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Donor offspring are significantly more likely than those raised by their biological parents to struggle with serious, negative outcomes such as delinquency, substance abuse, and depression, even when controlling for socio-economic and other factors. Donor offspring and those who were adopted are twice as likely as those raised by biological parents to report problems with the law before age Donor offspring are about 1.

Donor offspring are more than twice as likely as those raised by biological parents to report substance abuse problems with the adopted falling between the two groups. See Figure 1. Donor offspring born to heterosexual married couples, single mothers, or lesbian couples share many similarities. In our survey, of the donor offspring report they were born to heterosexual married couples, to single mothers, and 39 to lesbian couples.

While at first glance the number of those born to lesbian couples might seem rather small, this study is notable for having even 39 respondents who grew up with this experience. Most studies of the offspring of lesbian or gay parents are based on a smaller or similar number of respondents, and they typically lack the comparison groups that our survey offers. However, we must caution that due to the size of the sample of offspring of lesbian couples, most reported findings related to that particular group can only suggest differences or similarities, although where significant differences emerge they are noted.

All three groups of donor offspring appear fairly similar in a number of their attitudes and experiences. See Table 2. At the same time, there appear to be notable differences between donor offspring born to heterosexual married couples, single mothers, and lesbian couples. Overall, donor conceived persons born to single mothers seem to be somewhat more curious about their absent biological father, and seem to be hurting somewhat more, than those born to couples, whether those couples were heterosexual or lesbian.

Regarding family transitions, the single mothers by choice appear to have a higher number of transitions, although if the single mother married or moved in with someone, that would count as at least one transition. See Figure 3b. Similarly, even with controls, the offspring of single mothers who used a sperm donor to conceive are more than 2.

See Figure 2. However, substantial minorities of those born to lesbian couples still do report distressing experiences and outcomes, for example agreeing that the circumstances of their conception bother them, that it makes them sad to see friends with biological fathers and mothers, and that it bothers them that money was exchanged in their conception. Finally, more than one-third of donor offspring born to lesbian couples in our study agree it is wrong deliberately to conceive a fatherless child.

Donor offspring broadly affirm a right to know the truth about their origins. Depending on which question is asked, approximately two-thirds of grown donor offspring support the right of offspring to have non-identifying information about the sperm donor biological father, to know his identity, to have the opportunity to form some kind of relationship with him, to know about the existence and number of half-siblings conceived with the same donor, to know the identity of half-siblings conceived with the same donor, and to have the opportunity as children to form some kind of relationship with half-siblings conceived with the same donor.

As usual, the main problems include low sperm counts, abnormal sperm function, or blockages. Such problems may be the result of illnesses, injuries, chronic health problems, lifestyle, emotional stress, and even environmental factors. In any of these cases, the sperm washing process may become an effective way out. HIV is present in the plasma and other cells of the seminal fluid. As the sperm washing process separates sperm from the fluid, it removes the infection.

As a result, the technique enables to avoid the risk of infecting the mother as well as the future child. Hope the numbers below will explain it in full. The largest group affected 28, people are those of the reproductive age 15—44 years old. About one-third of them report the desire to have children.

To be more precise, these people are dreaming not of adoption or surrogacy. Their wish is biologic parenthood. In a word, they have the same hopes and intentions about having children as anyone else. Not long ago fathering a genetically related child for HIV-positive men was out of the question. Fortunately, nowadays the situation has changed.

Advanced fertility services have made it possible to fulfill their dreams. Italy was the place where it all started in Nevertheless, time passed. The Italian experience proved to be effective as both mothers and children stayed HIV-negative after the sperm washing technique. As a result, in the first baby conceived thanks to sperm washing was born. Therefore, that year became the milestone for many American HIV discordant couples. When a serodiscordant couple decides to conceive a child, they should visit an egg donor agency or a fertility specialist. The aim is to receive a comprehensive consultation on the all possible solutions for their problem.

Such solutions may include sperm and egg donors as well as participating in IVF programs. In case the couple intends to intrauterine insemination or in vitro fertilization, the preparatory stage will take some time. Consequently, the earlier they start the sooner an HIV-positive will undergo the sperm washing process. As we have already mentioned, lifestyle is one of the main ones. In case the couple wants to have a healthy pregnancy and birth, there are several rules to follow before conceiving. Eat healthy food. Stop smoking. Therefore, future parents should give up smoking to improve the odds of successful conception.

Refuse from alcohol. Unquestionably, alcohol also has a negative effect on conception. Secondly, it can affect the health of an unborn baby. An open-ended interview guideline was used with flexibility for incorporating issues raised relating to the research topic for further exploration. Each interview took, on average, two hours. On a few occasions, we had to arrange several sessions to complete one in-depth interview. We analyzed metaphors described by participants reflecting their experiences and tensions relating to semen.

