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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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Zaami S, Del Rio A, Negro F, Varone MC, Marinelli S, Montanari Vergallo G. The March 2021 Italian constitutional court ruling on surrogacy: a prelude to common European legislation for the sake of reproductive health? EUR J CONTRACEP REPR 2021; 27:61-66. [PMID: 34643125 DOI: 10.1080/13625187.2021.1987411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Surrogacy is an arrangement by which a surrogate mother bears a child for another couple or person, and is often thought of as a form of 'treatment' for couples (or even individuals) with fertility or sterility issues. Still, surrogacy entails ethical issues related to gender, fundamental human rights, exploitation and inequality. MATERIALS AND METHODS Starting from the Italian state of affairs, the authors have set out to briefly expound upon such complexities, taking into account relevant jurisprudence on the subject, with a particular focus on inter-country surrogacy and second-parent adoption, which can themselves engender significant legal dilemmas. When residents of countries where surrogacy is banned travel abroad and hire a surrogate, that may lead to considerable legal hurdles as well. RESULTS In Italy and elsewhere, the courts have all too often had to fill the vacuum left by the lack of targeted legislation. The Italian Constitutional Court has recently urged lawmakers to enact new legislation to uphold the minor's best interests. In fact, while some countries recognise the surrogate as the legal parent, others ascribe parenthood to the commissioning parents. That discrepancy can lead to a 'clash of laws', resulting in children ending up stateless and unable to maintain an already established family relationship. CONCLUSIONS Just like fundamental protection of human rights and public health, the regulation of revolutionary technologies that change the very notion of reproduction, parenthood, and human identity needs to be governed by uniform standards, shared at least by nations which espouse common core values.
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Affiliation(s)
- Simona Zaami
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | - Alessandro Del Rio
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | - Francesca Negro
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | - Maria Cristina Varone
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | | | - Gianluca Montanari Vergallo
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
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Macmillan CM, Allan S, Johnstone M, Stokes MA. The motivations of donor-conceived adults for seeking information about, and contact with, sperm donors. Reprod Biomed Online 2021; 43:149-158. [PMID: 34006483 DOI: 10.1016/j.rbmo.2021.04.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 03/29/2021] [Accepted: 04/05/2021] [Indexed: 11/25/2022]
Abstract
RESEARCH QUESTION How do the demographic characteristics, mental health experiences and disclosure experiences of donor-conceived adults shape motivations for seeking information about their sperm donors, contact with them, or both? DESIGN Sixty-nine Australian adults who conceived through sperm donors completed an online survey. Uniquely, information and contact seeking were investigated as two distinct concepts. RESULTS Participants reported a variety of demographic, mental health, disclosure and discovery experiences. Most had been motivated to seek information about their donor (88%), contact with them (71%), or both. The most commonly reported motivations for each act were for medical information, expanding their identity and curiosity. Logistic regression findings were significant for wanting medical information as a motivation for seeking donor information (P = 0.03). Endorsement of this motivation was associated with self-reported anxiety (P = 0.02) and less likely as participant age increased (P = 0.02). Motivation to contact donors for medical information was associated with self-reported anxiety (P = 0.02) and depression (P = 0.01), and more likely when the participant was raised in a household that included the recipient co-parent (P = 0.04). As years since disclosure or discovery increased, participants were less likely to report wanting medical information as a motivation (P = 0.02). CONCLUSION Overall, participants were motivated to obtain information and seek contact with sperm donors. Motivations for each were similar despite participants varying in age and reporting a range of circumstances regarding disclosure, some of which were adverse.
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Affiliation(s)
- Caitlin M Macmillan
- Department of Health Systems and Populations, Faculty of Medicine and Health Sciences, Macquarie University, 2 Technology Pl, Macquarie Park NSW 2113, Australia.
