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Pinto da Silva S, de Freitas C, Silva S. Medical ethics when moving towards non-anonymous gamete donation: the views of donors and recipients. JOURNAL OF MEDICAL ETHICS 2022; 48:616-623. [PMID: 34172523 DOI: 10.1136/medethics-2020-106947] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 04/15/2021] [Accepted: 05/04/2021] [Indexed: 06/13/2023]
Abstract
Drawing on the views of donors and recipients about anonymity in a country that is experiencing a transition towards non-anonymous gamete donation mandated by the Constitutional Court, we explore how the intersection between rights-based approaches and an empirical framework enhances recommendations for ethical policy and healthcare. Between July 2017 and April 2018, 69 donors and 147 recipients, recruited at the Portuguese Public Bank of Gametes, participated in this cross-sectional study. Position towards anonymity was assessed through an open-ended question in a self-report questionnaire, which was subject to content analysis. Preference for an anonymous donation regime was mentioned by 82.6% of donors and 89.8% of recipients; and all those with children. Instead of the rights-based reasoning used by the Constitutional Court, donors highlighted concerns over future relationships and recipients focused on socioethical values linked with the safeguard of safety, privacy and confidentiality. The remaining participants advocated the choice between anonymity or non-anonymity (double-track policy), invoking respect for their autonomy. The complex, diverse ethical views and reasoning of donors and recipients expand a traditionally dichotomous discussion. Their perspectives challenge the transition towards non-anonymity and international guidelines, raising awareness to the need for their involvement in the design of policies to enable choice according to their values and preferences, and of psychosocial counselling responsive to their socioethical concerns and sensitive to their parental status. Empirical frameworks complement rights-based approaches to uphold justice, fairness and equal respect, and to incorporate utility, beneficence and non-maleficence in policymaking and healthcare in the transition towards non-anonymity.
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Affiliation(s)
- Sandra Pinto da Silva
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Cláudia de Freitas
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Susana Silva
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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Graham S, Freeman T, Jadva V. A comparison of the characteristics, motivations, preferences and expectations of men donating sperm online or through a sperm bank. Hum Reprod 2020; 34:2208-2218. [PMID: 31711146 PMCID: PMC6892463 DOI: 10.1093/humrep/dez173] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 07/16/2019] [Indexed: 11/23/2022] Open
Abstract
STUDY QUESTION How do the demographic characteristics, motivations, experiences and expectations of unregulated sperm donors (men donating sperm online through a connection website) compare to sperm donors in the regulated sector (men donating through a registered UK sperm bank)? SUMMARY ANSWER Online donors were more likely to be older, married and have children of their own than sperm bank donors, were more varied in their preferences and expectations of sperm donation, and had more concerns about being a sperm donor. WHAT IS KNOWN ALREADY While studies have examined motivations and experiences of both regulated sperm bank, and unregulated online sperm donors, no study has directly compared these two groups of donors. STUDY DESIGN, SIZE, DURATION An email was sent to the 576 men who were registered sperm donors at the London Sperm Bank, the UK’s largest sperm bank regulated by the Human Fertilisation and Embryology Authority (HFEA), who had commenced donation between January 2010 and December 2016, and had consented to be contacted for research. The online survey, which contained multiple choice and open-ended questions, was completed by 168 men over a 7-week period. The responses were compared to those of sperm donors registered on Pride Angel, a large UK-based connection website for donors and recipients of sperm: our research team had already collected these data. In total, 5299 sperm donors were on Pride Angel at time of data capture and 400 men had completed a similar survey. The responses of 70 actual online sperm donors (i.e. those whose sperm had been used to conceive at least one child) were used for comparison with the sperm bank donors. PARTICIPANTS/MATERIALS, SETTING, METHODS The survey obtained data on the sperm donors’ demographic characteristics, motivations, experiences and expectations of sperm donation. Data from sperm bank donors were compared to online donors to examine differences between the two groups. The study compared online and clinic donors who had all been accepted as sperm donors: online donors who had been ‘vetted’ by recipients and sperm bank donors who had passed the rigorous screening criteria set by the clinic. MAIN RESULTS AND THE ROLE OF CHANCE A response rate of 29% was obtained from the sperm bank donors. Online donors were significantly older than sperm bank donors (mean ± SD: 38.7 ± 8.4 versus 32.9 ± 6.8 years, respectively) and were more likely to have their own children (p < 0.001 for both characteristics). Both groups rated the motivation ‘I want to help others’ as very important. Online donors rated ‘I don’t want to have children myself’, ‘to have children/procreate’ and ‘to enable others to enjoy parenting as I have myself’ as more important than sperm bank donors, whereas sperm bank donors rated financial payment as more important than online donors, as well as confirmation of own fertility. Most (93.9%) online donors had donated their sperm elsewhere, through other connection sites, fertility clinics, sperm banks or friends and family, compared to only 2.4% of sperm bank donors (p < 0.001). There was a significant difference in how donors viewed their relationship to the child, with online donors much less likely than sperm bank donors to see their relationship as a ‘genetic relationship only’. Online donors had more concerns about being a donor (p < 0.001), for example, being concerned about ‘legal uncertainty and child financial support’ and ‘future contact and uncertainty about relationship with donor-conceived child’. LIMITATIONS, REASONS FOR CAUTION Findings may not be representative of all sperm donors as only one online connection site and one HFEA registered sperm bank were used for recruitment. WIDER IMPLICATIONS OF THE FINDINGS Despite concern regarding shortages of sperm donors in licensed clinics and unease regarding the growing popularity of unregulated connection websites, this is the first study to directly compare online and sperm bank donors. It highlights the importance of considering ways to incorporate unregulated online sperm donors into the regulated sector. With many online donors well aware of the legal risks they undertake when donating in the unregulated online market, this would both increase the number of sperm donors available at clinics but also provide legal protection and support for donors. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by the Wellcome Trust Grants 104 385/Z/14/Z and 097857/Z/11/Z. The authors have no conflicts of interest.
