1. The Coptic Merchents.
1.1. Couple Mikhail and Georgette seeking for IVF and ICSI treatment.
1.2. Georgette: Has a condition with fat on ovaries resulting in ovarian and tubul infertility. Mikhail is a merchant worker and is exposed to chemicals and materials that cause infertility.
2. The Enchantment of Stratified Reproduction
2.1. Wealth
2.1.1. It is more likely that the upper class are like the Western Elite couples.
2.1.2. They are able to afford treatment
2.1.3. Travel abroad to Europe or USA for treatments. "Globalization"- The western technologies are "purchased" by Western sophisticated doctors from Egypt.
2.2. Physician / Patient Relationship.
2.2.1. Many couples seek treatment in other countries because they believe that with modern technology comes a more trust worthy physician.
2.2.2. If the physician is an upper class elite this would make them relatable to patients that are upper class elites thus they have more trust in that physician.
2.3. Stratisfied Reproduction
2.3.1. The privilege of the reproductive trajectories of the elites over the poor and disenpowered whose right to reproduce may be questioned.
3. The public Private Debate
3.1. Private Hospitals
3.1.1. Hospitals that are well equpided with the newest technologies.
3.1.2. They have support from the government with funds and such.
3.1.3. Usually only couples of higher class are able to afford to attend these hospitals for IVF and ICSI treatments due to costs of treatments.
3.2. Public Hospitals
3.2.1. Public hospitals are well equpided with new technologies as well. They have plenty of room for couples for treatments of all kind, except for fertility treatment.
3.2.2. There is no government support for public hospitals. There is no money funded for IVF in hospitals even though the money is there. There is even no problem to get new technologies from the Westerns.
4. The Three-Tiered System
4.1. IVF accessibility is based off of the class of the couples.
4.1.1. Three Classes: 1. The Elites. 2. Middle Class. 3. Lower Class/ masses.
4.1.2. Treatments for Egypt must be payed for immediately. In Egypt insurance companies are uncommon and they do not have credit cards because Egyptian law prohibits it.
4.2. Lower Class
4.2.1. It is rare for these women to be able to go through IVF treatments because of their lack of money.
4.2.2. Ways that this class will pay for treatments; Getting funds through charity, sell everything they own and having the money loaned to them or to try cheaper treatments such as artificial insemination.
4.2.3. It is believed that this class does not "deserve" to have children. That because they can barley afford to live on their own what gives them the right to bring a child into the world. Also that these test tube babies will not be good contributors to the future of Egypt.
4.3. Middle Class
4.3.1. This class is well represented in the IVF treatment. Even though they are able to afford it, money is still the #1 constraint but not as bad as the lower class.
4.3.2. The people are educated but still have a low pay. The average US will earn $1,892/month while in Egypt they will earn only $88/month.
4.3.3. These people like lower class will borrow money from family or sell just about everything they have such as gold jewelry to afford treatments.
4.3.4. Couples will migrate for work to the Arab Gulf states or Saudi Arabia in order to afford treatments. "No labor migration, no IVF"
4.4. Upper Class
4.4.1. The majority of the women of this class did not gain their wealth by inheritance or by their husbands but by their own career success.
4.4.2. Of the 66 women studied in Egypt doing IVF treatments, 1/3 of them were upper class.
4.4.3. No matter the career aspirations or even the desire for children these women still have little choice but to have to pursue mother hood. Unlike in Western worlds where women have the choice.
4.4.4. "Therapeutic Transitionalism" is very common for the elite class to travel to Europe or America. Although some choose not to for varies reasons; sense of pride for Egypt, logistical and moral reasons, doctor patient relationship.
4.4.4.1. Major Reason: Egyptian couples who are considered wealthy elites do not travel to other countries for treatment due to the major difference in Economy class between the two. A wealthy person in Egypt would not be considered that in the US and thus could not simply afford those treatments.