| | - Sonia Allan
- Department of Health Systems and Populations, Faculty of Medicine and Health Sciences, Macquarie University, 2 Technology Pl, Macquarie Park NSW 2113, Australia
| | - Melissa Johnstone
- Department of Health and Human Sciences, Faculty of Human Sciences, Macquarie University, 29 Wally's Walk, Balaclava Rd, Macquarie Park NSW 2109, Australia
| | - Mark A Stokes
- School of Psychology, Faculty of Health, Deakin University, 221 Burwood Hwy, Burwood Vic 3125, Australia
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Abstract
Donor-conceived neonates have poorer birth outcomes, including low birth weight and preterm delivery that are associated with poorer long-term health in adulthood through the developmental origins of health and disease (DOHaD) theory. The aim of this study was to conduct the first investigation of the adult health outcomes of donor-conceived people. An online health survey was completed by 272 donor sperm-conceived adults and 877 spontaneously conceived adults from around the world. Donor and spontaneously conceived groups were matched for age, sex, height, smoking, alcohol consumption, exercise, own fertility and maternal smoking. Donor sperm-conceived adults had significantly higher reports of being diagnosed with type 1 diabetes (P = 0.031), thyroid disease (P = 0.031), acute bronchitis (P = 0.008), environmental allergies (P = 0.046), sleep apnoea (P = 0.037) and having ear tubes/grommets surgically implanted (P = 0.046). This is the first study to investigate the health outcomes of adult donor sperm-conceived people. Donor sperm-conceived adults self-reported elevated frequencies of various health conditions. The outcomes are consistent with birth defect data from donor sperm treatment and are consistent with the DOHaD linking perturbed early growth and chronic disease in adulthood.
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Skoog Svanberg A, Sydsjö G, Lampic C. Psychosocial aspects of identity-release gamete donation - perspectives of donors, recipients, and offspring. Ups J Med Sci 2020; 125:175-182. [PMID: 31802698 PMCID: PMC7720987 DOI: 10.1080/03009734.2019.1696431] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Donor conception creates families with varying genetic linkage between family members. This may have short-term as well as lifelong psychosocial consequences for all involved. Gamete donors have traditionally been anonymous to recipients and offspring, but there is a growing trend towards identity-release donor programmes that give offspring the right to obtain the donor's identity. This review aims to provide an overview of the perspectives of donors and recipients and offspring involved in identity-release donation. The results show that both oocyte and sperm donors have primarily altruistic motives, and recipients, in particular lesbian and single women, are generally open about the donation to their offspring. The few existing studies on offspring perspectives indicate that those who are aware of their donor conception appear to be interested in contact with the donor, and most donors are open to such contact. Investigations of donors and recipients indicate a need for more counselling and support to manage family life with varying genetic linkage within and outside the family unit. This includes preparing for and managing future contact between the donor and his/her family and donor offspring and their family, as well as between donor siblings and their respective families.
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Affiliation(s)
- Agneta Skoog Svanberg
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- CONTACT Agneta Skoog Svanberg Department of Women’s and Children’s Health, Uppsala University, Uppsala, 751 05, Sweden
| | - Gunilla Sydsjö
- Department of Obstetrics and Gynaecology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Claudia Lampic
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
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Rubio MIJ, Agoglia IS. “Siempre le he contado su historia”: prácticas y narrativas familiares sobre “los orígenes” en adopciones monoparentales. MANA 2020. [DOI: 10.1590/1678-49442020v26n1a206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Resumen Las familias “dependientes del discurso” (Galvin 2006), como son las adoptivas, se conforman mediante cuatro prácticas: nombrar (designar a los miembros de la familia dándoles un lugar en ella), discutir (hablar sobre la situación familiar), narrar (elaborar una historia de adopción para los hijos) y ritualizar (reconocer la adopción con celebraciones y actividades cotidianas). En este artículo, analizamos las tres primeras prácticas en familias adoptivas monoparentales españolas y chilenas. Entre los resultados más sobresalientes, se muestran en estas configuraciones adoptivas actitudes y prácticas de apertura comunicativa, que conllevan narrar tempranamente a los hijos las circunstancias que rodearon su adopción y hablarles de sus madres y padres de origen, realizando esfuerzos por desculpabilizar y empatizar con estas figuras, e incluso sumándolas como parte de sus familias extendidas desde una perspectiva de pluriparentalidad.
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Dempsey D, Kelly F, Horsfall B, Hammarberg K, Bourne K, Johnson L. Applications to statutory donor registers in Victoria, Australia: information sought and expectations of contact. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2019; 9:28-36. [PMID: 31956702 PMCID: PMC6957838 DOI: 10.1016/j.rbms.2019.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 05/17/2019] [Accepted: 08/05/2019] [Indexed: 06/10/2023]
Abstract
Knowledge of genetic origins is widely believed to have consequences for health, family belonging and personal identity. Donor linking is the process by which donors, recipient parents (RP) and donor-conceived people (DCP) gain access to identifying information about each other. This paper reports on the information and contact sought by donor-linking applicants to the central and voluntary registers in the state of Victoria, Australia, which has one of the most comprehensive donor-linking legislative frameworks in the world. Applicants to the Victorian registers complete a statement of reasons (SOR), a written document that is given to the subject of the application, outlining their reasons for applying and their short- and long-term goals. SOR written by applicants between 29 June 2015 and 28 February 2017 who had agreed to be recontacted for research were analysed. Forty-two of 93 eligible applicants took part (45%). All applications pertained to donor sperm. RP were the largest applicant group (n = 19) followed by DCP (n = 17) and donors (n = 6). All applicants wanted personal information and most expressed a desire for contact. Single mothers of young children used the registers more than any other parent group, indicating that family structure may influence application patterns. While it is apparent that all applicants are eager for information and some form of interpersonal contact, further research is needed on how the legal and policy landscape of different jurisdictions influences expectations, as well as what happens after parties are linked.