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Affiliation(s)
- S Graham
- Centre for Family Research, University of Cambridge, Free School Lane, Cambridge CB2 3RF, United Kingdom
| | - T Freeman
- Centre for Family Research, University of Cambridge, Free School Lane, Cambridge CB2 3RF, United Kingdom
| | - V Jadva
- Centre for Family Research, University of Cambridge, Free School Lane, Cambridge CB2 3RF, United Kingdom
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Mahieu F, Decleer W, Osmanagaoglu K, Provoost V. Anonymous sperm donors' attitude towards donation and the release of identifying information. J Assist Reprod Genet 2019; 36:2007-2016. [PMID: 31463872 DOI: 10.1007/s10815-019-01569-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 08/15/2019] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Belgian legislation allows only strictly anonymous gamete donation and known donation (donation to a recipient known by the donor). Recently, an amendment of the legislation was proposed to grant donor offspring, as of 18 years old, the right to claim identifying information about their donor. PURPOSE The aim is to explore the attitude of actual sperm donors towards donation and the release of identifying information and to investigate which donors would be willing to donate when anonymity would be prohibited by law. METHODS All men who were accepted as sperm donors (n = 242) by AZ Jan Palfijn Hospital (Ghent, Belgium) were invited to complete an anonymous online survey. The response rate was 65.5%. RESULTS One in five (20.1%; n = 30) would continue sperm donation upon a legislation change towards identifiable donation. Three in four donors (75.2%) would agree to provide basic non-identifiable information about themselves and one in three (32.9%) would provide extra non-identifiable information such as a baby photo or a personal letter. Almost half of the donors (45.6%) would agree to donate in a system where the hospital can trace the donor at the child's request and contact the donor, leaving it to the donor to decide whether or not to have contact with the requesting donor child. CONCLUSION These findings show that only one in five current donors would continue to donate when identifiable. The study also demonstrates that current donors think more positive about alternative options and that nearly half of them are willing to be contacted by the hospital at the donor child's request, providing the donor can decide at that time whether or not to release his identity.
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Affiliation(s)
- F Mahieu
- Department of Reproductive Medicine, AZ Jan Palfijn Hospital, Henri Dunantlaan 5, 9000, Ghent, Belgium.
| | - W Decleer
- Department of Reproductive Medicine, AZ Jan Palfijn Hospital, Henri Dunantlaan 5, 9000, Ghent, Belgium
| | - K Osmanagaoglu
- Department of Reproductive Medicine, AZ Jan Palfijn Hospital, Henri Dunantlaan 5, 9000, Ghent, Belgium
| | - V Provoost
- Bioethics Institute Ghent, Department of Philosophy and Moral Sciences, Ghent University, Blandijnberg 2, 9000, Ghent, Belgium
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Interests, obligations, and rights in gamete and embryo donation: an Ethics Committee opinion. Fertil Steril 2019; 111:664-670. [DOI: 10.1016/j.fertnstert.2019.01.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 01/10/2019] [Indexed: 11/23/2022]
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Bolt S, Postema D, van der Heij A, B M Maas AJ. Anonymous Dutch sperm donors releasing their identity. HUM FERTIL 2019; 24:24-30. [PMID: 30652500 DOI: 10.1080/14647273.2018.1564156] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study examined the motivations of anonymous Dutch sperm donors to release their identity. It aimed to increase knowledge and encourage donors to become identifiable through a more informed decision, allowing more donor-conceived persons to contact their donors. Since 2010, anonymous sperm donors in the Netherlands can register in the Fiom KID-DNA Database developed by Fiom and Canisius Wilhelmina Hospital (CWZ). An online survey was sent to donors who registered in the database (May 2015-August 2017). A total of 179 male respondents participated in this study. The motives of most donors to register in the database were child-oriented: donors believe that their offspring are entitled to their physical and social details and/or they want to give their offspring the chance to contact them. Other motives are donor-oriented, such as the curiosity about the number of offspring, their well-being and the desire to establish contact. This research showed that, to encourage anonymous donors to release their identity, one should focus on providing information about the existence of DNA databases. As well as increasing the donor's awareness of problems donor-conceived persons can experience by the lack of knowledge about their descent, answering questions and concerns from donors, and exploring the curiosity about their offspring.
