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EGA Institute for Women's Health

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Reproductive Science and Society Group

The reproductive science group are a multi-disciplinary group using mixed methods to examine reproductive journeys from puberty to the menopause. We have a number of key collaborators, including Natural Cycles, Cryos, the Donor Conception Network and the Human Fertilisation and Embryology Authority. We are working on six main themes: fertility education, the menstrual cycle, reproductive technologies, fertility journeys, women’s experiences of consent, choice and decision-making in multiple women’s health contexts (e.g. ante-natal care, IVF, birth decisions, fetal medicine, women’s cancer), and the menopause. The team have a great interest in public engagement writing articles in the news and appearing on TV.

The team is led by Professor Joyce Harper who has been working in the field for over 30 years, and the senior members include Dr Zeynep Gurtin, Dr Suzy Buckley, Dr Jackie Nicholls and Alegria Vaz and an honorary appointment of Professor Emily Jackson (LSE).

The main themes of our research are:

Fertility education 

Joyce Harper is co-founder of the UK fertility education initiative (www.fertilityed.uk). The group was established in 2016 under the umbrella of the British Fertility Society. They have published two papers and successfully campaigned to get fertility education included in the UK curriculum. Joyce is working to develop tools for teachers to deliver fertility education and in 2020 will work with various schools to run a survey of sex and fertility education in the UK.

Joyce is heading a global fertility education campaign who have made a fertility education poster which was launched at the EU Parliament on 5th Nov 2019. The poster is being translated (35 languages so far). Joyce is working to help set up national committees. Joyce is trying to get as much publicity as possible and has been on ITN news and in various other media.

The menstrual cycle

Joyce is working with the app Natural Cycles. One paper is published which has had a big impact including being in the top 1% downloaded papers, and appeared in many media reports. Joyce took part in a USA documentary and was interviewed on women’s hour. The team are looking at fertility and menstrual cycle apps.

Reproductive technologies

The IfWH heads a multi-disciplinary group, the Reproductive Technologies Network, who meet once a year to discuss IVF add-ons, donation, egg freezing, etc. This has fostered collaborations across the UK.

Joyce is working with the HFEA on the traffic light system for IVF add-ons. She chairs the HFEA Horizon Scanning and is an advisor to the Science and Clinical advisory committee.

Fertility journeys 

Alegria’s PhD has focussed on Jewish women’s fertility journeys. She interviewed women who did not and did have fertility issues. Joyce headed the Ma’ayam project with the Chief Rabbi two years ago to educate professional Jewish women to be the interface between women and Rabbis concerning women’s health and this project will run again in 2020.

There are a number of projects ongoing relating to donor conception.

Women’s experiences of consent, choice and decision-making in multiple contexts.

The overall theme of Jackie’s work is understanding how women experience autonomous choice in relation to making decisions which require them to give consent. Enabling choice is an issue which has particular resonance in the context of women’s health where issues of maternal–fetal relationships, women’s socio-cultural roles and decisions about relationships are interconnecting with an increasing emphasis on authentic shared decision-making endorsed by UK law.  Despite the benefits of women being more involved in decision making and despite increasing endorsement by the courts for full discussion during consent ‘conversations’ little is known about womens’, families or professionals’ experiences of the consent process. When choice ‘failures’ occur not only may there be legal consequences but the undermining of public trust and the psychological & emotional costs to the individual are perpetuate so there is a pragmatic imperative to find better ways of sharing information, including communicating risk, with patients.

Consent in ante-natal contexts

Initial work has involved using direct observation of clinical consultations across a range of ante-natal contexts in which consent decisions were made.  in conjunction with individual interviews with women and with healthcare professionals.