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Affiliation(s)
| | | | - Briony Horsfall
- Swinburne University, Melbourne, Australia
- La Trobe University, Melbourne, Australia
| | - Karin Hammarberg
- Victorian Assisted Reproductive Treatment Authority, Melbourne, Australia
- Monash University, Melbourne, Australia
| | - Kate Bourne
- Victorian Assisted Reproductive Treatment Authority, Melbourne, Australia
| | - Louise Johnson
- Victorian Assisted Reproductive Treatment Authority, Melbourne, Australia
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Schrijvers A, Bos H, van Rooij F, Gerrits T, van der Veen F, Mochtar M, Visser M. Being a donor-child: wishes for parental support, peer support and counseling. J Psychosom Obstet Gynaecol 2019; 40:29-37. [PMID: 29110558 DOI: 10.1080/0167482x.2017.1396313] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES We aimed at exploring the wishes of Dutch donor-conceived offspring for parental support, peer support and counseling and sought to contribute to the improvement of health care for all parties involved with assisted reproductive technologies. METHODS We held semi-structured in-depth interviews with 24 donor-conceived offspring (Mage = 26.9, range 17-41) born within father-mother, two-mother and single mother families. The majority of the donor offspring was conceived with semen of anonymous donors. All offspring were recruited by network organizations and snowball sampling. The interviews were fully transcribed and analyzed using the constant comparative method. RESULTS Donor-conceived offspring wished that their parents had talked openly about donor conception and had missed parental support. They wished that their parents would have received counseling before donor sperm treatment on how to talk with their children about donor conception in several stages of life. They valued the availability of peer contact to exchange stories with other donor-conceived offspring and would have liked assistance in getting access to trustworthy information about characteristics and identifying information of their donor. Donor-conceived offspring wished to know where to find specialist counseling when needed. CONCLUSIONS Peer support and counseling by professionals for donor-conceived offspring should be available for those who need it. The findings also support professional counseling for intended parents before treatment to improve parental support for donor-children.
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Affiliation(s)
- Anne Schrijvers
- a Department of Obstetrics and Gynaecology, Centre for Reproductive Medicine , Academic Medical Centre, University of Amsterdam , Amsterdam , The Netherlands
| | - Henny Bos
- b Faculty of Social and Behavioral Sciences , Research Institute of Child Development and Education, University of Amsterdam , Amsterdam , The Netherlands
| | - Floor van Rooij
- b Faculty of Social and Behavioral Sciences , Research Institute of Child Development and Education, University of Amsterdam , Amsterdam , The Netherlands
| | - Trudie Gerrits
- c Faculty of Social and Behavioral Sciences , Sociology and Anthropology, University of Amsterdam , Amsterdam , The Netherlands
| | - Fulco van der Veen
- a Department of Obstetrics and Gynaecology, Centre for Reproductive Medicine , Academic Medical Centre, University of Amsterdam , Amsterdam , The Netherlands
| | - Monique Mochtar
- a Department of Obstetrics and Gynaecology, Centre for Reproductive Medicine , Academic Medical Centre, University of Amsterdam , Amsterdam , The Netherlands
| | - Marja Visser
- a Department of Obstetrics and Gynaecology, Centre for Reproductive Medicine , Academic Medical Centre, University of Amsterdam , Amsterdam , The Netherlands
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Zadeh S, Ilioi EC, Jadva V, Golombok S. The perspectives of adolescents conceived using surrogacy, egg or sperm donation. Hum Reprod 2019; 33:1099-1106. [PMID: 29701833 PMCID: PMC5972639 DOI: 10.1093/humrep/dey088] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 03/28/2018] [Indexed: 01/31/2023] Open
Abstract