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Blyth E, Crawshaw M, Frith L, van den Akker O. Gamete donors' reasons for, and expectations and experiences of, registration with a voluntary donor linking register. HUM FERTIL 2017. [PMID: 28635412 DOI: 10.1080/14647273.2017.1292005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This paper reports on a study of the views and experiences of 21 sperm donors and five egg donors registered with UK DonorLink (UKDL), a voluntary DNA-based contact register established to facilitate contact between adults who wish to identify and locate others to whom they are genetically related following donor conception. Specifically, the paper examines donors' reasons for searching for, or making information about themselves available to donor-conceived offspring. Their expectations of registration with UKDL, experiences of being registered and finally, the experiences of those who had contacted donor-conceived offspring and other genetic relatives are investigated. While most respondents reported largely positive experiences of registration, the study found significant issues relating to concerns about donation, DNA testing, possible linking with offspring and expectations of any relationship that might be established with offspring that have implications for support, mediation and counselling. Research that puts the experiences, perceptions and interests of gamete donors as the central focus of study is a relatively recent phenomenon. This study contributes to this debate and highlights directions for future research in this area.
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Affiliation(s)
- Eric Blyth
- a School of Human and Health Sciences, University of Huddersfield , Huddersfield , UK
| | - Marilyn Crawshaw
- b Department of Social Policy and Social Work , University of York , York , UK
| | - Lucy Frith
- c Department of Health Services Research , University of Liverpool , Liverpool , UK
| | - Olga van den Akker
- d Department of Psychology, Faculty of Science and Technology , Middlesex University , London , UK
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Freeman T, Jadva V, Tranfield E, Golombok S. Online sperm donation: a survey of the demographic characteristics, motivations, preferences and experiences of sperm donors on a connection website. Hum Reprod 2016; 31:2082-9. [PMID: 27412344 PMCID: PMC4991659 DOI: 10.1093/humrep/dew166] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 05/27/2016] [Accepted: 06/07/2016] [Indexed: 11/15/2022] Open
Abstract
STUDY QUESTION What are the demographic characteristics, motivations, preferences and experiences of heterosexual, gay and bisexual sperm donors on a connection website (i.e. a website that facilitates direct contact between donors and recipients of gametes)? SUMMARY ANSWER This demographically diverse group of men was donating for altruistic reasons and perceived the website as providing greater choice over donation arrangements: approximately one third favoured anonymous donation, most of whom were heterosexual, whilst gay and bisexual donors were more likely to be in contact with children conceived with their sperm. WHAT IS KNOWN ALREADY Despite substantially more sperm donors being registered on connection websites than with clinics, there has been very little research on this population. Current understanding of the impact of sexual orientation on donors' attitudes is also limited. STUDY DESIGN, SIZE, DURATION An online survey was conducted over 7 weeks with 383 men registered as sperm donors with Pride Angel, a large UK-based connection website for donors and recipients of sperm. PARTICIPANTS/MATERIALS, SETTING, METHODS The survey obtained data on participants' demographic characteristics and their motivations, preferences and experiences regarding online sperm donation, including attitudes towards contact with offspring. Differences according to participants' sexual orientation were examined. MAIN RESULTS AND THE ROLE OF CHANCE Most participants (80.4%, 308) were heterosexual, 10.5% (40) were gay and 9.1% (35) were bisexual; ages ranged from 18 to 69 years (median = 36, mean = 37.3, SD = 9.7). A greater proportion of gay and bisexual men desired open-identity donation (P < 0.005) and contact with offspring (P <0.005) than heterosexual men. Approximately one third (28.7%, 110) had donated sperm; 18.3% (70) had conceived at least one child, of whom a minority (25.7%, 18) were currently in contact with the child, comprising significantly more gay and bisexual than heterosexual men (P = 0.001). Heterosexual men were most likely to state a preference for natural insemination, although the large majority (94.3%, 66) of donors who had conceived children had used artificial insemination. LIMITATIONS, REASONS FOR CAUTION Findings may not be representative of all sperm donors using connection websites because members of only one website participated and participants were, by necessity, a self-selected sample. WIDER IMPLICATIONS OF THE FINDINGS This is the first comprehensive study of donors who connect with recipients via the internet, including a substantial number who have donated and conceived children. The findings indicate that sexual orientation may influence men's donation preferences and raise policy issues concerning donor recruitment and the incorporation of online sperm donation into clinical practice. STUDY FUNDING/COMPETING INTERESTS This study was supported by the Wellcome Trust (097857/Z/11/Z). E.T. is the co-founder of Pride Angel; the remaining authors have no conflicts of interest.
