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Gat I, Ronen M, Avraham S, Youngster M, Hourvitz A, Levtzion-Korach O. Israeli students' perceptions regarding sperm donation: dilemmas reflections with dominant demographic effect. Reprod Health 2024; 21:37. [PMID: 38500168 PMCID: PMC10946193 DOI: 10.1186/s12978-024-01767-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 03/02/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Sperm donation has undergone significant medical and social transformations in recent decades. This study aimed to explore Israeli students' perceptions towards sperm donation and investigate the potential influence of demographic characteristics on these perceptions. DESIGN The study encompassed 254 students from Tel-Aviv University, who completed an anonymous online survey in January-February 2021. This cross-sectional quantitative online survey, comprised 35 questions categorized into three sections: demographic data, assessment of prior knowledge, and perceptions of sperm donation (general perceptions related to both positive and negative stigmas associated with sperm donation, the roles and activities of sperm banks, and considerations surrounding identity disclosure versus the anonymity of sperm donors and their offspring). RESULTS Participants exhibited a relatively low level of prior knowledge (mean 31.2 ± 19 of 100). Scores for positive and negative stigmas ranged from 1.3 to 2.2. Notably, the statement "Donors' anonymity preservation is crucial to maintain sperm donation" received a mean of 3.7. Seeking for anonymous sperm donation identity both by recipients and offspring was ranked with low means (1.5 and 1.7, respectively). However, the pursuit of half-siblings by mothers or siblings themselves received higher ratings ranging from 2.7 to 3. Women's stigma ranking were notably lower, while men emphasized the importance of donor anonymity. CONCLUSIONS Sperm Banks hold a position of medical authority rather than being perceived as being commercial entity. The preservation of donor anonymity is widely accepted as a crucial element, prioritized over the requests for identity disclosure from recipients and offspring. Demographic parameters exhibit a strong and precise effects on participants' perceptions.
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Affiliation(s)
- Itai Gat
- Sperm Bank & Andrology Unit, Shamir Medical Center, Zrifin, Israel
- IVF Department, Shamir Medical Center, Zrifin, Israel
- Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Maya Ronen
- Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel.
- Obstetrics and Gynecology Department, Shamir Medical Center, Zrifin, Israel.
| | - Sarit Avraham
- IVF Department, Shamir Medical Center, Zrifin, Israel
| | | | - Ariel Hourvitz
- IVF Department, Shamir Medical Center, Zrifin, Israel
- Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Osnat Levtzion-Korach
- Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel
- Shamir Medical Center, Zrifin, Israel
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Wodoslawsky S, Fatunbi J, Mercier R, Braverman AM. Sperm donor attitudes and experiences with direct-to-consumer genetic testing. F S Rep 2023; 4:36-42. [PMID: 36959965 PMCID: PMC10028474 DOI: 10.1016/j.xfre.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/19/2022] [Accepted: 12/19/2022] [Indexed: 03/12/2023] Open
Abstract
Objective To identify factors influencing sperm donor willingness to participate in direct-to-consumer genetic testing, comfort with sharing genetically identifiable data in commercial genetic testing databases, and likelihood to donate sperm again. Design Cross-sectional online anonymous survey. Setting Multicenter, 2 large American sperm banks from July 1, 2020 to July10, 2021. Patients Sperm donors from 1980 to 2020. Interventions None. Main outcome measures Associations between donor demographic characteristics, donation history, and attitudes toward direct-to-consumer genetic testing. Results A total of 396 donors completed the survey. Most donations (61.5%) occurred from 2010 to 2020, and 34.3% were nonidentified donations. Nonidentified donors were less comfortable with their genetic data being shared than open-identity donors (25.4% vs. 43.8%) and were less likely than open-identity donors to donate sperm again (43.3% vs. 72.1%). Donors who donated after the inception of direct-to-consumer genetic testing in 2007 were less likely to participate in commercial genetic testing than those who donated before 2007 (25.8% vs. 37.1%). Most donors (87.4%) have disclosed their donation(s) to current partners, but fewer have disclosed them to their families (56.6%) or children (30.5%). Of the donors who had been contacted by donor-conceived persons, 79.5% were identified via direct-to-consumer genetic testing. Overall, 61.1% of donors would donate again regardless of direct-to-consumer genetic testing. Conclusions Direct-to-consumer genetic testing is playing a dynamic role in sperm donor identification, but donors seem willing to donate again. Implication counseling regarding future linkage and contact from donor-conceived persons needs to be standardized for potential donors before donation.
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Affiliation(s)
- Sascha Wodoslawsky
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Joy Fatunbi
- Department of Obstetrics and Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Rebecca Mercier
- Department of Obstetrics and Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Andrea Mechanick Braverman
- Department of Obstetrics and Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
- Reprint requests: Andrea Mechanick Braverman, Ph.D., Department of Obstetrics and Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, 833 Chestnut Street, Mezzanine, Philadelphia, Pennsylvania 19004.