STUDY QUESTION What are the perspectives of adolescents conceived using surrogacy, egg or sperm donation regarding their conception and the third party involved? SUMMARY ANSWER The majority of adolescents described feeling indifferent about their conception, and yet simultaneously reported an interest in the third party involved, or were in contact with them. WHAT IS KNOWN ALREADY There is an assumption that children conceived through reproductive donation will feel negatively about their origins in adolescence. However, little is known about the views of adolescents who have been conceived through different types of reproductive donation. STUDY DESIGN, SIZE, DURATION Forty-four adolescents, all of whom had been told about their conception in childhood, participated in a semi-structured interview as part of the sixth phase of a longitudinal, multi-method, multi-informant study of assisted reproduction families in the UK. PARTICIPANTS/MATERIALS, SETTING, METHODS All adolescents were aged 14 years, had been conceived using surrogacy (n = 22), egg donation (n = 13) or sperm donation (n = 9) to heterosexual couples, and varied in terms of their information about, and contact with, the third party involved in their conception. Semi-structured interviews were conducted in participants' homes. Interviews were analysed qualitatively to determine adolescents' perceptions of their conception, and their thoughts and feelings about the surrogate or donor involved. MAIN RESULTS AND THE ROLE OF CHANCE Adolescents were found to feel positive (n = 7), indifferent (n = 32) or ambivalent (n = 5) about their conception. Amongst adolescents not in contact with the surrogate or donor, most were interested (n = 16) in the surrogate or donor, and others were ambivalent (n = 4), or not interested (n = 6) in them. Adolescents in contact with the surrogate or donor expressed positive (n = 14), ambivalent (n = 1) or negative (n = 1) feelings about them. LIMITATIONS, REASONS FOR CAUTION Of 56 adolescents invited to take part in the study, 47 consented to take part, giving a response rate of 84%. It was not possible to obtain information from adolescents who do not know about their conception. WIDER IMPLICATIONS OF THE FINDINGS The findings contradict the assumption that children conceived through reproductive donation will feel negatively about their origins in adolescence and suggest that it may be helpful to draw a distinction between adolescents' feelings about their conception in general, and their feelings about the surrogate or donor in particular. 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, Cambridge CB2 3RF, UK
| | - E C Ilioi
- Centre for Family Research, University of Cambridge, Cambridge CB2 3RF, UK
| | - V Jadva
- Centre for Family Research, University of Cambridge, Cambridge CB2 3RF, UK
| | - S Golombok
- Centre for Family Research, University of Cambridge, Cambridge CB2 3RF, UK
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12
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Canzi E, Accordini M, Facchin F. 'Is blood thicker than water?' Donor conceived offspring's subjective experiences of the donor: a systematic narrative review. Reprod Biomed Online 2019; 38:797-807. [PMID: 30904355 DOI: 10.1016/j.rbmo.2018.11.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 11/14/2018] [Accepted: 11/27/2018] [Indexed: 12/21/2022]
Abstract
The aim of this study was to provide a systematic narrative review of the published research articles on donor conceived offspring's subjective experiences of their donor. A systematic search of electronic databases (PsycINFO and PubMed) provided 29 published quantitative and qualitative studies matching the inclusion criteria. The analysis of the studies outcomes led to the identification of four main themes: (i) views/representations of the donor; (ii) desire to contact the donor (in terms of desire to meet the donor, reasons for wanting to contact the donor, type and frequency of contact); (iii) reactions to discovering the donor's identity and contacting the donor; (iv) identity issues. The findings revealed that genetic ties do matter to donor conceived people, especially during adolescence or adulthood. Many donor conceived people were interested in contacting the donor and all of them needed to make meaning of the role of the donor, as well as to integrate it into their family life and self-concept. Besides curiosity and medical reasons, many people reported wanting to contact the donor to see what he/she looked like, and to have access to their own ancestry and genetic history.
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Affiliation(s)
- Elena Canzi
- Family Studies and Research University Centre, Catholic University of Milan, Milan, Italy.
