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Siermann M, Visser M, Schrijvers A, Mochtar M, Gerrits T. 'Doing' kinship: heterosexual parents' experiences of non-genetic parenthood through donor conception. Reprod Biomed Online 2023; 46:210-218. [PMID: 36270931 DOI: 10.1016/j.rbmo.2022.09.006] [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: 05/30/2022] [Revised: 08/26/2022] [Accepted: 09/07/2022] [Indexed: 01/31/2023]
Abstract
RESEARCH QUESTION How do Dutch heterosexual parents who achieved parenthood through donor conception navigate non-genetic parenthood and kinship? DESIGN A qualitative in-depth semi-structured interview study was performed between September 2018 and January 2019 with both partners of 13 Dutch heterosexual couples where the male partner suffered from infertility and who conceived a child with the help of a sperm donor. Interview questions were based on literature and clinical experiences of experts in the field of donor conception. Interviews were transcribed and analysed using thematic analysis. RESULTS All parents navigated non-genetic parenthood through 'doing' kinship: they negotiated the importance of nature versus nurture with regards to donor conception and non-genetic parenthood. Most parents perceived genetics as irrelevant for experiencing parenthood, bonding with their children and the preferred role of the donor in their future lives. Yet most of them found genetics relevant for generating similarities between the father and the child, and for wanting the same donor for all their children to ensure a full genetic relation among them. Additionally, based on the donor's genetic bond with the child, some men were anxious about the donor's role in the child's future life and the consequences for their position as a non-genetic father. A few women perceived genetics as relevant in terms of possible inherited illnesses from the donor. CONCLUSIONS Parents experienced several ambiguities regarding the role of genetics in donor conception and navigated 'doing' kinship in various ways. These aspects need to be taken into consideration during the counselling of prospective parents planning to conceive with donor conception.
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Affiliation(s)
- Maria Siermann
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, The Netherlands; Centre for Reproductive Medicine, Amsterdam UMC, Amsterdam, The Netherlands; Present address: Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
| | - Marja Visser
- Centre for Reproductive Medicine, Amsterdam UMC, Amsterdam, The Netherlands
| | - Anne Schrijvers
- Centre for Reproductive Medicine, Amsterdam UMC, Amsterdam, The Netherlands
| | - Monique Mochtar
- Centre for Reproductive Medicine, Amsterdam UMC, Amsterdam, The Netherlands
| | - Trudie Gerrits
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, The Netherlands
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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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3
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Informing offspring of their conception by gamete or embryo donation: an Ethics Committee opinion. Fertil Steril 2018; 109:601-605. [DOI: 10.1016/j.fertnstert.2018.01.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 01/03/2018] [Indexed: 11/19/2022]
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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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Scheib JE, Ruby A, Benward J. Who requests their sperm donor's identity? The first ten years of information releases to adults with open-identity donors. Fertil Steril 2016; 107:483-493. [PMID: 27887716 DOI: 10.1016/j.fertnstert.2016.10.023] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 10/15/2016] [Accepted: 10/16/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To report findings from 10 years of requests from adults eligible to obtain their open-identity sperm donor's information. DESIGN Analysis of archived family and donor data. Semistructured interviews at information releases. SETTING Not applicable. PATIENT(S) A total of 85 DI adults requesting 43 donor identities; program data on 256 DI families. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) We identified [1] demographic predictors of requesting donor identities, [2] information release timing and length, and [3] request motives. RESULT(S) Just >35% of eligible DI adults requested their donor's identity. Adults ranged from 18-27 years, requesting at median age 18 years. More women than men requested. Proportionally fewer adults requested when they had heterosexual-couple parents, and proportionally more when they had one rather than two parents. In interviews, the common theme was wanting to know more about the donor, especially about shared characteristics. Most adults planned to contact their donor. More than 94% of adults had donors who were open to contact; adults expressed modest expectations about this contact. CONCLUSION(S) In 2001, the first adults became eligible to obtain their open-identity sperm donor's information. Ten years of identity requests at one program indicates that information about one's donor is important to a significant proportion of these DI adults. Most requested their donor's identity soon after becoming eligible, suggesting some urgency to wanting the information. Interview data highlighted the role of donor information in helping adults better understand themselves and their ancestry. Findings hold important implications for practice and policy.
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Affiliation(s)
- Joanna E Scheib
- Department of Psychology, University of California, Davis, California; The Sperm Bank of California, Berkeley, California.
| | - Alice Ruby
- The Sperm Bank of California, Berkeley, California
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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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Freeman T, Zadeh S, Smith V, Golombok S. Disclosure of sperm donation: a comparison between solo mother and two-parent families with identifiable donors. Reprod Biomed Online 2016; 33:592-600. [PMID: 27617789 PMCID: PMC5084687 DOI: 10.1016/j.rbmo.2016.08.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 08/09/2016] [Accepted: 08/09/2016] [Indexed: 11/30/2022]
Abstract
Disclosure of donor conception to children was compared between solo mother and two-parent families with children aged 4–8 years conceived since the removal of donor anonymity in the UK. Semi-structured interviews were conducted with 31 heterosexual solo mothers and 47 heterosexual mothers with partners to investigate their decisions and experiences about identifiable donation and disclosure to their children. No significant difference was found in the proportion of mothers in each family type who had told their children about their donor conception (solo mothers 54.8%; partnered mothers 36.2%). Of those who had not told, a significantly higher proportion of solo mothers than partnered mothers intended to disclose (P < 0.05). Partnered mothers were more likely than solo mothers to feel neutral, ambivalent or negative about having used an identifiable donor (P < 0.05), and were less likely to consider children's knowledge of their genetic origins as extremely important (P < 0.05). These findings are relevant to provision of counselling services as it cannot be assumed that parents will tell their children about their origins or their entitlement to request the identity of their donor at the age of 18 years. Further qualitative research would increase understanding of solo mothers' attitudes towards disclosure.
