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Preimplantation genetic testing for monogenic disorders (PGT-M) offers variant carriers the option of preventing hereditary cancer transmission. We investigated the awareness and attitudes toward PGT-M among patients with breast cancer who underwent fertility preservation. A questionnaire-based survey was administered to 264 patients with breast cancer who were eligible for oocyte or embryo cryopreservation at in vitro fertilization clinics between October 2024 and March 2025. A total of 161 valid responses were analyzed. The survey assessed testing status, PGT-M awareness, willingness to undergo PGT-M, and opinions on future availability. The uptake rate of testing was 53.4%; 14% of the respondents were variant carriers. Only 16.8% had prior awareness of PGT-M, and 47.8% expressed a willingness to use PGT-M if available. Among -variant carriers, 3.3% reported that they would consider PGT-M, and 75% believed it should be made available upon request. Overall, 68.3% supported information sharing between oncology and fertility providers. These findings highlight the importance of expanding reproductive options and patient awareness of PGT-M in the care of patients with hereditary cancer. Discussions should focus on how best to provide accurate information and enable informed reproductive choices for those at genetic risk.

Recently, statistical analyses of demographic datasets have come to play an important role for studies into the evolution of human life history. In the first part of this paper, I highlight fertility decline, an evolutionarily paradoxical phenomenon in terms of fitness maximization. Then, I conduct a literature review regarding the effects of socioeconomic status on the number of offspring, especially in modern developed, (post-)industrial, and low-fertility societies. Although a non-positive relationship between them has often been recognized as a general feature of fertility decline, there actually exists a great deal of variation. Based on the review, I discuss the association between socioeconomic success and reproductive success, and tackle an evolutionary question as to why people seek higher socioeconomic success that would not directly lead to higher reproductive success. It has been suggested that, in modern competitive environments, parents should set a higher value on their investment in children, and aim to have a smaller number of high-quality children. Also, parents would maintain higher socioeconomic status for themselves so as to provide high-levels of investment in their children. In the second part, I broadly consider seemingly evolutionarily (mal)adaptive outcomes besides fertility decline, including child abuse, menopause, and suicide. The integration of the major three approaches to human behavioral and psychological research (behavioral ecology, evolutionary psychology, and cultural evolution) could lead to a deeper understanding. I provide a model for the integrated approach. Rich empirical evidence accumulated in demographic studies, especially longitudinal and cross-cultural resources, can assist to develop a theoretical framework.

This article investigates the role of the West German family planning association Pro Familia in the abortion reform of the 1960s and 1970s. It examines the question of legal abortion from the perspective of reproductive decision-making and asks who was to make a decision about having an abortion in the reform process—the woman, her doctor, or a counsellor. During the early reform suggestions of §218 in the 1960s, Pro Familia supported the West German solution of allowing legal abortion only in medical emergencies. Opinions within the organization changed as leading members witnessed legalization in Great Britain and New York. The feminist movement and the Catholic opposition to legal abortion influenced positions in the reform phase of the 1970s. Meanwhile, Pro Familia put emphasis on compulsory pregnancy crisis counselling as aid in decision-making for individual women and a tool for putting a decision into practice. Throughout the reform process, Pro Familia continued to perceive legal abortion not as way to enable women to make their own decision but as a pragmatic solution to emergencies.

The 1980s were characterized not only by Ronald Reagan’s rhetoric of ‘traditional family values’ but also by a fierce anti-abortion movement that challenged the legalization of abortion. While the women’s movement fought to preserve abortion rights and reproductive choice, an organization that originated with the 1970s women’s rights and self-help movements conceived ‘adoption’ as a moral alternative to abortion. The self-help organization Concerned United Birthparents, founded in 1976 sought the opening of records and moral recognition for ‘birthmothers’ (and later ‘birth-parents’ in general). While their emphasis on adoption as an alternative to abortion seemed to meet with President Reagan’s pro-adoption campaign and the Christian Right’s support for adoption, Concerned United Birthparents nonetheless pursued an agenda of its own, demanding respect and legitimacy for unmarried women’s reproductive decision-making. This article draws primarily on the records of Concerned United Birthparents to develop a new perspective on single women’s changing perception of their reproductive rights and choices in the 1980s. Transforming an originally conservative claim (‘adoption instead of abortion’) into individual ‘adoption rights’ and an inclusive concept of ‘choice’, Concerned United Birthparents drew on the social movements of the period. Moreover, it provided a case for liberal reproductive decision-making within an ultra-conservative political climate that challenges the assumption of an all-encompassing conservative revolution.

The 1960s revolutionized American contraceptive practice. Diaphragms, jellies, and condoms with high failure rates gave way to newer choices of the Pill, IUD, and sterilization.Fit to Be Tiedprovides a history of sterilization and what would prove to become, at once, socially divisive and a popular form of birth control. During the first half of the twentieth century, sterilization (tubal ligation and vasectomy) was a tool of eugenics. Individuals who endorsed crude notions of biological determinism sought to control the reproductive decisions of women they considered \"unfit\" by nature of race or class, and used surgery to do so. Incorporating first-person narratives, court cases, and official records, Rebecca M. Kluchin examines the evolution of forced sterilization of poor women, especially women of color, in the second half of the century and contrasts it with demands for contraceptive sterilization made by white women and men. She chronicles public acceptance during an era of reproductive and sexual freedom, and the subsequent replacement of the eugenics movement with \"neo-eugenic\" standards that continued to influence American medical practice, family planning, public policy, and popular sentiment.

