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Widbom A, Isaksson S, Sydsjö G, Skoog Svanberg A, Lampic C. The motives and experiences of donor-conceived persons requesting the identity of their sperm donors. Reprod Biomed Online 2024; 48:103413. [PMID: 37914558 DOI: 10.1016/j.rbmo.2023.103413] [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: 06/14/2023] [Revised: 09/01/2023] [Accepted: 09/11/2023] [Indexed: 11/03/2023]
Abstract
RESEARCH QUESTION What are the motives and experiences of donor-conceived persons (DCP) who search for and receive information about their identity-release sperm donor? DESIGN A qualitative interview study with 29 individuals (21 women, seven men, one non-binary) who were consecutively recruited after having requested information about their sperm donor at five Swedish University hospitals. All participants were conceived after donor insemination to heterosexual couples within an identity-release donation programme. Individual semi-structured interviews were conducted face-to-face or via telephone between September 2016 and November 2019, and transcribed audio recordings were analysed using reflexive thematic analysis. RESULTS The motives and experiences of DCP were described in two themes. The theme 'donor information can fill different needs' describes that varying motives, thoughts and feelings are related to searching for and obtaining donor information. Motives ranged from curiosity and a desire for agency over one's conception to hopes of finding a new father. The theme 'navigating donor information in a relational context' describes the process of obtaining donor information as interpersonal, highlighting that the DCP needs to balance the interests of different stakeholders, and that obtaining donor information can challenge the relationship quality with the father. CONCLUSIONS Obtaining the donor's identity has the potential to affect the understanding of DCP of themselves, and to influence relationships within their family in unexpected and challenging ways. Therefore, adequate resources should be allocated to support the growing number of families after identity-release donation.
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Affiliation(s)
- Andreas Widbom
- Department of Women's and Children's Health, Karolinska Institutet, 171 77 Stockholm, Sweden.
| | - Stina Isaksson
- Region Västra Götaland, Södra Älvsborg Hospital, Department of Research, Education and Innovation, 501 82 Borås, Sweden
| | - Gunilla Sydsjö
- Division of Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, 581 85 Linköping, Sweden
| | - Agneta Skoog Svanberg
- Department of Women's and Children's Health, Uppsala University, 751 85 Uppsala, Sweden
| | - Claudia Lampic
- Department of Women's and Children's Health, Karolinska Institutet, 171 77 Stockholm, Sweden; Department of Psychology, Umeå University, 901 87 Umeå, Sweden
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Siegel DR, Sheeder J, Kramer W, Roeca C. Are donor-conceived people willing to use donors themselves? Insights from individuals conceived via donor-assisted reproduction. Hum Reprod 2022; 37:2087-2094. [PMID: 35906918 DOI: 10.1093/humrep/deac169] [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: 04/09/2022] [Revised: 07/09/2022] [Indexed: 11/15/2022] Open
Abstract
STUDY QUESTION Are donor-conceived people (DCP) willing to utilize donor gametes themselves if unable to conceive spontaneously? SUMMARY ANSWER The majority of DCP would consider or are undecided about utilizing donor gametes and those who would consider the utilization are more likely to have been told about their donor-conceived origins at a young age by a family member and have overall positive experiences as a DCP. WHAT IS KNOWN ALREADY DCP view their donor conception as an important part of their self-identity and many desire contact with genetically related individuals. Additionally, many believe that sperm donation should only be practiced if identifying information on the donor is provided. STUDY DESIGN, SIZE, DURATION This was a cross-sectional study using a Web-based survey that was disseminated from 6 March to 15 August 2021. A total of 528 participants completed the questionnaire. PARTICIPANTS/MATERIALS, SETTING, METHODS The researcher-created survey was sent to registered users of the Donor Sibling Registry (DSR) who were conceived via donor-assisted reproduction and were 18 years of age or older. The survey was optional and anonymous, and the main outcome measure was the willingness to use donated gametes if unable to spontaneously conceive. MAIN RESULTS AND THE ROLE OF CHANCE Of the 528 participants who completed the survey, 40.2% (212/528) have or would consider using donor gametes themselves if unable to conceive spontaneously and 24.6% (130/528) were undecided. Those who had used or were undecided about the utilization were significantly younger (26 years vs. 31 years, P < 0.001) and less likely to be married (32.7% vs. 47.3%, P < 0.001) than those who would not consider using donor gametes. They were also less likely to self-identify as female (78.9% vs. 86.6%, P = 0.03) but had no difference in sexual orientation (P = 0.13). Additionally, they were more likely to have known about their donor-conceived origins for more years (18 (0-50) vs. 11 (0-61), P = 0.004), be informed by a family member (75.5% vs. 65.6%, P = 0.001) and have overall positive feelings about being conceived using a donor (93.0% vs. 52.5%, P < 0.001). LIMITATIONS, REASONS FOR CAUTION A major limitation is that DSR participants may not be representative of all DCP. Additionally, analyzing the DCP who stated that they were undecided about using donor gametes into the 'would consider' group may be overestimating the openness to utilization in this group. WIDER IMPLICATIONS OF THE FINDINGS The findings from this study give new insight for health care workers to further counsel patients who are considering using third-party reproduction by providing reassurance that the majority of their future children would consider similar means, if needed, to achieve their family-building goals. STUDY FUNDING/COMPETING INTEREST(S) Funding for this study was received from the Department of Obstetrics and Gynecology Division of Reproductive Endocrinology and Infertility, University of Colorado. All authors declare that there are no conflicts of interest to disclose. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- D R Siegel
- Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - J Sheeder
- Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - W Kramer
- Donor Sibling Registry, Nederland, CO, USA
| | - C Roeca
- Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Shady Grove Fertility, Greenwood Village, CO, USA
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Kirkman-Brown J, Calhaz-Jorge C, Dancet EAF, Lundin K, Martins M, Tilleman K, Thorn P, Vermeulen N, Frith L. OUP accepted manuscript. Hum Reprod Open 2022; 2022:hoac001. [PMID: 35178481 PMCID: PMC8847071 DOI: 10.1093/hropen/hoac001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 12/14/2021] [Indexed: 11/26/2022] Open
Abstract
STUDY QUESTION What information and support should be offered to donors, intended parents and donor-conceived people, in general and in consideration of the availability of direct-to-consumer genetic testing and matching services? SUMMARY ANSWER For donors, intended parents and donor-conceived offspring, recommendations are made that cover information needs and informed consent, psychosocial implications and disclosure. WHAT IS KNOWN ALREADY Trends indicate that the use of donor-assisted conception is growing and guidance is needed to help these recipients/intended parents, the donors and offspring, navigate the rapidly changing environment in which donor-assisted conception takes place. STUDY DESIGN, SIZE, DURATION A working group (WG) collaborated on writing recommendations based, where available, on evidence collected from a literature search and expert opinion. Draft recommendations were published for stakeholder review and adapted where relevant based on the comments received. PARTICIPANTS/MATERIALS, SETTING, METHODS Papers retrieved from PUBMED were included from 1 January 2014 up to 31 August 2020, focusing on studies published since direct-to-consumer genetic testing has become more widespread and accessible. The current paper is limited to reproductive donation performed in medically assisted reproduction (MAR) centres (and gamete banks): donation outside the medical context was not considered. MAIN RESULTS AND THE ROLE OF CHANCE In total, 32 recommendations were made for information provision and support to donors, 32 for intended parents and 27 for donor-conceived offspring requesting information/support. LIMITATIONS, REASONS FOR CAUTION The available evidence in the area of reproductive donation is limited and diverse with regards to the context and types of donation. General conclusions and recommendations are largely based on expert opinion and may need to be adapted in light of future research. WIDER IMPLICATIONS OF THE FINDINGS These recommendations provide guidance to MAR centres and gamete banks on good practice in information provision and support but should also be considered by regulatory bodies and policymakers at a national and international level to guide regulatory and legislative efforts towards the protection of donors and donor-conceived offspring. STUDY FUNDING/COMPETING INTEREST(S) The development of this good practice paper was funded by European Society of Human Reproduction and Embryology (ESHRE), covering expenses associated with the WG meetings, the literature searches and dissemination. The WG members did not receive any payment. The authors have no conflicts of interest to declare. DISCLAIMER This document represents the views of ESHRE, which are the result of consensus between the relevant ESHRE stakeholders and where relevant based on the scientific evidence available at the time of preparation. The recommendations should be used for informational and educational purposes. They should not be interpreted as setting a standard of care, or be deemed inclusive of all proper methods of care nor exclusive of other methods of care reasonably directed to obtaining the same results. They do not replace the need for application of clinical judgement to each individual presentation, nor variations based on locality and facility type. †ESHRE pages content is not externally peer reviewed. The manuscript has been approved by the Executive Committee of ESHRE.