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Affiliation(s)
- T Freeman
- Centre for Family Research, Department of Psychology, University of Cambridge, Free School Lane, Cambridge CB2 3RF, UK
| | - V Jadva
- Centre for Family Research, Department of Psychology, University of Cambridge, Free School Lane, Cambridge CB2 3RF, UK
| | | | - S Golombok
- Centre for Family Research, Department of Psychology, University of Cambridge, Free School Lane, Cambridge CB2 3RF, UK
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Abstract
To investigate why men offer sperm donation via the internet, a questionnaire was disseminated via 39 Dutch-language websites thought to be visited by potential sperm donors. Nine internet donors completed the survey, men who typically knew the women they were donating to. Their responses were compared with those of a control group of 35 general sperm bank donors who were recruited using flyers in Dutch sperm banks, and who were typically unaware of the identity of the eventual recipients. The findings shed light on the motives and attitudes of internet donors. Both groups of donors indicated that their primary motivation for donating was altruism (>80% of all respondents). However, internet donors had a more pronounced desire to procreate than sperm bank donors (6 out of 9, i.e. 66 vs. 22%, respectively) and more often felt that they had good genes they wished to pass on (5 out of 9, i.e. 55 vs. 31%, respectively). The main reason internet donors gave for donating via the internet was that they wanted to know the prospective parents and be kept up to date on the progress of the offspring conceived from their donations. This distinguishes them significantly from sperm bank donors. A further finding was that they were not prompted to avoid the formal donation circuit for which, by law in the Netherlands, pregnancies resulting from donations have to be registered in a central database. This study is subject to several, in some cases inevitable, limitations, but it provides an interesting starting point that future studies can seek to confirm and extend.
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Affiliation(s)
| | - Heinrich B Winter
- a Pro Facto , Ossenmarkt 5, 9712 NZ Groningen , The Netherlands.,b Faculty of Law , University of Groningen , PO Box 716, 9700 AS Groningen , The Netherlands
| | - Pim M W Janssens
- c Department of Clinical Chemistry and Haematology/Semen Bank , Rijnstate Hospital , PO Box 9555, 6800 TA Arnhem , The Netherlands
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van den Akker OBA, Crawshaw MA, Blyth ED, Frith LJ. Expectations and experiences of gamete donors and donor-conceived adults searching for genetic relatives using DNA linking through a voluntary register. Hum Reprod 2014; 30:111-21. [DOI: 10.1093/humrep/deu289] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Interests, obligations, and rights in gamete donation: a committee opinion. Fertil Steril 2014; 102:675-81. [DOI: 10.1016/j.fertnstert.2014.06.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 06/02/2014] [Indexed: 11/24/2022]
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Isaksson S, Sydsjö G, Skoog Svanberg A, Lampic C. Preferences and needs regarding future contact with donation offspring among identity-release gamete donors: results from the Swedish Study on Gamete Donation. Fertil Steril 2014; 102:1160-6. [PMID: 25123638 DOI: 10.1016/j.fertnstert.2014.06.038] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 06/12/2014] [Accepted: 06/21/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the attitudes and preferences regarding future contact with donation offspring among identity-release donors of oocytes or sperm. DESIGN Longitudinal cohort study. SETTING University-based fertility clinics in Sweden. PATIENT(S) A total of 210 women and men were questioned 5-8 years after their donation of oocytes or sperm. INTERVENTION(S) Questionnaires given to donors prior to their donation and 5-8 years after donation. MAIN OUTCOME MEASURE(S) Donors' attitudes and preferences regarding future contact with their donation offspring. RESULT(S) A majority of identity-release oocyte (65%) and sperm (70%) donors were positive toward being contacted by an offspring of mature age. More than half wanted to be notified by the clinic when an offspring requested information about them, but about a third were negative toward receiving this information. One in four reported a need for counseling regarding future contact with an offspring. CONCLUSION(S) Several years after donation, a majority of identity-release oocyte and sperm donors show positive attitudes toward future contact with their offspring. Donors appear to have different preferences for information and support regarding such contact. Fertility clinics and health-care services should provide counseling regarding contact with an offspring to the donors who express a need for this.