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Scheib JE, McCormick E, Benward J, Ruby A. Finding people like me: contact among young adults who share an open-identity sperm donor. Hum Reprod Open 2020; 2020:hoaa057. [PMID: 33585704 PMCID: PMC7872122 DOI: 10.1093/hropen/hoaa057] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 10/08/2020] [Indexed: 01/31/2023] Open
Abstract
STUDY QUESTION What interests and experiences do donor-conceived adults have with respect to same-donor peers/siblings, when they share an open-identity sperm donor? SUMMARY ANSWER Donor-conceived young adults report considerable interest in, and primarily positive experiences with, their same-donor peers, with some finding ‘people like me’. WHAT IS KNOWN ALREADY Through mutual-consent contact registries, director-to-consumer DNA testing and other means, donor-conceived people with anonymous (i.e. closed-identity) sperm donors are gaining identity-related information from, and establishing relationships with, people who share their donor. STUDY DESIGN, SIZE, DURATION Semi-structured, in depth telephone and Skype interviews with 47 donor-conceived young adults were carried out over a 31-month period. Inclusion criteria were being one of the first adults for each donor to obtain their identity and being at least 1-year post donor-information release. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants (aged 19–29 years, 68.1% women) were born to female same-sex couple parents (46.8%), a single mother (29.8%) or heterosexual couple parents (23.4%); all parents had conceived through the same US open-identity sperm donation program. The dataset was analyzed thematically and included interviews from only one participant per family. Each participant had a different donor. MAIN RESULTS AND THE ROLE OF CHANCE Interest in, and experiences with, same-donor peers suggested that they occupy a unique position in the lives of donor-conceived young adults who share their open-identity donor. Contact can provide identity-relevant information and support through the availability of relationships (whether actualized or potential), shared experiences, and easier relationships than with their donor. Most donor-conceived young adults felt positively about their contact experiences. Of those not yet linked, almost all expressed an interest to do so. Some had met the children raised by their donor. When asked, all expressed an interest in doing so. LIMITATIONS, REASONS FOR CAUTION Interviews were conducted with donor-conceived young adults who were uncommon in their generation in terms of: having an open-identity sperm donor; the majority knowing about their family’s origins from childhood; and having parents that accessed at the time one of the only open-identity sperm donation programs. Further research is needed to assess applicability to all donor-conceived adults; findings may be more relevant to the growing number of people who have an open-identity donor and learned in childhood about their family’s origins. WIDER IMPLICATIONS OF THE FINDINGS Participants were among the first generation of donor-conceived adults with an open-identity sperm donor. Their experiences and perspectives can provide essential guidance to programs and others with similar origins. Early disclosure of family origins and identifying the donor did not diminish the young adults’ interest in their same-donor peers. Positive experiences suggest that the benefits of contact include not only identity-relevant information (through shared traits and experiences), but also relationships with and support from people who understand the uncommon experience of being donor conceived. Implications include the need to educate families and intended parents about the potential benefits of knowing others who are donor conceived, and the risk of unexpected linking across families by donors, regardless of donor-conceived person or family interest. STUDY FUNDING/COMPETING INTEREST(S) The study was funded by the Lesbian Health Fund of GLMA: Health Professionals Advancing LGBTQ Equality. The authors have no conflict of interest to declare.
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Affiliation(s)
- J E Scheib
- Psychology Department, University of California, Davis, Davis, CA, USA.,The Sperm Bank of California, Berkeley, CA, USA
| | - E McCormick
- University of California Davis Medical Center, Sacramento, CA, USA
| | - J Benward
- Private Practice, San Ramon, CA, USA
| | - A Ruby
- The Sperm Bank of California, Berkeley, CA, USA
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Pasch LA. New realities for the practice of egg donation: a family-building perspective. Fertil Steril 2019; 110:1194-1202. [PMID: 30503105 DOI: 10.1016/j.fertnstert.2018.08.055] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 08/24/2018] [Accepted: 08/29/2018] [Indexed: 10/27/2022]
Abstract
The practice of egg donation in the United States has been based on assumptions about secrecy, anonymity, and contact among the parties that require reexamination. This article argues for the need to acknowledge that secrecy and anonymity are no longer viable assumptions and that all parties may have a strong interest in contact and connection. A shift in the narrative for the practice of egg donation from a purely medical perspective to a broader family-building perspective is described. Significant practice changes to accommodate the new realities, rooted in a family-building perspective, are outlined in the arenas of medical record retention, informed consent, recipient and donor preparation and counseling, facilitation of contact among the parties, and outreach to other medical professionals, with the goal of promoting not only healthy pregnancy, but also long-term positive family functioning.
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Affiliation(s)
- Lauri A Pasch
- Departments of Psychiatry and Obstetrics, Gynecology, and Reproductive Science, University of California, San Francisco, California.