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Affiliation(s)
| | - Jackson Kirkman-Brown
- Centre for Human Reproductive Science, University of Birmingham, IMSR, Birmingham, UK
- Correspondence address. University of Birmingham, IMSR, Birmingham B15 2TT, UK. E-mail: ;
| | | | - Eline A F Dancet
- KU Leuven, Department of Development and Regeneration, Leuven, Belgium
| | - Kersti Lundin
- Department of Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mariana Martins
- University of Porto, Faculty of Psychology and Education Sciences, Porto, Portugal
| | - Kelly Tilleman
- Department for Reproductive Medicine, Universitair Ziekenhuis Gent, Ghent, Belgium
| | - Petra Thorn
- Private Practice, Couple and Family Therapy, Infertility Counseling, Mörfelden, Germany
| | - Nathalie Vermeulen
- European Society of Human Reproduction and Embryology (ESHRE) Central Office, Strombeek-Bever, Belgium
| | - Lucy Frith
- Centre for Social Ethics and Policy, University of Manchester, Manchester, UK
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Lampic C, Skoog Svanberg A, Gudmundsson J, Leandersson P, Solensten NG, Thurin-Kjellberg A, Wånggren K, Sydsjö G. National survey of donor-conceived individuals who requested information about their sperm donor-experiences from 17 years of identity releases in Sweden. Hum Reprod 2021; 37:510-521. [PMID: 34918081 PMCID: PMC8888998 DOI: 10.1093/humrep/deab275] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 11/22/2021] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION What characterizes the group of donor-conceived (DC) individuals who request information about their identity-release sperm donor in Sweden, and what are their experiences of disclosure, information receipt and donor contact? SUMMARY ANSWER Following three decades of identity-release donation in Sweden, few DC individuals have requested donor information with varying experiences of information receipt and donor contact. WHAT IS KNOWN ALREADY In 1985, Sweden was the first country worldwide to enact legislation that gave DC individuals the right to obtain identifying information about their donor. Since then, identity-release gamete donation has become available in many countries but there is limited knowledge about the individuals who request donor information. STUDY DESIGN, SIZE, DURATION A nation-wide cross-sectional survey study was performed at all seven University hospitals that provided donation treatment in Sweden during 1985-2002. During this period only donor insemination to heterosexual couples was permitted. Inclusion criteria were being 18 years of age or older, conceived with donor sperm and having requested information about the donor by December 2020. Recruitment was performed during 2016-2020. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 60 individuals had requested information about their donor. Of these, 53 were approached and 40 individuals, representing 34 families, accepted study participation (75% response rate). Participants completed a postal survey with the WHO-10 well-being index and study-specific questions about experiences of disclosure, motivations for requesting donor information, receipt of information, as well as intentions and experiences of donor contact. Independent t-test and chi-square tests were used to compare ratings of participants with early and late disclosure. MAIN RESULTS AND ROLE OF CHANCE Of ∼900 DC individuals who had reached adult age, a total of 60 (≈7%) had requested information about the donor. Most of the 40 study participants (78%) made their requests within 2 years after reaching 18 years of age, or following disclosure at later ages (up to 32 years). Several participants had adult DC siblings in the family who had not requested any donor information. All except five participants received identifying information about the donor from the clinic. However, some donors had died or lacked contact information. Among those participants who were able to contact their donor, 41% had done so at the time of the study, while a third of the participants were unsure about potential contact. Several had met the donor in person and a few were in regular contact. About half of the participants had been informed about their donor conception in adolescence or adulthood (age 12-32), and there were significant differences between participants based on age at disclosure. Compared to those with early disclosure, participants with late disclosure were significantly more likely to be dissatisfied with the timing of their disclosure (P = 0.021), to react with negative emotions (P < 0.001), and to subsequently contact the donor (P = 0.047). LIMITATIONS, REASONS FOR CAUTION The limited population available for inclusion resulted in a small sample size, despite a high response rate. In addition, men's lower participation rate must be taken into consideration when interpreting the results. WIDER IMPLICATIONS OF THE FINDINGS The small number of individuals requesting information about their identity-release sperm donor is surprising. While not all DC individuals appear to be interested in donor information, it is reasonable to assume that some are unaware of their donor conception and thus unable to make informed decisions regarding their genetic origins. During the coming years, young women and men in many countries will become eligible to access identifying information about their donor. In order to meet the needs of these individuals, and to support positive outcomes for all involved parties, it is essential that adequate protocols and resources are developed. STUDY FUNDING/COMPETING INTEREST Financial support from The Swedish Research Council. There are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Claudia Lampic