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Affiliation(s)
- Stina Isaksson
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
| | - Gunilla Sydsjö
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | | | - Claudia Lampic
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Huddinge, Sweden
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Indekeu A, D'Hooghe T, Daniels KR, Dierickx K, Rober P. When 'sperm' becomes 'donor': transitions in parents' views of the sperm donor. HUM FERTIL 2014; 17:269-77. [PMID: 24851674 DOI: 10.3109/14647273.2014.910872] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract Little is known about recipients' views of their sperm donor. This study aimed to examine the possible transitions or consistencies in donor sperm recipients' (DSRs') view on the sperm donor over time. A longitudinal qualitative study of 19 Belgian heterosexual DSRs was undertaken. Interviews took place with both partners of the couple during pregnancy, at birth and 1.5-2 years after birth, and were analysed using a grounded theory approach. Recipients who intended to disclose exhibited a transition in their awareness of the donor from being of minimal importance to one who was increasingly seen as part of their family narrative. This was partly triggered by the offspring's life, remarks about resemblance and the socio-cultural context. The perceived position of the donor changed for most recipients from a threatening rival to a 'distractor'. This change was supported by the emerging father-child bond and the confidence that stemmed from it. These observations were applicable to those recipients who intended to disclose their donor conception; for those recipients who intended not to disclose, little or no transition was observed. This study describes and analyses the transitions and consistencies in recipients' views of the donor over different stages of the family life-cycle (pregnancy, birth, toddler stage) and could help the fertility clinics tailor their counselling to the specific stages of parenthood.
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Affiliation(s)
- Astrid Indekeu
- Centre for Biomedical Ethics and Law , KU Leuven, Leuven , Belgium
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Crawshaw M, Gunter C, Tidy C, Atherton F. Working with previously anonymous gamete donors and donor-conceived adults: recent practice experiences of running the Dna-based voluntary information exchange and contact register, UK Donorlink. HUM FERTIL 2013; 16:26-30. [PMID: 23009055 DOI: 10.3109/14647273.2012.731714] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Raes I, Ravelingien A, Pennings G. The right of the donor to information about children conceived from his or her gametes. Hum Reprod 2013; 28:560-5. [DOI: 10.1093/humrep/des444] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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Semen donors who are open to contact with their offspring: issues and implications for them and their families. Reprod Biomed Online 2012; 25:670-7. [DOI: 10.1016/j.rbmo.2012.09.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Revised: 09/13/2012] [Accepted: 09/13/2012] [Indexed: 11/19/2022]
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Van den Broeck U, Vandermeeren M, Vanderschueren D, Enzlin P, Demyttenaere K, D'Hooghe T. A systematic review of sperm donors: demographic characteristics, attitudes, motives and experiences of the process of sperm donation. Hum Reprod Update 2012; 19:37-51. [DOI: 10.1093/humupd/dms039] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
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Abstract
Two Australian government inquiries have recently called for the release of information to donor-conceived people about their gamete donors. A national inquiry, recommended 'as a matter of priority' that uniform legislation to be passed nationwide. A state-based inquiry argued that all donor-conceived people should have access to information and called for the enactment of retrospective legislation that would override donor anonymity. This paper responds to an opinion piece published in Human Reproduction in October 2012 by Professor Pennings in which he criticized such recommendations and questioned the motives of people that advocate for information release. I answer the arguments of Pennings, and argue that all parties affected by donor conception should be considered, and a compromise reached. The contact veto system is one such compromise. I discuss the education and support services recommended by the Victorian government and question Pennings' assertions that legislation enabling information release will lead to a decrease in gamete donation. Finally, I rebut Pennings' assertion that there is a 'hidden agenda' behind the call for information release. There is no such agenda in my work. If there is from others, then it is their discriminatory views that need to be addressed, not the move toward openness and honesty or the call for information by donor-conceived people.
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Abstract
The article reports qualitative research findings which explored the meanings of kinship and genetic knowledge of fifteen pre-1990 semen donors in the UK. This is presented in the context of public and academic debates about the regulation of access to genetic information, genetic information as intellectual property and kinship knowledge, and the multiple ownership of genetic information. Semen donors in the UK traditionally were expected to take no interest in what became of their donations and those who did were considered to be unsuitable as donors. However, the present research reveals that men who donated in the past hold varied attitudes, including curiosity about how donor offspring have fared and what they look like. Whilst some donors would welcome direct contact with donor offspring, there are practical and emotional obstacles to satisfying their curiosity. Donors' views reflect the varied understandings in the UK about the implications of genetic relatedness and the time and energy required to maintain and sustain relationships.