Referred cultural scripts of participants, such as advertisements for traditional practitioners on sexual health issues, were also analyzed.

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The participants often felt uncomfortable in providing written consent while discussing personal and intimate issues of their sexual lives. This formality appeared as a barrier to developing mutual trust and rapport with the participants. Therefore, verbal affirmation to be interviewed from an adult participant was considered appropriate to begin an interview. This verbal testimony was tape-recorded each time at the beginning of an interview.

Initially, we recruited professional translators to translate the tape-recorded interviews. However, we observed that the translated English version of the interview-texts lost the essence of sociolinguistic meanings and the context of psychosocial concerns of men regarding semen. We decided to transcribe the recorded interviews in the exact form by retaining special local terms and metaphors. Interpretation of data was manually performed by inter-subjective interpretations through examination of various interview-texts and field-diaries. We not only discussed the complex issues with the members of the research team, some informants and key-informants also participated in the analysis process.

We made careful, repeated, and systematic reviews of the transcripts linking them to the research questions and other relevant emerging views as suggested by several scholars 41 , 43 — Note-cards were used for identifying prominent themes, logical connections, clarifications, or relevant comments to assist in explaining similar statements made by informants. We identified and categorized emerging thoughts regarding semen. This process included the identification of salient themes and sub-themes, recurring ideas, meanings or languages, and logical relations linking people and their milieus.

Atypical or diverse data were not disregarded, but presented for analysis. Findings on various diverse perceptions of men about semen were grouped under the following themes: a disease and well-being, b masculinity, and c perspectives of medical practitioners. Perceptions of men were inter-linked with each other within a broader construction of masculinity. The majority of men did not believe that semen contained viruses which could transmit infections to women. Some men claimed that men were not always responsible, rather, in many instances, women were also unfaithful.

I do not think that men can transmit infections to women.

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There is no chance to get infection from faithful wife. However, if wives are unfaithful, they may transmit germs to husbands.

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    Along with traditional medicines, men were advised to take protein-rich diet e. Semen discharged through sexual intercourse, particularly within marital context, was described as normal. Thus, semen loss has societal meanings beyond physical bodies towards masculine discourse of male lives. In a sexually silent society, a physiological phenomenon, such as nocturnal emission, is culturally labelled as shameful. Men described swapno-dosh nocturnal emission and hasto-moithun masturbation as two major ways of semen loss in their lives.

    Although all men experienced an involuntary emission of semen while sleeping i. The first experience of nocturnal emission indicated that someone had reached adulthood and was capable of ejaculating semen during a dream. This involuntary event placed men in a shameful situation as one's sexual maturation and stimulation could not be made public by ejaculating on the bed sheet. Many traditional practitioners advised men that nocturnal emissions could weaken their seminal strength. Masturbation was the most secret sexual pleasure in the life of men and was reported as the first experience of voluntary ejaculation.

    All men spoke of masturbating, although most felt shy in expressing the action. Acknowledging social and religious disapproval, most men reported masturbation as an unavoidable reality in their lives. Findings revealed the following two major propositions:. These men thought that semen loss caused their physical weakness, fatigue, palpitations, loss of interest, headache, abdominal pain, forgetfulness, darkness around eyes, and giddiness.

    Some participants were confused about pre-ejaculatory fluid during sexual excitement. Young men stated that they had a secretion resembling vater mar white discarded sticky watery substance at the end of rice-cooking or chuner pani whitish water of lime taken with betel leaf. It looks like semen. However, I am not sure what it is.

    I am afraid and often lose my erection. Why this fluid comes before penetration? I am unmarried, so what will be my future? Now whenever I think about sex, it comes out. I am scared. This man probably experienced the secretion of pre-ejaculatory fluid, a normal physiological response to sexual stimulation. However, due to lack of information and understanding of sexual physiology, men often reported ambiguous complaints. Men from all backgrounds considered semen the source of physical, sexual and manly strength.

    Such prolonged intercourse is perceived necessary for providing sexual pleasure to women, and this has to be accredited by women. This can seize my power of impregnating my wife. You know that infertile men are not real men. Most men described sex as the way of spending physical energy through ejaculation of semen. Men claimed that 40 drops the range was between 10 and drops of blood are required to form a single drop of semen.

    Men believed that young men could produce semen rapidly because of their age and greater intake of food. Older men suffered from ailments for example, diabetes and hypertension that prevented them from taking nutritious eggs, meat, milk, ghee, and butter and sufficient amounts of food. Some men believed that poor people, who had less access to nutritious food, were not sexually potent. Many men reported that nutritious food could produce more semen to make men as birjoban purush , where birjo means semen, birjoban means someone rich in birjo , and purush means man.