- Department of Psychology, Umeå University, Umeå, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | | | - Johannes Gudmundsson
- Department of Women's and Children's Health, Reproductive Medicine Centre, Uppsala University Hospital, Uppsala, Sweden
| | - Pia Leandersson
- Reproductive Medicine Center, Skåne University Hospital Malmö, Malmö, Sweden
| | | | - Ann Thurin-Kjellberg
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.,Division of Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kjell Wånggren
- Department of Clinical Science, Intervention and Technology, Obstetrics and Gynecology, Karolinska Institutet, Huddinge, Sweden
| | - Gunilla Sydsjö
- Division of Children's and Women's Health, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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Widbom A, Isaksson S, Sydsjö G, Skoog Svanberg A, Lampic C. Positioning the donor in a new landscape-mothers' and fathers' experiences as their adult children obtained information about the identity-release sperm donor. Hum Reprod 2021; 36:2181-2188. [PMID: 34151354 PMCID: PMC8289314 DOI: 10.1093/humrep/deab146] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 05/08/2021] [Indexed: 12/15/2022] Open
Abstract
STUDY QUESTION How do heterosexual parents experience identity-release donation when adult children have obtained information about their sperm donor? SUMMARY ANSWER Adult offspring's receipt of identifying information about the sperm donor challenged the fathers' role as a parent, which was reflected in how parents positioned the donor in relation to the family. WHAT IS KNOWN ALREADY An increasing number of countries provide access to treatment with identity-release or 'open-identity' donors. However, there is limited knowledge about how parents experience and manage the situation when adult offspring obtain identifying information about the donor and may even establish contact with him. STUDY DESIGN, SIZE, DURATION This qualitative interview study included 23 parents whose offspring had obtained information about their sperm donor. Interviews were conducted from October 2018 to January 2019. PARTICIPANTS/MATERIALS, SETTING, METHODS A purposive sample of parents (15 mothers and 8 fathers) was recruited via adult offspring, who had requested identifying donor information at five Swedish University hospitals. All participating parents were part of a heterosexual couple who had conceived with sperm from an identity-release donor. Individual semi-structured interviews were conducted face-to face or via telephone, and transcribed audio recordings were analyzed using reflexive thematic analysis. MAIN RESULTS AND THE ROLE OF CHANCE The parents expressed diverse experiences related to their parenthood and the presence of the donor after offspring had obtained information about him; these were described in two themes. The theme 'Navigating (in)visible markers of parenthood' describes parenthood as embedded with dichotomous meanings of nature and nurture that parents navigated in relation to social approval. The theme 'Positioning the donor in a new landscape' describes how parents managed the presence of the donor by positioning him at a distance or acknowledging him as a person or even as part of the family, while some struggled to position him, giving rise to ambivalent feelings. The absence of genetic connectedness challenged the father's role as parent, which was reflected in parents' positioning of the donor. LIMITATIONS, REASONS FOR CAUTION The study was performed within the context of the Swedish legislation on identity-release donation and is based on experiences of heterosexual couples who had used sperm donation and had informed their offspring about their donor conception. This, together with the fact that parents' accounts were predominantly represented by mothers, must be taken into consideration regarding transferability to other populations. WIDER IMPLICATIONS OF THE FINDINGS Negotiations of social and genetic parenthood are still present among parents many years after treatment and may resurface when adult offspring obtain the donor's identity. Access of the adult offspring to identifying information about the donor may have unexpected consequences for family relations, including expanding the family to include the donor. Challenges related to male infertility and family dynamics indicate that parents should have access to counseling and support to manage family life with varying genetic linkage within and outside the family unit. STUDY FUNDING/COMPETING INTEREST(S) Financial support was from The Swedish Research Council (Grant 2013-2712). There are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Andreas Widbom