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Affiliation(s)
- Jennifer M Speirs
- University of Edinburgh, Centre for Research on Families and Relationships, Edinburgh, UK.
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Horowitz JE. Non-traditional Family Building Planning. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2011; 732:115-30. [DOI: 10.1007/978-94-007-2492-1_9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Rodino I, Burton P, Sanders K. Donor information considered important to donors, recipients and offspring: an Australian perspective. Reprod Biomed Online 2011; 22:303-11. [DOI: 10.1016/j.rbmo.2010.11.007] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2010] [Revised: 11/05/2010] [Accepted: 11/09/2010] [Indexed: 11/26/2022]
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Hu J, Zhu W, Liu W, Fan L. Factors affecting fecundity among sperm donors: a multivariate analysis. Andrologia 2011; 43:155-62. [DOI: 10.1111/j.1439-0272.2009.01036.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Jadva V, Freeman T, Kramer W, Golombok S. Sperm and oocyte donors' experiences of anonymous donation and subsequent contact with their donor offspring. Hum Reprod 2010; 26:638-45. [PMID: 21177310 DOI: 10.1093/humrep/deq364] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study examined the motivations and experiences of anonymous donors who decide to make themselves open to contact with their donor offspring. METHODS Online questionnaires were completed by 63 sperm donors and 11 oocyte donors recruited via the Donor Sibling Registry (http://www.donorsiblingregistry.com/), a US-based international registry that facilitates contact between donor-conceived offspring and their donors. RESULTS Donors' main reasons for donating were financial payment and wanting to help others. Sperm donors had donated between 1 and 950 times (median = 100) and oocyte donors had donated between 1 and 5 times (median = 2). The majority of sperm donors and more than one-third of oocyte donors expressed concerns about having donated. These concerns were mainly about the well-being of any children conceived using their gametes and not being able to make contact with them. Most sperm and oocyte donors felt that it was important to know how many offspring had been born using their donation, and 51% of sperm donors and 46% of oocyte donors wanted identifying information. All of the donors who had contact with their donor offspring reported positive experiences and the majority continued to have regular contact. CONCLUSIONS Although the sample may not be representative of all anonymous donors, this study highlights the importance of donors having access to information about their donor offspring and the positive consequences that may arise when contact is made.
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Affiliation(s)
- V Jadva
- Centre for Family Research, Faculty of Politics, Psychology, Sociology and International Studies, Free School Lane, University of Cambridge, Cambridge CB2 3RF, UK.
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Sills ES, Mykhaylyshyn LO, Dorofeyeva US, Walsh DJ, Salma U, Omar AB, Coull GD, David IA, Brickell KM, Tsar OM, Walsh AP. The long path to pregnancy: early experience with dual anonymous gamete donation in a European in vitro fertilisation referral centre. Reprod Health 2010; 7:20. [PMID: 20701806 PMCID: PMC2925351 DOI: 10.1186/1742-4755-7-20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Accepted: 08/11/2010] [Indexed: 11/21/2022] Open
Abstract
Background This investigation describes features of patients undergoing in vitro fertilisation (IVF) and embryo transfer (ET) where both gametes were obtained from anonymous donors. Methods Gamete unsuitability or loss was confirmed in both members of seven otherwise healthy couples presenting for reproductive endocrinology consultation over a 12-month interval in Ireland. IVF was undertaken with fresh oocytes provided by anonymous donors in Ukraine; frozen sperm (anonymous donor) was obtained from a licensed tissue establishment. For recipients, saline-enhanced sonography was used to assess intrauterine contour with endometrial preparation via transdermal estrogen. Results Among commissioning couples, mean±SD female and male age was 41.9 ± 3.7 and 44.6 ± 3.5 yrs, respectively. During this period, female age for non dual anonymous gamete donation IVF patients was 37.9 ± 3 yrs (p < 0.001). Infertility duration was ≥3 yrs for couples enrolling in dual gamete donation, and each had ≥2 prior failed fertility treatments using native oocytes. All seven recipient couples proceeded to embryo transfer, although one patient had two transfers. Clinical pregnancy was achieved for 5/7 (71.4%) patients. Non-transferred cryopreserved embryos were available for all seven couples. Conclusions Mean age of females undergoing dual anonymous donor gamete donation with IVF is significantly higher than the background IVF patient population. Even when neither partner is able to contribute any gametes for IVF, the clinical pregnancy rate per transfer can be satisfactory if both anonymous egg and sperm donation are used concurrently. Our report emphasises the role of pre-treatment counselling in dual anonymous gamete donation, and presents a coordinated screening and treatment approach in IVF where this option may be contemplated.