| | - Monica Accordini
- Family Studies and Research University Centre, Catholic University of Milan, Milan, Italy
| | - Federica Facchin
- Department of Psychology, Family Studies and Research University Centre, Catholic University of Milan, Milan, Italy
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13
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de Melo-Martín I, Rubin LR, Cholst IN. "I want us to be a normal family": Toward an understanding of the functions of anonymity among U.S. oocyte donors and recipients. AJOB Empir Bioeth 2018; 9:235-251. [PMID: 30398412 DOI: 10.1080/23294515.2018.1528308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Anonymity remains the more common practice in gamete donations, but legislation prohibiting anonymity with a goal of protecting donor-conceived children's right to know their genetic origins is becoming more common. However, given the dearth of research investigating the function of anonymity for donors and recipients, it is unclear whether these policies will accomplish their goals. The aim of this study was to explore experiences with anonymity among oocyte donors and recipients who participated in an anonymous donor oocyte program and to understand the ways in which anonymity functions for them. METHODS Semistructured interviews were conducted with 50 women: 28 oocyte donors and 22 recipients who were recruited from an academic center for reproductive medicine in the United States. RESULTS Donors and recipients view anonymity both as a mechanism to protect the interests of all parties (recipients, donors, and donor-conceived children) and as a point of conflict. Specifically, three key areas were identified where both donors and recipients saw anonymity as having an important role: relieving anxieties about family structures and obligations; protecting their interests and those of donor-conceived children (while acknowledging where interests conflict); and managing the future. CONCLUSION As gamete donation increasingly moves away from the practice of anonymity, examining why anonymity matters to stakeholders will be helpful in devising strategies to successfully implement identity-release options.
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Affiliation(s)
| | - Lisa R Rubin
- b Department of Psychology , New School for Social Research
| | - Ina N Cholst
- c The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine , Weill Cornell Medical College
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14
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Kalampalikis N, Doumergue M, Zadeh S. Sperm donor regulation and disclosure intentions: Results from a nationwide multi-centre study in France. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2018; 5:38-45. [PMID: 29774274 PMCID: PMC5952651 DOI: 10.1016/j.rbms.2018.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 11/30/2017] [Accepted: 02/12/2018] [Indexed: 05/11/2023]
Abstract
Gamete donation in Europe is not regulated by a common legal framework. Different laws regarding donor anonymity and remuneration exist in different countries. In France, gamete donation is characterized by a stable legal framework - the existing system of anonymous and non-remunerated donation remained unchanged following a period of public and parliamentary debate in 2011 - but little evidence is available concerning recipients' views and experiences of gamete donation. This article describes findings from a questionnaire completed individually by 714 heterosexual couple members undergoing a donor conception procedure at one of 20 national fertility centres in France. Participants were invited to report their attitudes towards the French legal framework, their perceptions of the anonymous donor, and their intentions to disclose donor conception to their child and to other people. The majority of respondents (93%) approved of the current legal framework. Participants indicated that they thought about the sperm donor in ways that emphasized his act of donation without describing him as a specific individual. A majority (71%) also stated that they intended to tell their child about their donor conception. Given that this is the largest nationwide study of French recipients of donor sperm, the findings make an important contribution to the research evidence currently available about prospective parents' perspectives in the increasingly uncommon context of donor anonymity in Europe.
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Abstract
When intended parents choose to have donor sperm treatment (DST), this may entail wide-ranging and long-lasting psychosocial implications related to the social parent not having a genetic tie with the child, how to disclose donor-conception and future donor contact. Counselling by qualified professionals is recommended to help intended parents cope with these implications. The objective of this study is to present findings and insights about how counsellors execute their counselling practices. We performed a qualitative study that included 13 counsellors working in the 11 clinics offering DST in the Netherlands. We held a focus group discussion and individual face-to-face semi-structured interviews, which were fully transcribed and analysed using thematic analysis. The counsellors combined screening for eligibility and guidance within one session. They acted according to their individual knowledge and clinical experience and had different opinions on the issues they discussed with intended parents, which resulted in large practice variations. The counsellors were dependent on the admission policies of the clinics, which were mainly limited to regulating access to psychosocial counselling, which also lead to a variety of counselling practices. This means that evidence-based guidelines on counselling in DST need to be developed to provide consistent counselling with less practice variation.