Cultural, ecological, familial and physiological factors consistently influence fertility behaviours, however, the proximate psychological mechanisms underlying fertility decisions in humans are poorly understood. Understanding the psychological mechanisms underlying human fertility may illuminate the final processes by which some of these known predictors have their influence. To date, research into the psychological mechanisms underlying fertility has been fragmented. Aspects of reproductive psychology have been examined by researchers in a range of fields, but the findings have not been systematically integrated in one review. We provide such a review, examining current theories and research on psychological mechanisms of fertility. We examine the methods and populations used in the research, as well as the disciplines and theoretical perspectives from which the work has come. Much of the work that has been done to date is methodologically limited to examining correlations between ecological, social and economic factors and fertility. We propose, and support with examples, the use of experimental methods to differentiate causal factors from correlates. We also discuss weaknesses in the experimental research, including limited work with non-WEIRD (western, educated, industrialized, rich and democratic) populations.

Anthropological engagement with moralities and ethics assumes that people evaluate themselves and others according to their notions of good and bad; yet little is known about how people evaluate the quality of their deliberations. Such evaluations of the seriousness of ethical deliberations prevail in Japan’s genetic counseling for pregnant couples considering NIPT, a maternal blood test early in pregnancy that does not endanger the pregnancy but might lead to termination dilemmas. These deliberations are based on the idea that the ambivalence over whether to provide or undergo a potentially selective test is virtuous. This article examines how Japanese policymakers, medical professionals, genetic counselors, and pregnant couples make decisions within social settings that valorize indecisiveness. Ambivalence emerges as the cognitive skill of seeing complexity clearly. How people and their ethnographers evaluate the quality of ethical deliberations is essential to contemplate if we are to understand how people seek to lead a moral life. 道徳と倫理への人類学的な関与は、人々が善悪の概念に従って自分自身や他 人を評価することを前提としている。 しかし、人々がその討議の良し悪しをど のように評価しているかについてはほとんど知られていない。このような倫理 討議の深刻な評価は、妊娠を危険にさらすことはないが中絶のジレンマにつな がる可能性のある妊娠初期の母体血液検査である NIPT を検討している妊娠 中のカップルに対する日本の遺伝カウンセリングでは一般的である。これらの 討議と躊躇いは、潜在的に選択的なテストを提供したり受けたりすることが道 徳にかなっているのかどうかという両価性の考えに基づいている。 この論文では、日本の政策立案者、医療専門家、遺伝カウンセラー、および妊 娠中のカップルが、決断をためらうことに評価する社会環境の中でどのように 決定を下すのかを調べる。両価性は、複雑さを明確に見る認知スキルとして 現れる。 人々とその民族誌学者が倫理的審理の質をどのように評価するのか は、人々がどのように道徳的な生活を送ろうとしているのかを理解し熟考する ことが不可欠だ。

Three case studies are presented to further our understanding of how responsibility is negotiated in families when making decisions about genetic risk. These draw on a model of responsibility generated in a study of reproductive decision‐making in families facing Huntington disease (HD) to illustrate the impact of prenatal testing on this process. This involves analyzing: how people present themselves as acting responsibly whether or not they utilize genetic testing; who they feel responsible to in their family and elsewhere; the impact that testing has on these relationships; and, how negotiating responsibility changes over time with repeated use of prenatal testing, changing risk status and maturational changes. Two key findings are: how decision‐making is perceived can become as important as what is decided; and, how responsibility is negotiated depends on which of these relationships are prioritized. Implications of the findings for clinical practice are noted and suggestions made for further applications of the model.

Most of the research on reproduction in those at risk for Huntington Disease (HD) has focused on the impact of genetic testing on reproductive decision-making. The main goal has been to determine whether discovering one is a carrier of the HD mutation changes an individual’s or couple’s decision to start a family or to have more children. The purpose of this qualitative study was to examine reproductive decision-making in a sample of individuals at risk for HD who have chosen not to pursue genetic testing. PHAROS (Prospective Huntington At Risk Observational Study) is a multi-site study that aims to establish whether experienced clinicians can reliably determine the earliest clinical symptoms of HD in a sample of individuals at 50% risk who have chosen not to pursue genetic testing. Data for this article were obtained from unstructured open ended qualitative interviews of a subsample of individuals participating in the PHAROS project. Interviews were conducted at six PHAROS research sites across the United States. In this paper, the research team used qualitative descriptive methods to construct and explore reproduction decision-making in three groups of people: 1) those who knew of their risk and decided to have children; 2) those who had children before they knew of their risk, and 3) those who chose not to have children based on their risk. We discuss the delicate balance health care professionals and genetic counselors must maintain between the benefits of providing hope and the dangers of offering unrealistic expectations about the time in which scientific advances actually may occur.

Determining how environmental conditions interact with individual intrinsic properties is important for unravelling the underlying mechanisms that drive variation in reproductive decisions among migratory species. We investigated the influence of sea ice conditions and body condition at arrival on the breeding propensity, i.e. the decision to reproduce or not within a single breeding season, and timing of laying in migrating common eiders (Somateria mollissima) breeding in the Arctic. Using Radarsat satellite images acquired from 2002 to 2013, we estimated the proportion of open water in the intertidal zone in early summer to track the availability of potential foraging areas for pre-breeding females. Timing of ice-breakup varied by up to 20 days across years and showed strong relationship with both breeding propensity and the timing of laying of eiders: fewer pre-breeding individuals were resighted nesting in the colony and laying was also delayed in years with late ice-breakup. Interestingly, the effect of sea ice dynamics on reproduction was modulated by the state of individuals at arrival on the breeding grounds: females arriving in low condition were more affected by a late ice-breakup. Open water accessibility in early summer, a likely proxy of food availability, is thus crucial for reproductive decisions in a (partial) capital breeder. Our predictive capacity in determining how Arctic-breeding seabirds respond to changes in environmental conditions will require incorporating such cross-seasonal cumulative effects.