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Bolt SH, Maas AJBM, Indekeu A, van Nistelrooij I. Legal age limits in accessing donor information: experiences of donor-conceived people, parents, sperm donors and counsellors. Reprod Biomed Online 2024; 48:103846. [PMID: 38579663 DOI: 10.1016/j.rbmo.2024.103846] [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: 10/02/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 04/07/2024]
Abstract
RESEARCH QUESTION What are the lived experiences of donor-conceived people, parents, sperm donors and counsellors related to legal age limits on accessing donor information in the Netherlands? DESIGN A phenomenological study was carried out that included 20 donor-conceived individuals, 15 parents, 6 sperm donors and 5 counsellors. Data were collected through online qualitative in-depth interviews and focus groups. The data were analysed using Dahlberg's Reflective Lifeworld Approach. RESULTS The results show how: (i) age limits create challenges related to dependency, autonomy and loyalty to parents; (ii) donor information can be important for identity development, which looks different at different ages; (iii) inaccessible information can lead to unfair loss and may be perceived as negative; (iv) relational stability provides a good foundation for dealing with the (in)accessibility of donor information; (v) procedural barriers and age limits increase the inaccessibility of donor information; and (vi) comprehensive counselling is desired for donor-conceived individuals, parents and donors. CONCLUSIONS This study shows that legal age limits on accessing donor information can lead to several negative consequences. The age limits focus on one individual, which is not appropriate for questions about ancestry that always pertain to a relational network. Counselling should be tailored to the child's needs, and the child's family should be involved. Furthermore, the donor should receive independent counselling.
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Affiliation(s)
| | | | - Astrid Indekeu
- Fiom, 's-Hertogenbosch, The Netherlands.; Centre for Sociological Research, KU Leuven, Leuven, Belgium
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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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Hershberger PE, Gallo AM, Adlam K, Driessnack M, Grotevant HD, Klock SC, Pasch L, Gruss V. Development of the Tool to Empower Parental Telling and Talking (TELL Tool): A digital decision aid intervention about children's origins from donated gametes or embryos. Digit Health 2023; 9:20552076231194934. [PMID: 37654721 PMCID: PMC10467186 DOI: 10.1177/20552076231194934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 07/28/2023] [Indexed: 09/02/2023] Open
Abstract
Objective This study aimed to create and develop a well-designed, theoretically driven, evidence-based, digital, decision Tool to Empower Parental Telling and Talking (TELL Tool) prototype. Methods This developmental study used an inclusive, systematic, and iterative process to formulate a prototype TELL Tool: the first digital decision aid for parents who have children 1 to 16 years of age and used donated gametes or embryos to establish their families. Recommendations from the International Patient Decision Aids Standards Collaboration and from experts in decision aid development, digital health interventions, design thinking, and instructional design guided the process. Results The extensive developmental process incorporated researchers, clinicians, parents, children, and other stakeholders, including donor-conceived adults. We determined the scope and target audience of the decision aid and formed a steering group. During design work, we used the decision-making process model as the guiding framework for selecting content. Parents' views and decisional needs were incorporated into the prototype through empirical research and review, appraisal, and synthesis of the literature. Clinicians' perspectives and insights were also incorporated. We used the experiential learning theory to guide the delivery of the content through a digital distribution plan. Following creation of initial content, including storyboards and scripts, an early prototype was redrafted and redesigned based on feedback from the steering group. A final TELL Tool prototype was then developed for alpha testing. Conclusions Detailing our early developmental processes provides transparency that can benefit the donor-conceived community as well as clinicians and researchers, especially those designing digital decision aids. Future research to evaluate the efficacy of the TELL Tool is planned.