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Affiliation(s)
- Marja Visser
- Department of Obstetrics and Gynaecology, Centre for Reproductive Medicine, Academic Medical Centre Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
| | - Trudie Gerrits
- Faculty of Social and Behavioral Sciences, Sociology and Anthropology, University of Amsterdam, Amsterdam, The Netherlands
| | - Fulco van der Veen
- Department of Obstetrics and Gynaecology, Centre for Reproductive Medicine, Academic Medical Centre Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
| | - Monique Mochtar
- Department of Obstetrics and Gynaecology, Centre for Reproductive Medicine, Academic Medical Centre Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
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Carone N, Baiocco R, Manzi D, Antoniucci C, Caricato V, Pagliarulo E, Lingiardi V. Surrogacy families headed by gay men: relationships with surrogates and egg donors, fathers’ decisions over disclosure and children’s views on their surrogacy origins. Hum Reprod 2017; 33:248-257. [DOI: 10.1093/humrep/dex362] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 11/19/2017] [Indexed: 11/12/2022] Open
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17
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Searching for ‘relations’ using a DNA linking register by adults conceived following sperm donation. BIOSOCIETIES 2017. [DOI: 10.1057/s41292-017-0063-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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18
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Zadeh S, Freeman T, Golombok S. 'What Does Donor Mean to a Four-Year-Old?': Initial Insights into Young Children's Perspectives in Solo Mother Families. CHILDREN & SOCIETY 2017; 31:194-205. [PMID: 28450763 PMCID: PMC5396304 DOI: 10.1111/chso.12181] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/21/2016] [Indexed: 05/08/2023]
Abstract
This study reports on the questions, thoughts and feelings of children aged 4-9 conceived by donor insemination to single mothers. Fifty-one mothers and 47 children from the same families were each administered a semi-structured interview. Mothers generally reported that while children either lack understanding, or have not yet been told, about their donor conception, they may be thinking and talking about the absence of a father. Most children did not mention either donor conception or father absence and reported positive feelings about their families and friendships. Possible explanations for the discrepancy between mothers' and children's reports are discussed.
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Affiliation(s)
- Sophie Zadeh
- Centre for Family ResearchUniversity of CambridgeCambridgeUK
| | - Tabitha Freeman
- Centre for Family ResearchUniversity of CambridgeCambridgeUK
| | - Susan Golombok
- Centre for Family ResearchUniversity of CambridgeCambridgeUK
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19
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Zadeh S, Jones CM, Basi T, Golombok S. Children's thoughts and feelings about their donor and security of attachment to their solo mothers in middle childhood. Hum Reprod 2017; 32:868-875. [PMID: 28184441 PMCID: PMC5400065 DOI: 10.1093/humrep/dex016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Accepted: 01/27/2017] [Indexed: 12/13/2022] Open
Abstract
STUDY QUESTION What is the relationship between children's thoughts and feelings about their donor and their security of attachment to their solo mothers in middle childhood? SUMMARY ANSWER Children with higher levels of secure–autonomous attachment to their mothers were more likely to have positive perceptions of the donor, and those with higher levels of insecure–disorganized attachment to their mothers were more likely to perceive him negatively. WHAT IS KNOWN ALREADY There is limited understanding of the factors that contribute to children's thoughts and feelings about their donor in solo mother families. In adolescence, an association was found between adolescents’ curiosity about donor conception and their security of attachment to their mothers. STUDY DESIGN, SIZE, DURATION 19 children were administered the Friends and Family Interview and Donor Conception Interview between December 2015 and March 2016 as part of the second phase of a longitudinal, multi-method, multi-informant study of solo mother families. PARTICIPANTS/MATERIALS, SETTING, METHODS All children were aged between 7 and 13 years and had been conceived by donor insemination to solo mothers. Interviews were conducted in participants’ homes. The Friends and Family Interview was rated according to a standardized coding scheme designed to measure security of attachment in terms of secure–autonomous, insecure–dismissing, insecure–preoccupied and insecure–disorganized attachment patterns. Quantitative analyses of the Donor Conception Interview yielded two factors: interest in the donor and perceptions of the donor. Qualitative analyses of the Donor Conception Interview were conducted using qualitative content analysis and thematic analysis. MAIN RESULTS AND THE ROLE OF CHANCE Statistically significant associations were found between the perception of the donor scale and the secure–autonomous and insecure–disorganized attachment ratings. Children with higher levels of secure–autonomous attachment to their mothers were more likely to have positive perceptions of the donor (r = 0.549, P = 0.015), and those with higher levels of insecure–disorganized attachment to their mothers were more likely to perceive him negatively (r = −0.632, P = 0.004). Children's narratives about the donor depicted him as a stranger (n = 8), a biological father (n = 4), a social parent (n = 3), or in ambivalent terms (n = 4). LIMITATIONS, REASONS FOR CAUTION Findings are limited by the wide age range of children within a small overall sample size. Participants were those willing and able to take part in research on donor conception families. The statistical significance of correlation coefficients was not corrected for multiple comparisons. WIDER IMPLICATIONS OF THE FINDINGS Findings highlight the importance of situating children's ideas about the donor within family contexts. It is recommended that those working with donor conception families consider this when advising parents about whether, what and how to tell children about donor conception. 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, UK
| | - C M Jones
- Centre for Family Research, University of Cambridge, Free School Lane, Cambridge, UK
| | - T Basi
- Centre for Family Research, University of Cambridge, Free School Lane, Cambridge, UK
| | - S Golombok
- Centre for Family Research, University of Cambridge, Free School Lane, Cambridge, UK
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20
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Zadeh S. Disclosure of donor conception in the era of non-anonymity: safeguarding and promoting the interests of donor-conceived individuals? Hum Reprod 2016; 31:2416-2420. [PMID: 27698073 DOI: 10.1093/humrep/dew240] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 08/07/2016] [Accepted: 08/22/2016] [Indexed: 12/15/2022] Open
Abstract
This article responds to a debate article published in Human Reproduction earlier this year. In that article, the authors suggested that parents should be encouraged to disclose the use of donor gametes to their children given rapid and widespread advances in genetic testing and sequencing. However, there is an urgent need to engage with the assertion that in this context, telling children about their donor conception both safeguards and promotes their interests, particularly if such disclosure is motivated by parents' anxieties about accidental discovery. Disclosure that is motivated by the notion of non-anonymity may also encourage parents to share misinformation about donors and encourage their children to have unrealistic expectations. Fertility professionals must remain mindful of these outcomes when discussing disclosure and the future implications of increasing access to genetic information with both prospective and current parents. It is strongly advised that future discussions about the end of donor anonymity are not conflated with the debate on disclosure.