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Affiliation(s)
- Tabitha Freeman
- Centre for Family Research, University of Cambridge, Free School Lane, Cambridge, CB2 3RF, UK.
| | - Sophie Zadeh
- Centre for Family Research, University of Cambridge, Free School Lane, Cambridge, CB2 3RF, UK
| | - Venessa Smith
- The London Women's Clinic, 113-115 Harley Street, London, W1G 6AP, UK
| | - Susan Golombok
- Centre for Family Research, University of Cambridge, Free School Lane, Cambridge, CB2 3RF, UK
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Mandatory counseling for gamete donation recipients: ethical dilemmas. Fertil Steril 2015; 104:507-12. [DOI: 10.1016/j.fertnstert.2015.07.1154] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 07/20/2015] [Accepted: 07/21/2015] [Indexed: 11/22/2022]
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Wilde R, McTavish A, Crawshaw M. Family building using donated gametes and embryos in the UK: Recommendations for policy and practice on behalf of the British Infertility Counselling Association and the British Fertility Society in collaboration with the Association of Clinical Embryologists and the Royal College of Nurses Fertility Nurses Forum. HUM FERTIL 2013; 17:1-10. [PMID: 24329028 DOI: 10.3109/14647273.2013.862041] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Ruth Wilde
- Complete Fertility Centre Southampton, Princess Anne Hospital , Southampton, Hampshire , UK
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Crawshaw M, Montuschi O. Participants’ views of attending parenthood preparation workshops for those contemplating donor conception parenthood. J Reprod Infant Psychol 2013. [DOI: 10.1080/02646838.2012.748886] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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12
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Isaksson S, Skoog Svanberg A, Sydsjö G, Thurin-Kjellberg A, Karlström PO, Solensten NG, Lampic C. Two decades after legislation on identifiable donors in Sweden: are recipient couples ready to be open about using gamete donation? Hum Reprod 2011; 26:853-60. [PMID: 21212053 DOI: 10.1093/humrep/deq365] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Two decades after the introduction of Swedish legislation that allows children born as a result of gamete donation access to identifying information about the donor, a nationwide multicentre study on the psychosocial consequences of this legislation for recipients and donors of gametes was initiated in 2005. The aim of the present study was to investigate recipient couples' attitudes and behaviour regarding disclosure to offspring and others, attitudes towards genetic parenthood and perceptions of information regarding parenthood after donation. METHODS The present study is part of the prospective longitudinal 'Swedish study on gamete donation', including all fertility clinics performing donation treatment in Sweden. A consecutive cohort of 152 heterosexual recipient couples of donated oocytes (72% response) and 127 heterosexual recipient couples of donated sperm (81% response) accepted participation in the study. In connection with the donation treatment, male and female participants individually completed two questionnaires with study-specific instruments concerning disclosure, genetic parenthood and informational aspects. RESULTS About 90% of participants (in couples receiving anonymous donated gametes) supported disclosure and openness to the offspring concerning his/her genetic origin. Only 6% of all participants had not told other people about their donation treatment. Between 26 and 40% of participants wanted additional information/support about parenthood following donation treatment. CONCLUSIONS Two decades after the Swedish legislation of identifiable gamete donors, recipient couples of anonymously donated sperm and oocytes are relatively open about their treatment and support disclosure to offspring. Recipient couples may benefit from more information and support regarding parenthood after gamete donation. Further studies are required to follow-up on the future parents' actual disclosure behaviour directed to offspring.
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Affiliation(s)
- S Isaksson
- Department of Public Health and Caring Sciences, Uppsala University, S-751 22 Uppsala, Sweden
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Blyth E, Langridge D, Harris R. Family building in donor conception: parents’ experiences of sharing information. J Reprod Infant Psychol 2010. [DOI: 10.1080/02646830903295018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
Beyond the scientific progress in assisted reproductive technologies (ART), it is necessary to discuss the ethical considerations behind these advances. Ethical issues concerning sperm donation have been considered and discussed by government and non-governmental agencies, the public, media and academic institutions in many countries. Recommendations and guidelines concerning sperm donation issues vary from country to country and between professional groups within countries. This paper attempts to present an overview of findings and reports from various agencies concerning the ethics of sperm donation. The following topics are considered: limiting the number of donor offspring; minimizing risk of infection and genetics from sperm donors; age requirements for sperm donors; and anonymity versus non-anonymity of sperm donors. The diversity of policies shows that each country has its unique set of guidelines tailored toward its own specific needs. Similarly, countries designing their own procedures and guidelines concerning reproductive medicine must tailor them toward their own needs and practical considerations. In Mainland China, the anonymous policy for sperm donation should still be carried out, and the number of donor offspring should be revaluated. ART procedures must be conducted in a way that is respectful of those involved. Ethical principles must respect the interests and welfare of persons who will be born as well as the health and psychosocial welfare of all participants, including sperm donors.
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15
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Leese H. The legacy of IVF. HUM FERTIL 2008; 11:69-70. [PMID: 18569060 DOI: 10.1080/14647270802191519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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