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5
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Informing offspring of their conception by gamete or embryo donation: an Ethics Committee opinion. Fertil Steril 2018; 109:601-605. [DOI: 10.1016/j.fertnstert.2018.01.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 01/03/2018] [Indexed: 11/19/2022]
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Bracewell-Milnes T, Saso S, Abdalla H, Thum MY. A systematic review investigating psychosocial aspects of egg sharing in the United Kingdom and their potential effects on egg donation numbers. HUM FERTIL 2017; 21:163-173. [PMID: 28549399 DOI: 10.1080/14647273.2017.1329554] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This review aims to provide an up-to-date knowledge of the psychosocial aspects of egg donation from the perspectives of the egg share donor and their recipient. It explores the motives, experiences and attitudes of egg sharers and their views towards donor anonymity and disclosure. Conclusions are made on how these findings can guide clinical practice and improve egg sharing numbers. A systematic search of peer-reviewed journals of four computerized databases was undertaken. Eleven studies were included in the review. Psychosocial aspects towards donation were positive from the egg share donor and recipient. Concerns raised were whether participating in the egg sharing scheme would impact on their success rates, as well as frustration expressed by a minority regarding the lack of knowledge of egg sharing outside of fertility clinics. The 2005 legislative changes in the UK have not caused the anticipated dramatic decrease in egg donation; however, oocyte donation still falls short of demand. Egg sharing provides a practical option for more patients to access IVF, whilst also providing more donor oocytes. Improved information provision will result in greater awareness of egg sharing, with the potential to recruit more donors and meet the needs of recipients currently on long waiting lists.
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Affiliation(s)
- Timothy Bracewell-Milnes
- a Division of Surgery and Cancer, Institute of Developmental Reproductive & Developmental Biology , Imperial College London , London , UK
| | - Srdjan Saso
- a Division of Surgery and Cancer, Institute of Developmental Reproductive & Developmental Biology , Imperial College London , London , UK
| | - Hossam Abdalla
- b Fertility Specialist , The Lister Hospital , London , UK
| | - Meen-Yau Thum
- b Fertility Specialist , The Lister Hospital , London , UK
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Whyte S, Torgler B, Harrison KL. What women want in their sperm donor: A study of more than 1000 women's sperm donor selections. ECONOMICS AND HUMAN BIOLOGY 2016; 23:1-9. [PMID: 27359087 DOI: 10.1016/j.ehb.2016.06.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 05/24/2016] [Accepted: 06/12/2016] [Indexed: 06/06/2023]
Abstract
Reproductive medicine and commercial sperm banking have facilitated an evolutionary shift in how women are able to choose who fathers their offspring, by notionally expanding women's opportunity set beyond former constraints. This study analyses 1546 individual reservations of semen by women from a private Australian assisted reproductive health facility across a ten year period from 2006 to 2015. Using the time that each sample was available at the facility until reservation, we explore women's preference for particular male characteristics. We find that younger donors, and those who hold a higher formal education compared to those with no academic qualifications are more quickly selected for reservation by women. Both age and education as proxies for resources are at the centre of Parental Investment theory, and our findings further build on this standard evolutionary construct in relation to female mate preferences. Reproductive medicine not only provides women the opportunity to become a parent, where previously they would not have been able to, it also reveals that female preference for resources of their potential mate (sperm donor) remain, even when the notion of paternal investment becomes redundant. These findings build on behavioural science's understanding of large-scale decisions and human behaviour in reproductive medical settings.
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Affiliation(s)
- Stephen Whyte
- School of Economics and Finance, Queensland University of Technology, Gardens Point, 2 George St., Brisbane, QLD 4001, Australia.
| | - Benno Torgler
- School of Economics and Finance, Queensland University of Technology, Gardens Point, 2 George St, Brisbane, QLD 4001, Australia; and CREMA-Center for Research in Economics, Management and the Arts, Switzerland.
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8
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Scheib JE, Ruby A, Benward J. Who requests their sperm donor's identity? The first ten years of information releases to adults with open-identity donors. Fertil Steril 2016; 107:483-493. [PMID: 27887716 DOI: 10.1016/j.fertnstert.2016.10.023] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 10/15/2016] [Accepted: 10/16/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To report findings from 10 years of requests from adults eligible to obtain their open-identity sperm donor's information. DESIGN Analysis of archived family and donor data. Semistructured interviews at information releases. SETTING Not applicable. PATIENT(S) A total of 85 DI adults requesting 43 donor identities; program data on 256 DI families. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) We identified [1] demographic predictors of requesting donor identities, [2] information release timing and length, and [3] request motives. RESULT(S) Just >35% of eligible DI adults requested their donor's identity. Adults ranged from 18-27 years, requesting at median age 18 years. More women than men requested. Proportionally fewer adults requested when they had heterosexual-couple parents, and proportionally more when they had one rather than two parents. In interviews, the common theme was wanting to know more about the donor, especially about shared characteristics. Most adults planned to contact their donor. More than 94% of adults had donors who were open to contact; adults expressed modest expectations about this contact. CONCLUSION(S) In 2001, the first adults became eligible to obtain their open-identity sperm donor's information. Ten years of identity requests at one program indicates that information about one's donor is important to a significant proportion of these DI adults. Most requested their donor's identity soon after becoming eligible, suggesting some urgency to wanting the information. Interview data highlighted the role of donor information in helping adults better understand themselves and their ancestry. Findings hold important implications for practice and policy.