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Affiliation(s)
- Sophie Zadeh
- Centre for Family Research, University of Cambridge, Free School Lane, Cambridge, CB2 3RQ, UK
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21
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Raes I, Ravelingien A, Pennings G. Donor Conception Disclosure: Directive or Non-Directive Counselling? JOURNAL OF BIOETHICAL INQUIRY 2016; 13:369-379. [PMID: 27116204 DOI: 10.1007/s11673-015-9686-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 06/17/2015] [Indexed: 06/05/2023]
Abstract
It is widely agreed among health professionals that couples using donor insemination should be offered counselling on the topic of donor conception disclosure. However, it is clear from the literature that there has long been a lack of agreement about which counselling approach should be used in this case: a directive or a non-directive approach. In this paper we investigate which approach is ethically justifiable by balancing the two underlying principles of autonomy (non-directive approach) and beneficence (directive approach). To overrule one principle in favour of another, six conditions should be fulfilled. We analyse the arguments in favour of the beneficence principle, and consequently, a directive approach. This analysis shows that two conditions are not met; the principle of autonomy should not be overridden. Therefore, at this moment, a directive counselling approach on donor conception disclosure cannot be ethically justified.
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Affiliation(s)
- Inez Raes
- Bioethics Institute Ghent (BIG), Department of Philosophy and Moral Science, Ghent University, Blandijnberg 2, B-9000, Gent, Belgium.
| | - An Ravelingien
- Bioethics Institute Ghent (BIG), Department of Philosophy and Moral Science, Ghent University, Blandijnberg 2, B-9000, Gent, Belgium
| | - Guido Pennings
- Bioethics Institute Ghent (BIG), Department of Philosophy and Moral Science, Ghent University, Blandijnberg 2, B-9000, Gent, Belgium
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22
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Visser M, Mochtar MH, van der Veen F. Open-Identity Sperm Donation: How Does Offering Donor-Identifying Information Relate to Donor-Conceived Offspring's Wishes and Needs? JOURNAL OF BIOETHICAL INQUIRY 2016; 13:363-364. [PMID: 27365103 DOI: 10.1007/s11673-016-9730-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 05/05/2016] [Indexed: 06/06/2023]
Affiliation(s)
- Marja Visser
- Academic Medical Centre, University of Amsterdam, Center for Reproductive Medicine, Meibergdreef 9, Amsterdam, Noord-Holland, 1105 AZ, The Netherlands.