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Affiliation(s)
- Patricia E. Hershberger
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Agatha M. Gallo
- Department of Human Development Nursing, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Kirby Adlam
- Department of Human Development Nursing, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Martha Driessnack
- School of Nursing, Oregon Health & Science University, Portland, OR, USA
| | - Harold D. Grotevant
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, USA
| | - Susan C. Klock
- Departments of Obstetrics and Gynecology and Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lauri Pasch
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Valerie Gruss
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
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Glidden EA, Thibaut D, Goodman J. The impact of the method of genetic identity disclosure on the donor conceived adult. J Psychosom Obstet Gynaecol 2022; 43:258-264. [PMID: 35077297 DOI: 10.1080/0167482x.2022.2030307] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Aim: 106 donor conceived people (DCP) responded to an anonymous survey study that examined the impact of the method of genetic identity disclosure and age at the time of the disclosure on their emotional wellbeing, familial relations, and perceptions of donor conception practices.Methods: Participants were asked to select the way in which they were informed they are DCP and the age group at which this occurred, and then were asked to select strongly agree, agree, neither agree or disagree, disagree, or strongly disagree in response to 26 statements that examined their perceptions of the topics listed above. Responses were grouped based on the age of genetic identity disclosure and the method of genetic identity disclosure, then numerically compared by assigning each type of response a number. Statistical analysis using repeatedmeasures ANOVA was performed to identify differences among these factors.Results: This analysis revealed that most participants 18 ≥ years and most participants who discovered their genetic identity through means other than through their parent(s) had worse emotional wellbeing and familial relations. However, most participants among all categories had a negative perception of donor conception practices.Conclusion: Continued work is needed to understand and support the growing DCP population.
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Affiliation(s)
- Emily Ann Glidden
- Lake Erie College of Osteopathic Medicine - Bradenton Campus, Bradenton, FL, USA
| | - Dylan Thibaut
- Lake Erie College of Osteopathic Medicine - Bradenton Campus, Bradenton, FL, USA.,Burnett School of Biomedical Sciences, University of Central Florida, Orlando, FL, USA
| | - Jerry Goodman
- Lake Erie College of Osteopathic Medicine - Bradenton Campus, Bradenton, FL, USA
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Sociological Accounts of Donor Siblings' Experiences: Their Importance for Self-Identity and New Kinship Relations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042002. [PMID: 35206190 PMCID: PMC8871783 DOI: 10.3390/ijerph19042002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/28/2022] [Accepted: 02/05/2022] [Indexed: 11/16/2022]
Abstract
A fundamental part of the adolescent self is formed through interaction with intimates, usually family members whose roles are reasonably well-defined. However, donor siblings-children who share a sperm donor-lack social scripts for interacting with one another, particularly when they are raised in different households. Moreover, they are often challenged to figure out their relationship to newly discovered genetic relatives. This article examines how donor-conceived teens and young adults navigate relationships with their half siblings and form intimate relationships. Drawing on Garfinkel's concept of indexing, or the use of familiar categories to make sense of new situations, these youth rely upon their personal knowledge of friends and family to figure out what kinds of relationship they can develop with donor siblings. Based on interviews with 62 youth aged 14-28, who had their own social media accounts and who had chosen to establish contact with their donor siblings, the articles discusses the three stages most donor siblings go through-"anticipation", "first contact", and "relationship building"-and the way those stages shape individual identity formation. In the course of the analysis, the article also explores whether interaction with donor siblings affected individual's sense of identity and whether feelings of closeness with donor siblings differ for youth raised as solo children versus those who have siblings with whom they share a household. For those who report feeling close, youth describe how intimacy is sustained and negotiated at a distance. Finally, as much as youth pick and choose intimates from their larger network, the article also argues that their collective identity as related-kin members remains.
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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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Bolt SH, Notermans C, van Brouwershaven AC, Maas AJBM, Indekeu A. The ongoing work of kinship among donor half-siblings in The Netherlands. BIOSOCIETIES 2021. [DOI: 10.1057/s41292-021-00259-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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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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Golombok S. Love and Truth: What Really Matters for Children Born Through Third‐Party Assisted Reproduction. CHILD DEVELOPMENT PERSPECTIVES 2021. [DOI: 10.1111/cdep.12406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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