Doctoral Dissertation Research: Cultural and Social Dimensions of Anti-Mullerian Hormone Screening Technologies

博士论文研究：抗苗勒氏管激素筛查技术的文化和社会维度

• 批准号: 1823543
• 负责人: Thomas McDade
• 金额: $ 0.76万
• 依托单位: Northwestern University
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-01 至 2019-06-30
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=1823543&HistoricalAwards=false
• 关键词: Doctoral; Dissertation; Research; Cultural; Social

Demographic shifts in the United States, including a later average age of first birth have significantly changed how women and couples navigate family planning. For women, age is one of the best predictors of fertility: that is, whether a woman will be able to conceive. Younger women are typically more fertile, and ability to conceive declines until a woman reaches menopause. However, the age at which an individual woman becomes less fertile varies depending on many factors unique to her individual body, including genetic makeup, diet, lifestyle, and environment. Over the past decade, medical providers have increased the use of a simple blood test to measure a woman's anti-Mullerian hormone (AMH) level, a hormone secreted by a woman's remaining pool of eggs. AMH level has been used in some medical settings as an indicator of fertility, with lower values suggesting reduced fertility. AMH screening is a low-cost fertility test and is becoming more widely available in the United States. As AMH testing is becoming more widespread, it is important to understand how women are using test results as a tool in family planning and to navigate their biological parenthood options. In addition to providing funding for the training of a graduate student in anthropology in methods of empirical, scientific data collection and analysis, the project would enhance scientific understanding by broadly disseminating its findings to organizations invested in discovering more effective means of improving public health.Moira Kyweluk, under the supervision of Dr. Thomas McDade of Northwestern University, will explore the cultural and social dimensions of AMH testing. The research will take place at two locations where AMH testing is common: first, at a network of private clinics that offer fertility testing for low out-of-pocket costs directly to consumers and second, at a large research hospital fertility clinic where testing is often a part of family planning using reproductive technologies like egg freezing and in vitro fertilization. The project uses anthropology methods including careful observation and recording of conversations in both clinics, as well as interviews with patients and providers who deliver test results. Qualitative data will help the research team understand why and when women seek AMH testing, as well as the role of romantic partners, family and social networks on accessing fertility testing and taking action using test results. Importantly, this project will gather data on experiences with low-cost fertility testing from women from diverse socioeconomic statuses, races, ethnicities and sexual orientations, deliberately including women often overlooked in research on reproductive technologies, since most patients who have access to fertility medical care in the United States and thus comprise the majority of research participants are white and affluent. Ultimately, data from this project will be important in helping women and providers make decisions about when, whether, and how to take this sort of fertility test since it can have impacts on family planning decisions, emotional health, and social life. Early fertility screening and ongoing screening throughout a woman's life could soon become a standard of care. Information from these interviews will be available to the public to give women more information about others' experiences with elective AMH testing.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.

美国的人口结构变化，包括生育第一胎的平均年龄的推迟，极大地改变了妇女和夫妇进行计划生育的方式。对于女性来说，年龄是生育能力的最佳预测因素之一：即女性是否能够怀孕。年轻女性通常生育能力更强，但在女性进入更年期之前，受孕能力会下降。然而，女性生育能力下降的年龄取决于其个体身体特有的许多因素，包括基因构成、饮食、生活方式和环境。在过去的十年中，医疗服务提供者越来越多地使用简单的血液测试来测量女性的抗苗勒氏管激素（AMH）水平，这是一种由女性剩余卵子分泌的激素。 AMH 水平已在一些医疗环境中用作生育能力的指标，较低的值表明生育能力下降。 AMH 筛查是一种低成本的生育力测试，在美国越来越普及。随着 AMH 测试变得越来越普遍，了解女性如何使用测试结果作为计划生育的工具并指导她们的亲生父母选择非常重要。除了为人类学研究生的实证、科学数据收集和分析方法的培训提供资金外，该项目还将通过向致力于发现改善公共卫生的更有效方法的组织广泛传播其研究结果来增强科学理解。 莫伊拉Kyweluk 在西北大学 Thomas McDade 博士的指导下，将探索 AMH 测试的文化和社会层面。该研究将在两个 AMH 检测常见的地点进行：首先，在私人诊所网络中，直接向消费​​者提供低自付费用的生育检测；其次，在一家大型研究医院生育诊所，进行检测。通常是计划生育的一部分，使用卵子冷冻和体外受精等生殖技术。该项目使用人类学方法，包括仔细观察和记录两个诊所的对话，以及采访提供测试结果的患者和提供者。定性数据将帮助研究团队了解女性寻求 AMH 检测的原因和时间，以及浪漫伴侣、家庭和社交网络在获取生育力检测和利用检测结果采取行动方面的作用。重要的是，该项目将收集来自不同社会经济地位、种族、民族和性取向的女性的低成本生育测试经验数据，并有意将在生殖技术研究中经常被忽视的女性纳入其中，因为大多数患者能够获得生育医疗服务在美国，因此大多数研究参与者都是富裕的白人。最终，该项目的数据对于帮助妇女和提供者决定何时、是否以及如何进行此类生育力测试非常重要，因为它可能对计划生育决策、情绪健康和社交生活产生影响。早期生育力筛查和女性一生的持续筛查可能很快就会成为一种护理标准。这些采访的信息将向公众开放，以便为女性提供更多有关其他人选择性 AMH 测试经验的信息。该奖项反映了 NSF 的法定使命，并通过使用基金会的智力价值和更广泛的影响审查标准进行评估，被认为值得支持。