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    Birjoban , thus, also indicates sexually powerful. Men who had less income reported their frustration about physical and sexual weaknesses which might have resulted from their less intake of nutritious food. Fat rich in fat, such as ghee , was considered good for the production of semen. Many believed that poor men have poor quality of semen too. The poor quality of semen could result in the birth of children with poor physical and mental growth. Essentially, their belief was that the quality of semen determines the intellectual quality of children. For a good-quality tree, you need good quality of seeds; similarly, if you want to have good children, you need good quality of semen.

    A child in a poor family infrequently achieves success in professional or family life.

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    Some young men were concerned about the small quantity of their semen per ejaculation. One unmarried man stated that he and his friend had measured the amount of ejaculated semen after masturbation and evaluated their sexual potentia-lity. Most men were unaware of any standard amount of discharged semen per ejaculation. An unmarried man stated: I ejaculate a small amount of semen. I have seen people in pornographic movies ejaculate a huge amount of semen.

    Probably, I have a shortage of semen. I have to marry quickly. Otherwise, after marriage, I will have a shortage of semen. These men were terrified of lacking a sufficient amount of semen. They believed only a finite amount of semen could be stored in the male body. Thus, semen could be automatically discharged while urinating or defaecating which resulted from sexual weakness and diseases making men less masculine. Some newly-married men were concerned about the small amounts of their ejaculated semen.

    They reported that their semen gradually decreased in amount after marriage due to its regular discharge. They were frightened and began taking more nutritious food to increase the production of semen to ensure fatherhood. Some men reported being familiar with these terms which were mentioned in the leaflets of traditional practitioners. A few young men reported experiencing this problem during urination. I sometimes pass semen-like substances during urination in the morning which looks like a thin thread. When I get up in the morning and go for urination, semen-like white fluid passes either before or after urination chikon dharai ber hoi.

    I must be sexually weak. If this continues, stock of my semen will be finished. What will I do in my married life? One doctor has told me to drink less water. Now I am even afraid to urinate. Another doctor said, I had to drink more water. What should I do? Would you kindly suggest me where should I go for treatment? This young man perceived serious physical problems needing appropriate medical investigation. Although he visited doctors, the advice he gained was inconsistent, confusing, and contradictory. His perceptions of decreasing body storage of semen due to passing urine and becoming sexually weak cannot only be analyzed as the sexual health problem of an individual originating from lack of knowledge.

    We need to understand that men's concerns regarding semen storage and its depletion are culturally implanted. Traditionally, semen is considered a source of physical and sexual potency for men, further reinforced by the advertisements of traditional practitioners. Traditional practitioners described nocturnal emissions as symptoms of sexual diseases and dhatu durbolota. I went to a village doctor to get rid of swapno-dosh.

    He stated that it happens due to too much sexual thinking, and it is a sexual disease. He asked me not to think about sex. Believe me, despite having any sexual thoughts, it often happens. I explained, but the doctor did not believe. He laughed and asked me to marry soon. If I lose semen in this way, I will have no semen left for my wife.

    It makes me worried. I heard that my friends had swapno-dosh hardly once a month or less than that. Why do I have so frequent swapno-dosh? We discussed the issue of semen loss with both allopathic STD specialists and traditional practitioners in both urban and rural areas.

    Allopathic physicians dismissed common claim of men that masturbation leads to problems of semen loss. Traditional practitioners supported this belief. There is a limit of production of semen in human body. If a young man is involved in masturbation, his semen, the vital source of energy, will be lost before marriage. Therefore, he will suffer from general weakness, and there are many other side-effects. He may have lost his memory, may not concentrate in his studies, and have acne on his face, and his eyes may be shrunken.

    To produce semen, a person requires taking rich food, and in our poor society, it is not possible for many men to eat nutritious food, so production of semen is hampered. Many may be infertile in future life. Moreover, masturbation is religiously considered a sinful act. Men who engage in it suffer from guilt which is bad for his overall health and well-being. He cannot be able to be a productive citizen.

    These beliefs and propositions were described in the leaflets of traditional practitioners for wide dissemination. Many men self-diagnosed their physical problems as a result of semen loss. A traditional practitioner claimed:. Allopathic doctors only know about syphilis and gonorrhoea, they have few specific antibiotics to treat every problem, and they do not know much about sexual concerns of men and pay little attention to semen loss. Our knowledge is based on reported concerns of men.

    Many men visited these practitioners more often than allopathic doctors on the following grounds:. I first visited an ayurvedic doctor and took his medicines for few months without any significant improvement. I found that he did not understand my problem. He thought that I was suffering from mental problem. He stated that everything was fine with me. He gave me some vitamin tablets, …is not that strange? He labelled me as a psychiatric patient. Then I returned to my ayurvedic doctor, at least he understood my problem.