5. Knowledge
5.1. Problems of Procreative Knowledge:
5.1.1. There is a major difference is knowledge about the human body and its procreative processes.
5.1.2. Related to the class of people
5.1.2.1. People of lower class not only lack access to capital but also have bliefs about human reproduction and technologies that prevent these couples from IVF treatment.
5.1.2.2. The "fact" that was discovered that both egg and sperm are involved in procreation is not a cultural script of lower class Egyptians.
5.1.3. "Monogenetic"
5.1.3.1. It is believed that procreation is "monogenetic"- the idea that it is men not men and women that bring forth new life
5.1.3.2. The men are the creators of life; they are the true "blood" relatives of their children.
5.1.4. Lesser educated citizens are "scientifically literate" in their own right.
5.1.4.1. There are many models of monogenetic that are still among the Egyptian masses.
5.1.4.2. "Preformation" modles were widly accepted in Europe. This arrival lent considerable support to monogeneitc models.
5.1.5. Having Education or Lacking Education
5.1.5.1. Educated Egyptians from lower to middle upper class are exposed to Western style science. Thus they have learned the model of procreation and women as "egg producers." If they egg is absent then their is no possibility to create life.
5.1.5.2. The lesser educated people are less likely to expose the idea that are of egg producers.
5.1.5.2.1. This lack of acceptance of a women's egg could be a leading reason as to why women are more likely to be blamed for not being able to procreate.
5.2. Mortality and Scientific Literacy
5.2.1. A major concern with procreation is that IVF occurs separate from sex.
5.2.1.1. It is not the idea that sex is being disrupted that raises so much concern it is the idea of what goes on during in vitro/ outside of the body. Some men fear that something could happen to their sperm such as getting it mixed with another mans sperm.
5.2.1.2. Gender Diminsions: Women are more concerned that of the "artificiality" of the fetuses created. This appears to not be natural thus not okay. Because the fetus would not be within the females body the baby could be considered as a "stranger" even if it involved both male sperm and female egg. This occurs from a lack of general knowledge of how IVF works.
5.3. Aquiring Scientific Literacy
5.3.1. More and more Egyptian couples have been willing to undergo treatments of IVF due to their acquired knowledge of and moral acceptance of these technologies.
5.3.2. Men and women were both able to explain how the IVF treatments worked in detail and also explain why this technology was necessary to overcome infertility.
5.4. Path of Knowledge: How people acquired the information and misinformation about these technologies.
5.4.1. Lower class
5.4.1.1. The lower class are majority uneducated and thus illiterate in both english and Arabic. They are unable to acquire knowledge through printed information. Instead they gain their knowledge from the physicians and must relay entirely on broadcasting.
5.4.2. Middle to Upper Class
5.4.2.1. These people are of educated and literate people so they do everything they can to read everything about these new treatments.
5.4.2.1.1. Ex. of reading material: Newspapers, magazines, articles, books written by physicians, Arabic speaking audiences ect.
5.4.2.2. These women are proud to simply be "readers" and "self-educators"
5.5. Scientific literacy in a Mass-Mediated Society
5.5.1. Media in Egypt is one of the major and main reasons and resources to educated people on the subject of health.
5.5.2. Why the media is so good in Egypt.
5.5.2.1. Media in Egypt is nothing new. Their history of film production dates back to 1930's. Egypt is considered both "Hollywood" and "CNN" of the middle east.
5.5.2.2. Because there is a relatively long exposure to television, the viewing audience is considered to be potentially quite sophisticated.
5.5.2.3. There are televisions is nearly every Egyptian home.
5.5.3. "Spreading the word" about test tube baby making.
5.5.3.1. 1. Media have promoted awareness of the new reproductive technologies. Showing the presence of these technologies in their country.
5.5.3.2. 2. Media have provided publicity of specific IVF centers.
5.5.3.3. 3. Media have covered ongoing developments in the global arena, providing international news service accounts of new uses of the reproductive technologies in other countries.
5.5.3.4. 4. From ongoing coverage the media have made these new reproductive technologies "normal" over time.