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Affiliation(s)
- Joanna E Scheib
- Department of Psychology, University of California, Davis, California; The Sperm Bank of California, Berkeley, California.
| | - Alice Ruby
- The Sperm Bank of California, Berkeley, California
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9
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Bracewell-Milnes T, Saso S, Bora S, Ismail AM, Al-Memar M, Hamed AH, Abdalla H, Thum MY. Investigating psychosocial attitudes, motivations and experiences of oocyte donors, recipients and egg sharers: a systematic review. Hum Reprod Update 2016; 22:450-65. [DOI: 10.1093/humupd/dmw006] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 02/15/2016] [Indexed: 11/12/2022] Open
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Crawshaw M, Daniels K, Adams D, Bourne K, van Hooff J, Kramer W, Pasch L, Thorn P. Emerging models for facilitating contact between people genetically related through donor conception: a preliminary analysis and discussion. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2015; 1:71-80. [PMID: 29911188 PMCID: PMC6001351 DOI: 10.1016/j.rbms.2015.10.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 08/07/2015] [Accepted: 10/14/2015] [Indexed: 05/18/2023]
Abstract
Previous research indicates interest among some donor-conceived people, donors and recipient parents in having contact. Outcomes of such contact appear largely, but not universally, positive. This paper seeks to understand better the characteristics of associated support services. Information gathered using the authors' direct experiences and professional and personal networks in different parts of the world indicates the emergence of four main groupings: (i) publically funded services outside of treatment centers; (ii) services provided by fertility treatment or gamete bank services; (iii) services provided privately by independent psychosocial or legal practitioners; and (4) services organized by offspring and/or recipient parents. Key operational features examined were: (i) who can access such services and when; (ii) what professional standards and funding are in place to provide them; and (iii) how 'matching' and contact processes are managed. Differences appear influenced variously by the needs of those directly affected, local policies, national legislation and the interests of the fertility services which recruit gamete donors and/or deliver donor conception treatments. The paper is intended to inform fuller debate about how best to meet the needs of those seeking information and contact, the implications for the way that fertility treatment and gametes donation services are currently provided and future research needs.
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Affiliation(s)
- Marilyn Crawshaw
- Department of Social Policy and Social Work, University of York, UK
- Corresponding author.
| | - Ken Daniels
- School of Social Work and Human Services, University of Canterbury, Christchurch, New Zealand
| | - Damian Adams
- School of Nursing and Midwifery, Flinders University, SA 5042, Australia
| | - Kate Bourne
- Victorian Assisted Reproductive Treatment Authority, Melbourne, Australia
| | | | - Wendy Kramer
- Donor Sibling Registry, Nederland, CO 80466, USA
| | - Lauri Pasch
- Departments of Psychiatry and Obstetrics, Gynecology and Reproductive Science, University of California San Francisco, USA
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Zadeh S, Freeman T, Golombok S. Absence or presence? Complexities in the donor narratives of single mothers using sperm donation. Hum Reprod 2015; 31:117-24. [PMID: 26545622 PMCID: PMC4677963 DOI: 10.1093/humrep/dev275] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 10/07/2015] [Indexed: 12/16/2022] Open
Abstract
STUDY QUESTION How do single mothers who have conceived a child via anonymous or identity-release sperm donation represent the donor? SUMMARY ANSWER While the majority of mothers described their anonymous and identity-release donors as symbolically significant to their families, others were more likely to emphasize that their lack of information limited their thoughts about him. WHAT IS KNOWN ALREADY There is limited understanding of the factors that impact upon how single mothers represent the donor, and whether or not they are determined by specific donor programmes (anonymous or identity-release). STUDY DESIGN, SIZE, DURATION Qualitative interviews were conducted with 46 women who had treatment at a UK licensed fertility clinic during the years 2003–2009. Twenty mothers (43%) had used an anonymous donor, and 26 (57%) had used an identity-release donor. PARTICIPANTS/MATERIALS, SETTING, METHODS Among the 46 mothers interviewed, all had at least one child conceived via donor insemination who was between the ages of 4 and 9 years. Mothers were heterosexual and were currently without a live-in and/or long-term partner. Interview data were analysed qualitatively according to the principles of thematic analysis. MAIN RESULTS AND THE ROLE OF CHANCE Findings indicated marked diversity in single mothers' representations of the donor. Most (n = 27) mothers talked about the donor as symbolically significant to family life and were likely to describe the donor as (i) a gift-giver, (ii) a gene-giver and (iii) a potential partner. Others (n = 16) talked about the donor as (i) unknown, (ii) part of a process and (iii) out of sight and out of mind. There were mothers with anonymous and identity-release donors in each group. Several mothers explained that their feelings about the donor had changed over time. LIMITATIONS, REASONS FOR CAUTION All mothers conceived at a licensed fertility clinic in the UK. Findings are limited to individuals willing and able to take part in research on donor conception. WIDER IMPLICATIONS OF THE FINDINGS The study offers greater insight into the factors influencing the donor narratives produced in single-mother families. It has implications for the counselling and treatment of single women seeking fertility treatment with donor gametes in both anonymous and identity-release programmes. Given that the number of clinics offering identity-release programmes worldwide seems to be increasing, the finding that single women may have varying preferences with regard to donor type, and varying interest levels with regard to donor information, is important. It is recommended that clinicians and other fertility clinic staff guard against making assumptions about such preferences and any thoughts and feelings about the donor or donor information on the basis of marital status. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by the Wellcome Trust [097857/Z/11/Z]. The authors have no conflicts of interest to declare.
