constructs an explanatory history of the introduction, growth and social regulation ... more This article constructs an explanatory history of the introduction, growth and social regulation of IVF in Turkey, labelling it a form of ‘patriarchal pronatalism’. Based on sociological research between 2006 and 2010, including analysis of regulatory and media materials as well as an in-depth clinical ethnography and interviews with IVF patients and practitioners, the paper contextualizes Turkey’s ‘IVF boom’ within the wider and governmental contexts of reproductive politics. Examining both the legal framework and the surrounding rhetoric, it highlights how the nationally pertinent tensions between Islam and secularism unfold in this particular field, and traces how the rise of neo-conservatism and the expansion of the role of religious organizations and discourses has led to the promotion and development of assisted reproduction, but only within strictly enforced conjugal confines. This work contributes not only to the significant sociological and anthropological scholarship on the globalization, localization and repro-national character of assisted reproductive technologies around the world, but also to the growing scholarship examining the contours of reproductive citizenship, gender relations and family formation in contemporary Turkey.

Globalized Fatherhood, edited by Marcia C. Inhorn, Wendy Chavkin & José-Alberto Navarro

The Changing World Religion Map, edited by Stanley Brunn. Springer (forthcoming).

Clinical Ethics, 7: 183-192., 2012

This paper reports the results of a survey study examining the knowledge, motivations and concern... more This paper reports the results of a survey study examining the knowledge, motivations and concerns of egg-share donors and recipients, and assesses the clinical and policy implications of these findings. The survey, combining quantitative and qualitative items, was completed by 48 donors and 38 recipients who took part in an egg-sharing scheme at the London Women's Clinic between 2007 and 2009. Although the most important motivation for all egg-sharers was to have a baby, both donors and recipients displayed multiple motivations, including elements of self-interest and altruism. Many viewed egg-sharing as a reciprocal process in which two women with different needs help one another. The results are reassuring from an ethical and policy perspective: they suggest that if information about egg-sharing was more widely available (especially through general practitioners), more women may consider becoming egg-share donors, gaining swift access to their own treatment and reducing the UK's egg donor shortage.

FVV in OBGYN, MONOGRAPH, 24-29., 2012

This paper discusses the social, religious, and resource considerations around infertility and th... more This paper discusses the social, religious, and resource considerations around infertility and the provision of assisted reproductive technologies in the Muslim Middle East. Demonstrating the social need for IVF by millions of invol- untarily childless Muslim men and women, as well as the religious permissibility of the technique according to Islam, we provide the positive examples of Turkey and Egypt regarding how resource concerns may be tackled and access to ARTs broadened. We end the paper by making a call for ARTs and infertility treatments to be incorporated into comprehensive reproductive care regimes, and for reproductive rights to encompass the facilitation as well as the control of fertility.

Human Reproduction, 27(6): 1690-1701., 2012

BACKGROUND: This paper presents finding from a study of the emotional and relational aspects of ... more BACKGROUND:
This paper presents finding from a study of the emotional and relational aspects of egg-sharing, exploring egg-share donors' and recipients' thoughts and feelings about each other, about each other's treatment outcome and any resulting children, as well as their attitudes towards disclosure of donor origins and contact between donors and donor offspring in the future. It is the first study of this population since the removal of donor anonymity in 2005.
METHODS:
A paper or online questionnaire was completed anonymously by 48 donors and 38 recipients who took part in egg-sharing between 2007 and 2009. Data were obtained on a range of measures-including demographics, family circumstances, motivations and anxieties, feelings about egg-sharing, retrospective assessments and views on regulation-and analysed to facilitate cross-group and within-group comparisons of donors and recipients.
RESULTS:
This study found very few differences between donors and recipients, as well as between successful and unsuccessful egg-share participants. Donors and recipients expressed sentiments of goodwill towards one another, and displayed attitudes of openness regarding disclosure decisions and future contact among donors and donor-conceived offspring. While some donors and recipients wanted to know the outcome of their donor's/recipient's treatment, others preferred not to.
CONCLUSIONS:
Most significantly, concerns voiced regarding the potential psychological harm to donors, particularly those whose own treatment ends unsuccessfully, were not borne out by the data.