| | - Monique H Mochtar
- Academic Medical Centre, University of Amsterdam, Center for Reproductive Medicine, Meibergdreef 9, Amsterdam, Noord-Holland, 1105 AZ, The Netherlands
| | - Fulco van der Veen
- Academic Medical Centre, University of Amsterdam, Center for Reproductive Medicine, Meibergdreef 9, Amsterdam, Noord-Holland, 1105 AZ, The Netherlands
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23
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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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24
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Ravelingien A, Provoost V, Pennings G. Open-Identity Sperm Donation: How Does Offering Donor-Identifying Information Relate to Donor-Conceived Offspring's Wishes and Needs? JOURNAL OF BIOETHICAL INQUIRY 2015; 12:503-509. [PMID: 24996630 DOI: 10.1007/s11673-014-9550-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 05/08/2014] [Indexed: 06/03/2023]
Abstract
Over the past years, a growing number of countries have legislated open-identity donation, in which donor-conceived offspring are given access to the donor's identity once the child has reached maturity. It is held that donor anonymity creates identity problems for such children similar to the "genealogical bewilderment" described within the adoption context. The study of the social and psychological effects of open-identity donation is still very much in its infancy, but what has been left unquestioned is whether (and to what extent) offering access to the donor's name and address is an adequate response to such effects. This study has two goals: First, we aim to provide a systematic review of the reasons why donor-conceived (DC) offspring want to know the identity of their sperm donor. Second, we examine to what extent the provision of donor-identifying information can satisfy the reasons mentioned. The most important motivations appear to be: (1) to avoid medical risks and consanguineous relationships; (2) to satisfy curiosity; (3) to learn more about the self or to complete one's identity; (4) to learn more about what kind of person the donor is (biographical information, why he donated, etc.); (5) to form a relationship with the donor and/or his family; and (6) to learn about one's ancestry/genealogy. Our analysis shows that for nearly all of these reasons access to the donor's identity is not necessary. In those cases where it is, moreover, donor identification is not sufficient. What is really needed is (extended) contact with the donor, rather than the mere provision of his name.
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Affiliation(s)
- An Ravelingien
- Bioethics Institute Ghent, Department of Philosophy and Moral Sciences, Ghent University, Blandijnberg 2, 9000, Ghent, Belgium.
| | - Veerle Provoost
- Bioethics Institute Ghent, Department of Philosophy and Moral Sciences, Ghent University, Blandijnberg 2, 9000, Ghent, Belgium.
| | - Guido Pennings
- Bioethics Institute Ghent, Department of Philosophy and Moral Sciences, Ghent University, Blandijnberg 2, 9000, Ghent, Belgium.
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Janssens PMW, Thorn P, Castilla JA, Frith L, Crawshaw M, Mochtar M, Bjorndahl L, Kvist U, Kirkman-Brown JC. Evolving minimum standards in responsible international sperm donor offspring quota. Reprod Biomed Online 2015; 30:568-80. [PMID: 25817048 DOI: 10.1016/j.rbmo.2015.01.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 01/28/2015] [Accepted: 01/29/2015] [Indexed: 11/26/2022]
Abstract
An international working group was established with the aim of making recommendations on the number of offspring for a sperm donor that should be allowable in cases of international use of his sperm. Considerations from genetic, psychosocial, operational and ethical points of view were debated. For these considerations, it was assumed that current developments in genetic testing and Internet possibilities mean that, now, all donors are potentially identifiable by their offspring, so no distinction was made between anonymous and non-anonymous donation. Genetic considerations did not lead to restrictive limits (indicating that up to 200 offspring or more per donor may be acceptable except in isolated social-minority situations). Psychosocial considerations on the other hand led to proposals of rather restrictive limits (10 families per donor or less). Operational and ethical considerations did not lead to more or less concrete limits per donor, but seemed to lie in-between those resulting from the aforementioned ways of viewing the issue. In the end, no unifying agreed figure could be reached; however the consensus was that the number should never exceed 100 families. The conclusions of the group are summarized in three recommendations.
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Affiliation(s)
- Pim M W Janssens
- Chairman of the Working Group, Department of Clinical Chemistry and Haematology, Semen Bank, Rijnstate Hospital, Arnhem, The Netherlands.
| | - Petra Thorn
- Praxis für Paar-und Familientherapie, Mörfelden, Germany
| | - Jose A Castilla
- U. Reproducción, UGC de Obstetricia y Ginecología, Hospital Universitario Virgen de las Nieves, Granada, Spain; Clinica MasVida Reproducción, Sevilla, Spain
| | - Lucy Frith
- Department of Health Services Research, University of Liverpool, Liverpool, UK
| | - Marilyn Crawshaw
- Department of Social Policy and Social Work, University of York and Independent Researcher, York, UK
| | - Monique Mochtar
- Centrum voor Voortplantingsgeneeskunde, Academic Medical Centre, Amsterdam, The Netherlands
| | - Lars Bjorndahl
- Centre for Andrology and Sexual Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Ulrik Kvist
- Department of Physiology, Karolinska Institute, Stockholm, Sweden
| | - Jackson C Kirkman-Brown
- Centre for Human Reproductive Science (ChRS), Birmingham Women's NHS Foundation Trust, Birmingham, UK; School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK
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