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Affiliation(s)
- S Zadeh
- Centre for Family Research, University of Cambridge, Free School Lane, Cambridge CB2 3RQ, UK
| | - T Freeman
- Centre for Family Research, University of Cambridge, Free School Lane, Cambridge CB2 3RQ, UK
| | - S Golombok
- Centre for Family Research, University of Cambridge, Free School Lane, Cambridge CB2 3RQ, UK
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12
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Woodward JT. Third-party reproduction in the Internet Age: the new, patient-centered landscape. Fertil Steril 2015; 104:525-30. [PMID: 26070518 DOI: 10.1016/j.fertnstert.2015.05.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 05/21/2015] [Accepted: 05/21/2015] [Indexed: 11/25/2022]
Abstract
The rise of the Internet Age has brought a host of sweeping changes to the landscape of third-party reproduction. What began as a dyadic relationship between doctor and patient has evolved into a more complex system in which patients are able to access information online from a variety of external sources. Patients often seek to play a more active role in their third-party reproductive care, and the Internet allows them to do so. Further, demand for both medical and psychosocial information about donors and donor-conceived siblings, available online through patient forums and genetic registries, has altered the perception of gamete donation from a one-time event to an ongoing relationship. The advantages and disadvantages for patients and providers of this freer flow of information between third-party participants are examined. Search motivations of recipients and offspring, as well as types of information sought, are detailed. Recommendations are made regarding strategies fertility programs can use to optimally support their patients and navigate this new landscape.
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Affiliation(s)
- Julia T Woodward
- Psychological Services Program, Duke Fertility Center, Durham, North Carolina; and Department of Psychiatry and Behavioral Sciences and Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina.
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Goldberg AE, Scheib JE. Female-partnered and single women's contact motivations and experiences with donor-linked families. Hum Reprod 2015; 30:1375-85. [PMID: 25883034 DOI: 10.1093/humrep/dev077] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 03/18/2015] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION What are female-partnered and single mothers' motivations and experiences at one donor insemination (DI) program with regard to contacting other families who share the same sperm donor? SUMMARY ANSWER By and large, women reported seeking contact to obtain (i) support for their children and/or themselves, and (ii) information about shared traits and medical problems, ultimately describing a range of contact experiences, both positive (e.g. special bond created) and negative (e.g. uncomfortable encounters). WHAT IS KNOWN ALREADY There is a growing phenomenon of donor insemination families-parents and/or offspring-seeking others who share their donor (i.e. are 'donor-linked'). There is limited understanding about parental motivations and experiences-especially in the presence of a second parent-due to the methodological constraints of previous quantitative studies. STUDY DESIGN, SIZE, DURATION Semi-structured telephone interviews were conducted with 50 donor insemination mothers (14 single, 36 female-partnered). Participants were recruited by email invitation to parent members of a family-matching service at one donor insemination program in the USA. The criterion for inclusion was having matched to at least one donor-linked family. PARTICIPANTS/MATERIALS, SETTING, METHODS Among the 50 mothers interviewed, all had at least one child conceived via donor insemination, who was between ages 0 and 15 years at first contact. Families matched with a median of three donor-linked families (range 1-10). Interview data were analyzed through qualitative (i.e. thematic) analysis. MAIN RESULTS AND THE ROLE OF CHANCE Overarching themes emerged of seeking contact to obtain (i) support and (ii) information about children's shared physical and psychological traits. Some wanted to increase their child's family network, through adding a sibling, but more often as extended family. Data, from partnered parents especially, revealed the challenges of balancing the boundaries of family formed without the genetic link with the perceived benefits of exploring the child's donor origins. LIMITATIONS, REASONS FOR CAUTION Interviews focused on openness and information-sharing were conducted with parents from one American donor insemination program. Findings are limited to individuals who were open enough to share their experiences and able to take the time to do so. WIDER IMPLICATIONS OF THE FINDINGS As donor-linking services become established independently (e.g. donor insemination program registries) or by the government (e.g. Victoria, Australia's Voluntary Register), these findings provide evidence that linking services are valued by individuals affected by donor conception. Caution is warranted, however, in that some participants reported mismatched expectations, both across donor-linked families and within families (e.g. between partners), suggesting the need for information and guidance both during and after matching. Overall, the range and balance of reported positives and negatives indicate that donor-linking can provide individuals with support and donor origins information-which are particularly important when these are not available elsewhere. STUDY FUNDING/COMPETING INTERESTS Clark University provided support. No competing interests.
