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TIMING FERTILIY- A Comparative Analysis of Time Constructions and the Social Practice of Egg-Freezing in Germany and Israel

Periodic Reporting for period 1 - TIMEGG (TIMING FERTILIY- A Comparative Analysis of Time Constructions and the Social Practice of Egg-Freezing in Germany and Israel)

Reporting period: 2018-02-01 to 2020-01-31

"A new concept of “Social Egg Freezing” (SEF) has been introduced in the 2000s. It was made possible by new advancements in reproductive medicine such as vitrification (fast freezing). Healthy women are now given the possibility to cryopreserve their oocytes to prolong their fertility. This practice has triggered ongoing academic and public debates on its social and ethical implications. This project analyzed and extended our understanding of the concept of ""freezing"" while employing the analytical prism of 'sociology of time'. My research examined the interplay of culture and bioethics in an interdisciplinary and empirical manner by comparing experts' and lay positions in Germany and Israel. This cross-cultural juxtaposition is especially promising since the German regulatory and legal framework regarding new reproductive technologies is rather restrictive, while the Israeli regulation has been identified as extremely permissive.

Objectives
a. In-depth socio-empirical analysis of the meaning given to ‘time’ in the context of reproductive medicine
b. A dual comparative analysis of such time meanings by comparing two national contexts as well as experts and lay ethics
c. Sociological and ethical theorization of the time-dimension for the relationship of reproduction, labor and gender

Conclusion
While SEF is highly controversial among experts in both countries, the nature of the controversy varies while highlighting cross-cultural difference regarding perception of appropriate reproductive timing. Those findings contribute to the analysis of reproduction from a life-course perspective.
Several experts raised concerns regarding the potential usage of SEF as a mean for solving gendered time conflicts in the context of the labor market. Such a usage can be theoretically discussed in relation to the concepts of “clinical labor”.
The motivations of SEF users can be classified along three types: postponing motherhood (German users); singlehood and waiting for the right partner (Israeli and German users); and long-term planning (Israeli religious users). Theorization of relevant temporality formations include the “extended present”, “waiting” and “reproductive futurism” respectively."
Methodology
We conducted qualitative semi-structured interviews (N=67), with both experts (physicians, lawyers, sociologists, philosophers and ethicists) and lay users of SEF from Israel and Germany. Additionally, a discourse analysis of (a) relevant publications (academic, regulative and medical); and (b) relevant internet forums has been undertaken. Data analysis followed the grounded theory method.

Results
1. SEF is highly controversially discussed among experts in both countries. Yet, I identified cross-cultural differences within the two expert communities. In Germany, the controversy circles around the (de)legitimation of late-motherhood and concerns were raised regarding postponing reproduction. In Israel, the controversy revolves around the legitimation of SEF as potentially giving women new opportunities and is negotiated as reproductive planning. Relevant cultural scripts to explain the differences include pro-natalism in Israel and social expectations regarding ‘good’ motherhood in Germany.
2. The motivations of SEF users can be classified along three different types reflecting the socio-cultural construction of temporality. German SEF users saw the decision to become a mother as less evident and more negotiable (highlighting labor market demands, ideas of “readiness” and perceived social expectations for devoted motherhood). One rather small group (only German SEF users) viewed SEF as an opportunity to postpone motherhood or ‘gain more time’ for making reproductive decisions. A second group of interviewees (both Israeli and German users) identified the lack of stable relationship as a main motivation for using SEF, which enables them to continue “waiting” for the right partner. This group demonstrates how the phenomenology of singlehood produces a certain temporal identity that is shared by SEF users regardless of their cultural background. The third group (comprised only of Israeli religious users), used the procedure in the hope to have a multiple number of children. This last type highlights the need for intra-cultural understandings (such as religiosity as a cofactor to gender).
3. The role of life-course ideals and related perceptions regarding ‘appropriate‘ timetables become important in shaping the debate around late motherhood and the postponing of reproduction (Rimon-Zarfaty & Schweda 2019). For theory building, the analysis of SEF users’ motivations uncovers different temporality formations and time logics embedded in gender and reproduction meanings. Those include the highly gendered notion of “extended present” (Leccardi 2005), “waiting” and related normative interpretations (Lahad 2012;2017), and transparent forms of “reproductive futurism” (Edelman 2004). Finally, several experts raised concerns regarding possible future motivations for using SEF as a mean for solving gendered time conflicts in the context of the labor market. Such concerns frame SEF as potential medicalization and (non-transparent) “clinical labor” (Cooper and Waldby 2014), govern by male centered model of ideal participation in the labor force.

Exploitation and dissemination
Academic Dissemination included a paper published in a peer-reviewed journal, six presentations in international conferences, invited talks in academic forums and the organization of two events (international workshop and a stakeholders’ conference). Future dissemination will include two papers in progress as well as the co-editing of a planned ‘special issue’.
Public Dissemination included lecture to the general public, development of relevant teaching materials, participation as an interviewed expert in a German newspaper article and the establishment of a project’s webpage and Facebook page.
The project uncovered the role played by temporality in the moral reasoning of reproduction and reproductive medicine. It further unveiled certain social factors interacting with such temporality constructions. Those include idea(l)s of proper motherhood, ‘appropriate’ family formation and ties, changes in women’s career and educational paths, and in relationships’ patterns and formations. It therefore adds a new perspective regarding the connection between women biographies, gendered time restrictions and reproductive decision making. Furthermore, the project sets a methodological framework for examining temporality constructions in cross-cultural analysis of modern biomedicine. The individualistic perspective often prevailing in medical or ethical discourses is challenged by deciphering the hidden socio-political context (i.e. unveiling mechanism of “cryopolitics”) in individual narratives.
An inductive outcome of the project is the realization of an overview of the complex and even sometimes contradictory medical information provided for SEF (e.g. uncertain success rates and related medical risks). We therefore initiated a new and separate examination of informed consent procedures and the related users’ experiences and understandings (by collecting informed consent forms and further interviews with SEF users). The new data collection was finalized in the last months of the project. This should result in publishing recommendations for handling informed consent procedures for professionals.
Program flyer of organized international workshop- part 2
A photo illustrating a frozen egg
Program flyer of organized international workshop-part 1