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Affiliation(s)
- Eric Scott Sills
- Division of Reproductive Endocrinology, The Sims Institute/Department of Obstetrics & Gynaecology, School of Medicine, Royal College of Surgeons in Ireland; Dublin, Ireland.
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Sawyer N. Sperm donor limits that control for the 'relative' risk associated with the use of open-identity donors. Hum Reprod 2010; 25:1089-96. [PMID: 20172868 DOI: 10.1093/humrep/deq038] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The majority of countries that support the use of donor insemination (DI) in artificial reproductive technology (ART) limit the number of children born from one donor. The setting of these donor limits, though intended to control for the risk of inadvertent half-sibling unions between the offspring of anonymous donors, actually have no evidence base. Controlling for the risk of inadvertent half-sibling unions may soon become unnecessary due to the increasing world-wide use of open-identity sperm donors and the revocation of donor anonymity in many countries. With the shift from anonymous to open-identity donation, the central issue is not the risk of genetic abnormality from inadvertent half-sibling consanguinity; it is the psycho-social impact of the multiple use of open-identity sperm donors. Despite this, the jurisdictions that allow or mandate the use of open-identity donors continue to observe existing limits that do not consider nor specifically control for the psycho-social impact of the multiple use of open-identity sperm donors. It is proposed that: (i) conservative interim donor limits be placed on the multiple use of open-identity donors, while research into the psycho-social impact of disclosure is undertaken to inform the establishment of evidence-based limits; and (ii) the existing limits in jurisdictions where anonymity is still commonly practiced or protected could be raised, if an updated mathematical model was used for calculating evidence-based anonymous donor limits.
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Affiliation(s)
- Neroli Sawyer
- School of Behavioural and Social Sciences and Humanities, University of Ballarat, University Drive, Mount Helen, Ballarat, VIC 3353, Australia.
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Crawshaw M, Marshall L. Practice experiences of running UK DonorLink, a voluntary information exchange register for adults related through donor conception. HUM FERTIL 2009; 11:231-7. [DOI: 10.1080/14647270801908228] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
Since 1 April 2005, gamete donors in the United Kingdom (UK) have to be willing, in the future, to be identified to offspring should the offspring want this. This change in law has lead to considerable anxiety about the future availability of donors. This paper presents an overview of the research evidence concerning semen donors' views on anonymity and openness, as it appears in referred journals since 1995. Research evidence that is available, but not yet been published in referred journals, is also reviewed. The nature of this evidence is analysed and criticized. Research on the views of potential semen donors is also reviewed, as is the evidence that is available from jurisdictions that have changed the law and required donor openness. The evidence shows that it is possible to recruit semen donors who are required to be identifiable in the future. The evidence, while not conclusive, points to an open system attracting different kinds of men than an anonymous system, and this has clear implications for future recruitment policies. The evidence-based approach to recruitment of gamete donors challenges some of the beliefs, attitudes and fears that have been associated with this law change in the UK, and in other countries where similar changes have taken place.
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Affiliation(s)
- Ken Daniels
- School of Social Work and Human Services, University of Canterbury, Christchurch, New Zealand.
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27
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Interests, obligations, and rights of the donor in gamete donation. Fertil Steril 2008; 91:22-7. [PMID: 19084224 DOI: 10.1016/j.fertnstert.2008.09.062] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2008] [Accepted: 09/19/2008] [Indexed: 01/13/2023]
Abstract
This Ethics Committee report outlines the interests, obligations, and rights of both male and female donors who choose to provide gametes for use by others.
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28
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Scheib JE, Cushing RA. Open-identity donor insemination in the United States: is it on the rise? Fertil Steril 2007; 88:231-2. [PMID: 17531992 DOI: 10.1016/j.fertnstert.2007.04.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2006] [Revised: 11/17/2006] [Accepted: 11/17/2006] [Indexed: 11/19/2022]
Abstract
Information about US donor insemination programs was reviewed to determine whether an increasing number are offering open-identity donation. Results indicate that indeed, numbers are rising and that the ratio of open-identity to anonymous sperm donors in a program increases the longer that the program has offered an open-identity option.
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Affiliation(s)
- Joanna E Scheib
- Department of Psychology, University of California, Davis, California 95616, USA.