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Affiliation(s)
- A E Goldberg
- Department of Psychology, Clark University, Worcester, MA 01610, USA
| | - J E Scheib
- Department of Psychology, University of California, Davis, CA 95616, USA The Sperm Bank of California, Berkeley, CA 94704, USA
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Lampic C, Skoog Svanberg A, Sydsjö G. Attitudes towards disclosure and relationship to donor offspring among a national cohort of identity-release oocyte and sperm donors. Hum Reprod 2014; 29:1978-86. [PMID: 25030191 PMCID: PMC4131739 DOI: 10.1093/humrep/deu152] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
STUDY QUESTION What are oocyte donors and sperm donors' attitudes towards disclosure and relationship to donor offspring? SUMMARY ANSWER Oocyte and sperm donors in an identity-release donor programme support disclosure to donor offspring and have overall positive or neutral attitudes towards future contact with offspring. WHAT IS KNOWN ALREADY There is a global trend towards open-identity gamete donation with an increasing number of countries introducing legislation allowing only identifiable donors. While women and men who enrol in identity-release donor programmes accept that they may be contacted by donor offspring, there is limited knowledge of their attitudes towards disclosure to donor offspring and how they perceive their relationship to potential donor offspring. STUDY DESIGN, SIZE AND DURATION The present study is part of the ‘Swedish study on gamete donation’, a prospective cohort study including donors at all fertility clinics performing donation treatment in Sweden. During a 3-year period (2005–2008), donors were recruited consecutively and a total of 157 oocyte donors and 113 sperm donors (who did not donate to a specific ‘known’ couple) were included prior to donation. Participants in the present study include 125 female (80%) and 80 male donors (71%) that completed two follow-up assessments. PARTICIPANTS/MATERIALS, SETTINGS AND METHODS Participants completed two postal questionnaires 2 months after donation and 14 months after donation. Attitudes towards disclosure to donor offspring were assessed with an established instrument. Perceptions of involvement with donor offspring and need for counselling was assessed with study-specific instruments. Statistical analyses were performed with non-parametric tests. MAIN RESULTS AND THE ROLE OF CHANCE A majority of oocyte and sperm donors supported disclosure to donor offspring (71–91%) and had positive or neutral attitudes towards future contact with offspring (80–87%). Sperm donors reported a higher level of involvement with potential donor offspring compared with oocyte donors (P = 0.005). Few donors reported a need for more counselling regarding the consequences of their donation. LIMITATIONS, REASONS FOR CAUTION While the multicentre study design strengthens external validity, attrition induced a risk of selection bias. In addition, the use of study-specific instruments that have not been psychometrically tested is a limitation. WIDER IMPLICATIONS OF THE FINDINGS The positive attitudes towards disclosure to offspring of female and male identity-release donors are in line with previous reports of anonymous and known donors. While our results on donors' general positive or neutral attitudes towards future contact with potential donor offspring are reassuring, a subset of donors with negative attitudes towards such contact warrants concern and suggests a need for counselling on long-term consequences of donating gametes. STUDY FUNDING The ‘Swedish study on gamete donation’ was funded by the Swedish Research Council, the Swedish Council for Health, Working Life and Welfare, and the Regional Research Council in Uppsala-Örebro. There are no conflicts of interest to declare.