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Stina Isaksson
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden,Department of Research, Education and Innovation, Region Västra Götaland, Södra Älvsborg Hospital, Borås, Sweden
| | - Gunilla Sydsjö
- Division of Children’s and Women’s Health, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | | | - Claudia Lampic
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden,Correspondence address. Department of Women's and Children's Health, Karolinska Institutet, Tomtebodavägen 18A, 171 77 Stockholm, Sweden. E-mail: http://orcid.org/0000-0002-1739-4486
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Carone N, Bos HMW, Shenkman G, Tasker F. Editorial: LGBTQ Parents and Their Children During the Family Life Cycle. Front Psychol 2021; 12:643647. [PMID: 33679568 PMCID: PMC7930207 DOI: 10.3389/fpsyg.2021.643647] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 01/26/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Nicola Carone
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Henny M. W. Bos
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
| | - Geva Shenkman
- Interdisciplinary Center Herzliya (IDC), Hertzlya, Israel
| | - Fiona Tasker
- Department of Psychological Sciences, School of Science, Birkbeck University of London, London, United Kingdom
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Carone N, Gartrell NK, Rothblum ED, Koh AS, Bos HMW. The stability of psychological adjustment among donor-conceived offspring in the U.S. National Longitudinal Lesbian Family Study from childhood to adulthood: differences by donor type. Fertil Steril 2021; 115:1302-1311. [PMID: 33541691 DOI: 10.1016/j.fertnstert.2020.12.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 12/11/2020] [Accepted: 12/11/2020] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To study differences by sperm donor type in the psychological adjustment of the U.S. National Longitudinal Lesbian Family Study (NLLFS) offspring across three time periods from childhood to adulthood. DESIGN U.S.-based prospective cohort study. SETTING Paper-and-pencil questionnaires and protected online surveys. PATIENT(S) A cohort of 74 offspring conceived by lesbian parents using an anonymous (n = 26), a known (n = 26), or an open-identity (n = 22) sperm donor. Data were reported when offspring were ages 10 (wave 4), 17 (wave 5), and 25 (wave 6). INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Achenbach Child Behavior Checklist administered to lesbian parents when offspring were ages 10 and 17 and the Achenbach Adult Self-Report administered to offspring at age 25. RESULT(S) In both relative and absolute stability, no differences were found in internalizing, externalizing, and total problem behaviors by donor type over 15 years. However, both externalizing and total problem behaviors significantly declined from age 10 to 17 and then increased from age 17 to 25. Irrespective of donor type, among the 74 offspring, the large majority scored continuously within the normal range on internalizing (n = 62, 83.8%), externalizing (n = 62, 83.8%), and total problem behaviors (n = 60, 81.1%). CONCLUSION(S) The results reassure prospective lesbian parents and provide policy makers and reproductive medicine practitioners with empirical evidence that psychological adjustment in offspring raised by lesbian parents is unrelated to donor type in the long term.
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Affiliation(s)
- Nicola Carone
- Department of Brain and Behavioral Sciences, Lab on Attachment and Parenting - LAG, University of Pavia, Pavia, Italy.
| | - Nanette K Gartrell
- Williams Institute, School of Law, University of California Los Angeles, Los Angeles, California; Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, the Netherlands
| | - Esther D Rothblum
- Department of Women's Studies, San Diego State University, San Diego, California
| | - Audrey S Koh
- School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California
| | - Henny M W Bos
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, the Netherlands
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Scheib JE, McCormick E. Adults from donor-conceived families: some good news (from a longitudinal study). Fertil Steril 2020; 114:764-765. [PMID: 32888680 DOI: 10.1016/j.fertnstert.2020.06.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Joanna E Scheib
- Psychology Department, University of California, Davis, California; The Sperm Bank of California, Berkeley, California
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