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29
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Abstract
The practice of gamete donation has, until recently, been shrouded in secrecy. The stigma associated with infertility and, in particular, donor insemination has been the main factor contributing to this secrecy. Over the last 20 years, this secrecy and the anonymity of the gamete donors has been challenged. In the first instance, the challenge came from governments in some countries legislating to abolish donor anonymity. Counsellors, social workers and psychologists advocating for the interests and needs of children and their families, as well as parents who did not wish to keep gamete donation secret from their children, were also instrumental in the change of policies and practice. Those offspring who know that they were conceived as a result of gamete donation are also calling for an end to the secrecy. This chapter reviews the changes that have occurred and which are still occurring, and reviews the research associated with these changes.
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Affiliation(s)
- Ken Daniels
- School of Social Work and Human Services, University of Canterbury, Christchurch, New Zealand.
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30
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Crawshaw MA, Blyth ED, Daniels KD. Past semen donors' views about the use of a voluntary contact register. Reprod Biomed Online 2007; 14:411-7. [PMID: 17425819 DOI: 10.1016/s1472-6483(10)60886-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This paper reports on qualitative data from a UK Department of Health-funded telephone interview study of 32 men who donated sperm samples at King's College Hospital, London between 1988 and 2002. The study considers the donors' attitudes and views about a proposed voluntary information exchange and contact register. The results suggest that semen donors continue to manage thoughts and feelings that arise from donation throughout their lifetimes, linked to their philosophical beliefs and/or evolving personal and social experiences. Some donors supported the register proposal even if they anticipated that there might be a personal cost to themselves. Several saw contact with donor offspring and/or knowledge about the outcome of their donation as potentially satisfying, indicating that it is possible to retain an interest in those to whom one is genetically related regardless of social contact. There was strong support among donors to have: (i) some control over information release and contact and (ii) access to ongoing information, advice or support from professionals who are skilled and experienced in search and reunion services. Some donors would be willing to be approached for information or contact even if they did not register. The findings indicate important policy and practice messages about the ongoing needs of donors.
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Affiliation(s)
- Marilyn A Crawshaw
- Department of Social Policy and Social Work, University of York, York, YO10 5DD, UK.
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31
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Godman KM, Sanders K, Rosenberg M, Burton P. Potential sperm donors’, recipients’ and their partners’ opinions towards the release of identifying information in Western Australia. Hum Reprod 2006; 21:3022-6. [PMID: 16849591 DOI: 10.1093/humrep/del274] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The aim of this study was to examine Western Australian potential sperm donors' and recipients' opinions towards the release of identifying information and their intentions to disclose. METHODS Forty-five potential sperm donors, 33 recipients and 12 partners completed an anonymous questionnaire regarding their opinions on the release of identifying information, whether a child should be told about the manner of their conception, the level of expected contact of donor with future donor offspring and the importance of anonymity in their decision to donate. RESULTS Slightly less than one-half (48.9%) of potential donors indicated that they would still donate if their identity was revealed to future offspring. When asked whether they would consider contact with offspring, 80% responded positively, with 42% favouring one-off contact. The majority of recipients (82%) and partners (92%) were planning to inform their offspring about the manner of their conception, with 69% of recipients believing that the offspring should receive identifying information about the donor. Recipients were ambivalent about the level of contact between their offspring and the donor. CONCLUSION These results suggest that the move to an open-identity donor system in Western Australia will benefit the majority of recipient parents who are intending to disclose; however, it also suggests a 50% decline in the number of potential sperm donors.
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Affiliation(s)
- Kate M Godman
- School of Anatomy and Human Biology, The University of Western Australia, Nedlands, Australia
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32
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Janssens PMW, Simons AHM, van Kooij RJ, Blokzijl E, Dunselman GAJ. A new Dutch Law regulating provision of identifying information of donors to offspring: background, content and impact. Hum Reprod 2005; 21:852-6. [PMID: 16339167 DOI: 10.1093/humrep/dei407] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In 2004 a law was introduced in The Netherlands, which gives offspring conceived by semen or oocyte donation the right to know the identity of the donor. The law also regulates the provision of other information concerning the donor to the offspring, their parents or their general practitioner. With the introduction of this law, a choice has been made in which the wish of offspring prevails above others involved. Donors can no longer claim absolute anonymity; they are anonymous at the time of donation, but if a child aged > or =16 years requests information the donor may now be traced. During 15 years of debate on the abolition of donor anonymity the number of donors decreased by >70% and the number of semen banks by 50%. We describe the debate which led to the law, the characteristics of the law itself and note some of the probable and possible consequences for donor offspring, parents, donors and semen banks.
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Affiliation(s)
- P M W Janssens
- Hospital Rijnstate, Alysis zorggroep, Department of Clinical Chemistry/Semenbank, Postbus 9555, 6800TA Arnhem, The Netherlands.
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