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Affiliation(s)
- C Lampic
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE-141 83 Huddinge, Sweden
| | - A Skoog Svanberg
- Department of Women's and Children's Health, Uppsala University, SE-751 85 Uppsala, Sweden
| | - G Sydsjö
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, SE-581 85 Linköping, Sweden Department of Obstetrics and Gynecology in Linköping, County Council of Östergötland, SE-58183 Linköping, Sweden
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RAVITSKY VARDIT. Conceived and Deceived: The Medical Interests of Donor-Conceived Individuals. Hastings Cent Rep 2014; 42:17-22. [DOI: 10.1002/hast.9] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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16
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Strengths and pitfalls of Canadian gamete and embryo donor registries: searching for beneficent solutions. Reprod Biomed Online 2013; 28:369-79. [PMID: 24447960 DOI: 10.1016/j.rbmo.2013.10.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2013] [Revised: 07/19/2013] [Accepted: 10/23/2013] [Indexed: 11/20/2022]
Abstract
For the gamete and embryo donation community, it is well recognized that the implementation of a gamete and embryo donor registry (GEDR) represents a good initiative to ensure the best possible health conditions for donor-conceived individuals. Be they national, institutional or independent, GEDR can play a major role in the transmission of health-related genetic and medical information. However, from a bioethical analysis standpoint, GEDR raise many questions regarding the extent of their beneficent nature. Based on the recent Canadian GEDR aborted attempt, this article will focus on bioethical issues and paradoxes that can impact the wellbeing of donor-conceived individuals, half-siblings, donors and parents. On one hand, the implementation of a GEDR can be ethically justified as a beneficent action towards lessening harm associated with the transmission of hereditary disease and increasing the effectiveness of preventive and therapeutic approaches. On the other hand, examined through the concept of nonpaternalistic beneficence, GEDR challenge us to recognize beneficiaries' free agency, as well as the importance to transmit reliable and pertinent information. Ultimately, beyond an individualistic application of the principle of beneficence, socioethics invite us to consider consistency with societal values as a prerequisite for achieving a common good. Because the issue of whether or not to protect the donor's anonymity occupies the forefront of the discussion surrounding gamete and embryo donation, there is less interest in other initiatives, which may be implemented to ensure the best possible medical and psychosocial conditions for donor-conceived individuals. In this article, we propose a bioethical analysis of the use of gamete and embryo donor registries (GEDR) from the angle of the principle of beneficence. More specifically, we will concentrate on the Canadian situation regarding GEDR. We will look at the strengths and pitfalls of this mechanism and suggest a solution to maximize the benefits of a GEDR. Many have suggested that such an initiative could have a beneficial impact on the wellbeing of donor-conceived individuals, half-siblings, donors and parents, by ensuring the constant flow of health-related medical and genetic information. As self-evident as the social acceptability of a GEDR may seem, we wish to show the limitations of the benefits that a registry is supposed to provide. We argue that a GEDR has to do more than simply transmit health-related information between parties. It also has to be based on pertinent and reliable data, be useful for health promotion and recognize beneficiaries' free agency. Ultimately, the implementation of a GEDR has to take into consideration wider social values.
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Gudipati M, Pearce K, Prakash A, Redhead G, Hemingway V, McEleny K, Stewart J. The sperm donor programme over 11 years at Newcastle Fertility Centre. HUM FERTIL 2013; 16:258-65. [DOI: 10.3109/14647273.2013.815370] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Blyth E, Kramer W, Schneider J. Perspectives, experiences, and choices of parents of children conceived following oocyte donation. Reprod Biomed Online 2013; 26:179-88. [DOI: 10.1016/j.rbmo.2012.10.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Revised: 10/15/2012] [Accepted: 10/16/2012] [Indexed: 11/30/2022]
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19
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Raes I, Ravelingien A, Pennings G. The right of the donor to information about children conceived from his or her gametes. Hum Reprod 2013; 28:560-5. [DOI: 10.1093/humrep/des444] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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20
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Zhou JJ, Pelka S, Lange K, Palmer CGS, Sinsheimer JS. Dissecting prenatal, postnatal, and inherited effects: ART and design. Genet Epidemiol 2011; 35:437-46. [PMID: 21638309 DOI: 10.1002/gepi.20591] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Revised: 03/31/2011] [Accepted: 04/14/2011] [Indexed: 11/11/2022]
Abstract
With the failure of common variants alone to explain the bulk of trait heritability, it becomes more important to understand the contribution of maternally inherited effects, prenatal effects, and postnatal environmental effects. These effects can be disentangled by studying families containing children conceived by assisted reproductive technologies (ART). We propose and develop a model that is an extension of the variance component model commonly used in pedigree analysis. Our model is flexible enough to allow any number of family members and degrees of relationship; thus, researchers can use both small and extended families simultaneously. Simulations demonstrate that our method has appropriate statistical properties and is robust to model misspecification and accurate in the presence of missing data. Most importantly, our method is able to disentangle maternally inherited effects from prenatal effects, which are confounded in traditional family studies. Our analyses also provide guidance to researchers designing studies that will use ART families to clarify genetic and environmental factors underlying traits.
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Affiliation(s)
- J J Zhou
- Department of Biomathematics, The University of California-Los Angeles, CA 90095, USA
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Jadva V, Freeman T, Kramer W, Golombok S. Sperm and oocyte donors' experiences of anonymous donation and subsequent contact with their donor offspring. Hum Reprod 2010; 26:638-45. [PMID: 21177310 DOI: 10.1093/humrep/deq364] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study examined the motivations and experiences of anonymous donors who decide to make themselves open to contact with their donor offspring. METHODS Online questionnaires were completed by 63 sperm donors and 11 oocyte donors recruited via the Donor Sibling Registry (http://www.donorsiblingregistry.com/), a US-based international registry that facilitates contact between donor-conceived offspring and their donors. RESULTS Donors' main reasons for donating were financial payment and wanting to help others. Sperm donors had donated between 1 and 950 times (median = 100) and oocyte donors had donated between 1 and 5 times (median = 2). The majority of sperm donors and more than one-third of oocyte donors expressed concerns about having donated. These concerns were mainly about the well-being of any children conceived using their gametes and not being able to make contact with them. Most sperm and oocyte donors felt that it was important to know how many offspring had been born using their donation, and 51% of sperm donors and 46% of oocyte donors wanted identifying information. All of the donors who had contact with their donor offspring reported positive experiences and the majority continued to have regular contact. CONCLUSIONS Although the sample may not be representative of all anonymous donors, this study highlights the importance of donors having access to information about their donor offspring and the positive consequences that may arise when contact is made.
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Affiliation(s)
- V Jadva
- Centre for Family Research, Faculty of Politics, Psychology, Sociology and International Studies, Free School Lane, University of Cambridge, Cambridge CB2 3RF, UK.
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The views of adult offspring of sperm donation: essential feedback for the development of ethical guidelines within the practice of assisted reproductive technology in the United States. Fertil Steril 2010; 93:2236-46. [DOI: 10.1016/j.fertnstert.2008.12.119] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2008] [Revised: 12/01/2008] [Accepted: 12/22/2008] [Indexed: 11/21/2022]
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23
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Jadva V, Freeman T, Kramer W, Golombok S. Experiences of offspring searching for and contacting their donor siblings and donor. Reprod Biomed Online 2010; 20:523-32. [PMID: 20129827 DOI: 10.1016/j.rbmo.2010.01.001] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2009] [Revised: 06/08/2009] [Accepted: 11/17/2009] [Indexed: 10/20/2022]
Abstract
This study investigates a new phenomenon whereby individuals conceived by donor insemination are searching for and contacting their donor and/or 'donor siblings' (i.e. donor offspring conceived by the same donor who are their genetic half siblings). On-line questionnaires were completed by members of the Donor Sibling Registry (DSR), a US-based registry that facilitates contact between donor conception families who share the same donor. Of the 165 donor offspring who completed the survey, 15% were searching for their donor siblings, 13% were searching for their donor, and 64% were searching for both. Differences were found according to family type and age of disclosure. Fewer offspring from heterosexual couple families had told their father about their search when compared with offspring from lesbian couple families who had told their co-parent. Offspring who had found out about their conception after age 18 were more likely to be searching for medical reasons, whereas those who had found out before age 18 tended to be searching out of curiosity. Some offspring had discovered large numbers of half siblings (maximum=13). The majority of offspring who had found their donor relations reported positive experiences and remained in regular contact with them.
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Affiliation(s)
- Vasanti Jadva
- Centre for Family Research, University of Cambridge, Free School Lane, Cambridge, UK.
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Daniels K, Gillett W, Grace V. Parental information sharing with donor insemination conceived offspring: a follow-up study. Hum Reprod 2009; 24:1099-105. [PMID: 19164306 DOI: 10.1093/humrep/den495] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Studies of parental decision making regarding information sharing with offspring conceived as a result of donor insemination are almost all based on a 'one point in time' design. This study reports on parental decision making at two points in time, Time 1 and Time 2, 14 years apart. METHODS Forty-four of 57 families (77%) who had agreed to take part in a follow-up study were interviewed. An in-depth semi-structured interview format was used. In addition, two questionnaires seeking mainly quantitative data were administered. RESULTS Fifteen families (35%) had told their offspring of the donor insemination conception at Time 2 (2004). An additional seven families said they had always wanted or intended to tell the children and asked for assistance on how to do this. Where partners were in agreement on information sharing at Time 1 (1990)-either to tell or not to tell-this position was maintained. Where there was disagreement, or uncertainty, two-thirds had not told and one-third had. CONCLUSIONS Despite the professional and socio-political culture at the time of treatment, almost half of the families in this study ended up sharing the donor insemination conception with their offspring. The results support the need for appropriate preparation for donor insemination family building.
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Affiliation(s)
- Ken Daniels
- University of Canterbury, Private Bag 4800, Christchurch, New Zealand.
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26
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Scheib JE, Ruby A. Contact among families who share the same sperm donor. Fertil Steril 2008; 90:33-43. [PMID: 18023432 DOI: 10.1016/j.fertnstert.2007.05.058] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2006] [Revised: 04/29/2007] [Accepted: 04/29/2007] [Indexed: 12/13/2022]
Affiliation(s)
- Joanna E Scheib
- Department of Psychology, University of California, Davis, California 95616, USA.
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27
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The impact of disclosure on donor gamete participants: donors, intended parents and offspring. Curr Opin Obstet Gynecol 2008; 20:265-8. [DOI: 10.1097/gco.0b013e32830136ca] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Jacobstein JM. Federal regulatory pre-emption of state tort claims against the manufacturers of medical devices and pharmaceutical drugs. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2008; 36:594-597. [PMID: 18840254 DOI: 10.1111/j.1748-720x.2008.309.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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