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Cabar FR, de Oliveira MA, Machado ANC. Critical Analysis of The Changes in CFM Resolution 2294/21 And Its Impacts on Assisted Human Reproduction. JBRA Assist Reprod 2022; 26:659-665. [PMID: 35416023 PMCID: PMC9635607 DOI: 10.5935/1518-0557.20220007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The Brazilian Federal Board of Medicine (CFM) issued resolution number 2294/21, which regulates human reproduction procedures in Brazil, bringing significant changes to clinical practice in assisted human reproduction, and it raised ethical, bioethical, and legal discussions between professionals and patients. This study aims to analyze these changes in different aspects, especially because some of them are controversial. Evidence-based knowledge resources were used to support the analyses of crucial points that were impacted by this change. A literature review was carried out to obtain information about guidelines and laws, as well as articles that contemplate ethical discussions on assisted reproduction. The search sites used were BVS, Pub Med, LILACS and Google Scholar. The keywords used were law, legislation, bioethics, reference guide and assisted human reproduction. Relevant official documents from the Brazilian State were also found and included in the survey. The new resolution regarding the use of assisted reproduction techniques brought important changes, with clinical implications for couples who wish to become pregnant, and there is a need for a broad discussion concerning these repercussions from clinical, ethical, bioethical, and legal points of view.
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Affiliation(s)
- Fabio Roberto Cabar
- Faculdade de Medicina da Universidade de São Paulo -
Departamento de Obstetrícia e Ginecologia. São Paulo, SP, Brazil ,Corresponding Author: Fábio Roberto Cabar,
Secretaria da Divisão de Clínica Obstétrica, University of
Sao Paulo School of Medicine, São Paulo, SP, Brazil,
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Family Histories, Family Stories and Family Secrets: Late Discoveries of Being Adopted. GENEALOGY 2021. [DOI: 10.3390/genealogy5040105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This paper reviews what we know about the experiences of adopted people who discover in later-life that they are adopted. It begins by discussing how and why various facets of the adoption experience have come to the fore over the 20th and 21st century time span of contemporary adoption. The paper concludes with the fact that research on the late discovery of adoption is in its infancy. It also points to parallels that will exist for people who have been conceived by anonymous donation and raises additional areas for possible research.
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Bonan S, Chapel-Lardic E, Rosenblum O, Dudkiewicz-Sibony C, Chamouard L, Wolf JP, Thiounn N, Condat A, Chalas C, Patrat C, Mendes N, Drouineaud V. Characteristics and intentions of heterosexual couples comprising a transgender man awaiting sperm donation to conceive a child. Andrology 2021; 9:1799-1807. [PMID: 34467677 DOI: 10.1111/andr.13103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 08/08/2021] [Accepted: 08/13/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND More than half of transgender (TG) men wish to have children. Until recently, TG people in France were rarely offered gamete donation, mainly because the Bioethics Law allows the use of assisted reproductive technologies (ART) only in infertile couples. The only option currently available for heterosexual couples with a TG man is ART with sperm donation. The Center for Study and Preservation of Eggs and Sperm (CECOS) of the Cochin Hospital is the first French center to propose sperm donation to such couples, and has done so since 1999. OBJECTIVES To determine the main characteristics and intentions of 43 couples, including a TG man and his cisgender female partner awaiting sperm donation. MATERIALS AND METHODS A retrospective analysis was carried out on the records from October 2010 to December 2019, of 43 couples with a TG man who applied for sperm donation at the CECOS of the Cochin Hospital (Paris, France). RESULTS The mean age of TG men and cisgender women was 32 ± 6.6 and 29.7 ± 4.6 years, respectively. In 77% of cases, the couple met before the man's transition. Eighty-one percent of the couples were in a stable relationship for at least 3 years, and 94% wished to have a child for no more than 5 years. Almost all of the couples (95%) intended to inform their child of their conception by sperm donation and the father's transidentity (92%). DISCUSSION Due to restrictive French legislation, the profile of our couples probably does not reflect that of all couples consisting of a TG man and a cisgender woman. The study took place over a long period of time and the characteristics of the couples could probably change over time. CONCLUSION The couples often met before the man's transition, cohabited for several years, intended to inform their child of sperm donation and the father's transidentity.
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Affiliation(s)
- Sarah Bonan
- Service de Biologie de la Reproduction - CECOS, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris (AP-HP) Centre, Université de Paris, Paris, France
| | - Emeline Chapel-Lardic
- Service de Biologie de la Reproduction - CECOS, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris (AP-HP) Centre, Université de Paris, Paris, France
| | - Ouriel Rosenblum
- Service de Biologie de la Reproduction - CECOS, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris (AP-HP) Centre, Université de Paris, Paris, France.,Service de Psychiatrie de l'enfant et de l'adolescent, Hôpital Universitaire La Pitié - Salpétrière, Assistance Publique - Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France
| | - Charlotte Dudkiewicz-Sibony
- