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Institutional theorists treat law and regulations as external factors that is part of the organization’s environment. While institutional theory has been criticized for its inability to recognize the role of agents and to theorize agency, the growing literature on institutional work and institutional entrepreneurship, partially informed by and co-produced with practice theory, advances a more dynamic view of processes of institutionalization. In order to cope with legal and regulatory frameworks, constituting the legal environment of the organization, there are evidence of organizational responses in the form of bargaining, political negotiations, and decoupling of organizational units and processes. The purpose of this paper is to report how legal and regulatory frameworks both shape clinical practices while at the same time they are also informed by the activities and interests of professional communities and commercial clinics.

This paper reports an empirical study of the Swedish-assisted conception industry and is based on a case study methodology including the use of interviews and formal documents and reports issues by governmental agencies.

The empirical material demonstrates how scientists in reproductive medicine and clinicians regard the legal and regulatory framework as what ensures and reinforces the quality of the therapies. At the same time, they actively engage to modify the legal and regulatory framework in the case when they believe it would benefit the patients. The data reported presents one successful case of how PGD/PGS can be used to develop the efficacy of the therapy, and one unsuccessful case of regulatory change in the case of patient interest groups advocating a legalization of commercial gestational surrogacy. In the former case, scientific know-how and medicinal benefits served to “push” the new clinical practice, while in the latter case, the “demand-pull” of patient interest groups fails to get recognition in regulatory and policy-making quarters.

The study contributes to the literature on agency in institutional theory (e.g. the emerging literature on institutional work) by emphasizing how legal and regulatory frameworks are in a constant process of being modified and negotiated in the face of novel technoscientific practices and social demands. More specifically, this process include many scientific, technological, economic, political and social relations and resources, making the legal environment of organizations what is the outcome from joint negotiations and agreements across organizational and professional boundaries.

The purpose of this paper is to offer a Christian perspective on the ethical issues related to natural procreation and artificial reproduction methods.

This paper uses descriptive and comparative methodology between the ethical aspects specific to natural procreation and artificial reproduction.

Religious beliefs play a significant role in shaping the moral perspective when an infertile couple is confronted with the choice between natural procreation and artificial reproduction.

This paper survey a broad bibliography and offers a critical evaluation of the moral aspects specific to different methods of reproductive technologies compared to the natural procreation approach.

The purpose of this paper is to compare user involvement in the case of assisted reproductive technologies in England and Portugal through the concepts of voice, choice and co-production, assessing the implications for user empowerment.

This qualitative study draws primarily on policy review and uses exploratory semi-structured interviews with key informants as a way of illustrating points. Data on the following themes was compared: voice (users’ representativeness on licensing bodies and channels of communication between users and doctors); choice (funding and accessibility criteria; choice of fertility centres, doctors and level of care); and co-production (criteria through which users actively engage with health professionals in planning the treatment).

Inter- and intra-healthcare systems variations between the two countries on choice and co-production were identified. Differences between funding and accessibility, regions, public and private sectors and attitudes towards doctor-patient relationship (paternalistic/partnership) were the key issues. Although consumer choice and indicators of co-production are evident in treatment pathways in both countries, user empowerment is not. This is limited by inequalities in accessibility criteria, dependence on doctors’ individual perspectives and lack of genuine and formal hearing of citizens’ voice.

Enhancing users’ involvement claims for individual and organizational cultures reflecting user-centred values. Effective ways to incorporate users’ knowledge in shared decision making and co-design are needed to empower patients and to improve the delivery of care.

This study aims to examine the research productivity and network visualisation on reproductive health (RH) domain with several bibliometric indicators and applied visualisation approach in co-authorship, citation, co-occurrence of keywords and bibliographic coupling analysis in the area of RH.

This study used bibliometric indicators to determine the highly productive authors, source title, documents and organisations. This study used Web of Science database and retrieved a total of 18,186 scientific publications on the domain of RH published during the period of 2010–2020. Data analysis was also performed using VOS viewer software and RStudio.

The findings discovered the increasing trends of research publications in reproductive health in past ten years. The USA UK, China and Australia were the top four productive countries in terms of publishing research in the arena, and “Kishsin DM” and “Hauser R” have secured in top two positions under highly prolific authors category. University of California, Harvard University and University of London were observed under the top three productive institutions in the domain. This study also revealed association and collaboration among authors, country and institutions in the visualisation analysis. The core findings of co-occurrence of keywords emphasised that “RH,” “assisted reproductive technology,” “women,” “pregnancy” and “in-vitro fertilization” were established frequently used keywords and have robust link strength.

The findings will be helpful to the researchers to know about the status of latest trends and development of the domain. This study is also helpful to the library authority for collection development in the specific subject domain.

To the best of the authors’ knowledge, there was no past study found on the evaluation of research productivity and network visualisation in the domain of RH, which is a globally important issue.

The purpose of this paper is to examine marketing tactics used in the clinic websites of cross-border reproductive care (CBRC) providers and analyse what ethical implications exist when targeting the vulnerable consumer group of infertility sufferers.

The sampling design was to collect clinic websites from regions known to be popular destinations for CBRC, and who were marketing directly to US-based consumers through their online websites. There were three stages of data collection: organic Google search that displayed Google AdWords of clinics who advertised; organic Google search results; and searching via the WhatClinic.com database for additional private clinics with websites. The websites were then audited for their marketing tactics according to the best practice guidelines from the American Medical Association, American College of Obstetricians and Gynaecologists, ethics committee of the American Society for Reproductive Medicine (ASRM).

Through this analysis, it was confirmed that these clinics are attempting to establish their credibility and attract foreign consumers through their promised rates of success, years of experience and use of testimonials. In total, 32 of the 35 sites contained at least one factor considered misleading by ASRM guidelines, such as the publishing of inaccurate or non-transparent success rates, the use of sales promotions and guarantees often used in consumer products, or the use of misleading language. Out of the 24 sites that posted success rates, 17 of those rates would be considered deceptive by not clarifying the source of the numbers or by being so far from the global averages of 30 per cent.

Marketing practitioners have a specific responsibility to recognise vulnerable market segments; therefore this initial study seeks to add to the understanding of consumer vulnerability through an intersectional view of global reproductive service consumption.

A global standard of marketing guidelines specific to CBRC clinics needs to be implemented across all regional/countries in order to communicate ethically, improve credibility, reputation and trust among consumer and international bodies. Counselling services need to be integrated within all assisted reproductive technology services. Service-country to home-country continued care protocols should be created for patients travelling home in order to collect data on CRBC experiences.

This study contributes to the CBRC literature in providing new insights into current clinic marketing trends and highlights ethical implications to industry stakeholders.

The aim of this article is to review the literature on fertility tourism in terms of social policy implications. There has been a global growth in interest in fertility tourism, especially amongst these in developed countries travelling to developing countries for fertility needs. Due to women's increased involvement in the workforce and changing societal norms, the age at which females start having children has risen resulting in a need for many to seek fertility help. These developments have led to a growth in fertility tourism and related services.

The authors undertake a systematic literature review on fertility tourism to identify cognate research themes that relate to social policies such as assisted reproduction facilities, medical tourism and changing societal attitudes.

The findings of the study have important implications for social policy particularly regarding the tourism and health industry, practitioners and policymakers. This involves focussing on new geographic regions that are underrepresented in current research but have a high interest in fertility tourism. Currently much of the research is centred around western contexts but as evident in our review newly emerging markets in countries that have high infertility rates requires further attention. In addition, the authors provide directions for future research avenues that focus on how to evaluate changing social policies with regards to reproductive choices.

Whilst there has been much discussion in the media about fertility tourism there is limited knowledge about social policies related to human reproductive systems, so this article is amongst the first to discuss societal implications.

The purpose of this paper is to explore factors influencing decision making about disclosure of assisted reproductive technology (ART) use in the workplace.

A qualitative study design was used. In total, 31 women and 6 men who were using or had recently used ART were recruited from British fertility networks and interviewed. Data were transcribed verbatim and thematically analysed.

Two main strands were identified each encompassing two themes: “Concerns about disclosure” covered the very personal nature of disclosing ART treatment and also career concerns and “Motives for disclosure” covered feeling which was necessary to disclose and also the influence of workplace relationships.

The relatively small, self-selected sample of participants was recruited from fertility support networks, and lacked some diversity.

Clarity about entitlements to workplace support and formal protection against discrimination, along with management training and awareness raising about ART treatment is needed to help normalise requests for support and to make decisions about disclosure within the workplace easier.

The study has highlighted an understudied area of research in ART populations. The data provide insight into the challenging experiences of individuals combining ART with employment and, in particular, the complexity of decisions about whether or not to disclose.

There is abundant research on surrogacy; however, migration scholars have not addressed surrogacy-driven migration. Policies related to surrogacy and surrogacy-led migration are under-researched. The paper argues that surrogacy-led migration or fertility/reproductive migration constitutes a significant part of mainstream migration. The purpose of this paper is to reflect on the policy dilemmas in various countries.

A total of 9 surrogate mothers (4 from India; 2 from Thailand, 2 from Indonesia and 1 from Nepal) and 8 commissioning parents (2 from Japan; 4 from Europe; 1 from the USA; 1 from Australia) and 2 doctors (1 from India and 1 from Thailand) selected on snowball basis were interviewed between 2014 and 2016 by using a checklist.

The deficiency and inconsistency of laws regarding surrogacy facilitated the growth of the surrogacy market. Therefore, a uniform policy would help to define and improve the surrogacy and surrogacy-led migration management.

This paper demonstrates the interplay of surrogacy and mainstream migration. This is a fresh addition to the study of migration.

Expert systems have come to the forefront in the modeling of problems. One of the major problems facing the expert system designers is to develop an accurate knowledge base and a meaningful model of uncertainty associated with complex models. Decision-making is based on knowledge, and decision system support needs a knowledge base as well. An adequate knowledge acquisition (KA) process leads to accurate knowledge and improves the decision-making process. To manage the risk of a medical service (twin pregnancy in this case) a knowledge management system was created. The captured knowledge may be associated with an uncertainty. This study aims to introduce a method for evaluating the reliability of a tacit KA model. It assisted engineering managers in assessing and prioritizing risks. The study tried to use this method in risk management and new case in the health domain.

In this study, relevant variables were identified in the knowledge management literature reviews and the domain of expertise management. They are validated by a group of domain experts. Kendall’s W indicator was used to assess the degree of consensus. On the basis of combined cognitive maps, a cognitive network was constructed. Using Bayesian belief networks and fuzzy cognitive maps, an uncertainty assessment method of tacit KA was introduced. To help managers focus on major variables, a sensitivity analysis was conducted. Reliability of model was calculated for optimistic and pessimistic values. The applicability and efficacy of the proposed method were verified and validated with data from a medical university.

Results show that tacit KA uncertainty can be defined by independent variables, including environmental factors, personality and acquisition process factors. The reliability value shows the accuracy of the captured knowledge and the effectiveness of the acquisition process. The proposed uncertainty assessment method provides the reliability value of the acquisition model for knowledge engineers, so it can be used to implement the project and prevent failures in vital factors through necessary actions. If there is not a satisficed level of reliability, the KA project reliability can be improved by risk factors. The sensitivity analysis can help to select proper factors based on the resources. This approach mitigated some of the disadvantages of other risk evaluation methods.

The contribution of this study is to combine the uncertainty assessment with tacit KA based on fuzzy cognitive maps and the Bayesian belief networks approach. This approach used the capabilities of both narrative and computational approaches.

This study examines the relationship between the dimensions of fertility care quality and the dimensions of experiential relationship marketing in fertility tourism.

The data used in this study were based on a sample of 532 Mainland Chinese fertility tourists who received fertility care services in eight private fertility clinics in four Malaysian states, indicating that the proposed model fitted the data.

Findings show that the dimensions of fertility care quality (professional skills, patient orientation and physical comfort) and experiential value positively influence experiential satisfaction. Additionally, experiential trust is positively influenced by both experiential satisfaction and experiential value. Also, experiential commitment is positively influenced by experiential satisfaction, experiential trust and experiential value.

Fertility tourism service providers could focus on refining the dimensions of fertility care quality to improve experiential relationship marketing.

This paper provides the data that result in a better understanding of the relationship between the dimensions of fertility care quality and the dimensions of experiential relationship marketing in fertility tourism.