Reproductive BioMedicine Online, Ethics, Bioscience and Life 24: 698-708., 2012

Egg-sharing schemes involve a woman sharing a portion of her eggs with another in exchange for fr... more Egg-sharing schemes involve a woman sharing a portion of her eggs with another in exchange for free or reduced-cost fertility treatment and have been regulated in the UK since 1998. However, while being perceived as a unique anomaly (within the UK system) such schemes have caused considerable debate. Some critics have been concerned that the benefit-in-kind (i.e. fertility treatment) offered in exchange for donating eggs might compromise the consent of potential donors, particularly those who have no other means to access treatment, and lead to exploitation and the commodification of gametes. This article reports empirical findings that engage directly with these concerns. First, data on the demographic characteristics, circumstances and treatment outcomes of donors and recipients are presented, followed by data on egg sharers' own retrospective assessments of egg-sharing and their opinions regarding its ethics and regulation. This study shows that, contrary to some expectations, there are very few differences in the characteristics, experiences and opinions of egg-sharing donors and recipients, and also highlights the overwhelmingly positive assessment of egg-sharing by women who have taken part in such schemes.

Appears in M. Inhorn and S. Tremayne. (eds.) Islam and Assisted Reproductive Technologies: Sunni and Shia Perspectives. New York: Berghahn., 2012

Appears in M. Richards, J. Appleby & G. Pennings (eds.) Reproductive Donation: Bioethics, Policy and Practice. Cambridge: Cambridge University Press., 2012

One of the most striking aspects of assisted reproductive technologies (ARTs) has been their rapi... more One of the most striking aspects of assisted reproductive technologies (ARTs) has been their rapid globalization, leading to the birth of more than five million “miracle babies” (Franklin, 2012) around the world. This global spread, however, has involved sophisticated processes of “localization” (Inhorn and Van Balen, 2002), generating myriad permutations regarding the regulation, practice and reception of ARTs in different contexts. Indeed, the different incarnations of this “global form” (Knecht et al., 2012) have been the subject of a growing body of scholarship, in which social scientists, using mostly ethnographic methods, have sought to describe and analyse IVF practice, its socio-cultural impact and the experience of IVF patients in specific contexts (see Inhorn and Birenbaum-Carmeli, 2008). This thesis is in conversation with and a contribution to the work of these scholars.

Based on several periods of fieldwork in Turkey between April 2006 and December 2009, including archival analysis, clinical ethnography, “expert” interviews and semi-structured interviews with 50 women/couples undergoing IVF treatment, I provide an account of the experiences of Turkish IVF patients. This thesis illustrates the ways in which childlessness, infertility and IVF treatment are understood and constructed by Turkish men and women, as well as their reactions to and feelings surrounding these experiences.

The thesis is divided into two parts. In the first, I establish the context for my findings. Starting with a review of key ART ethnographies, I outline the important themes and findings to emerge from this literature. Then, I move to a detailed discussion of my methodology, explaining and accounting for key research decisions, elucidating the main challenges and acknowledging the important considerations that must be borne in mind when assessing this study. The section concludes with a broad contextualisation of contemporary Turkey and the role of ARTs – in particular the local particularities surrounding the regulation, organisation and representation of tüp bebek. This discussion, with references to my previously published work, draws the broad parameters within which IVF patients’ own narratives and experiences are situated.
In the second part, comprised of four chapters, I report on the data from my clinical ethnography, focusing predominantly on patient interviews. Following a roughly chronological structure, each of the chapters addresses a different aspect of women/couples’ experiences, although many themes resonate throughout the chapters. Chapter 4 describes the social and familial consequences of involuntary childlessness and how couples seek to negotiate these. Chapter 5 follows couples’ journeys to the IVF clinic through their retrospective accounts of the medicalisation of infertility. Chapter 6 focuses on the IVF cycle and the unexpected challenges that couples must navigate. Chapter 7 begins where treatment “ends”, relating women/couple’s nuanced encounters with uncertainty and their heartfelt attempts to conceive the future. Through these four chapters, I show how what begins as a straightforward expectation or assumed norm of parenthood is transformed for these couples, who must employ not only ARTs, but also creativity, imagination and perseverance in the art of making babies.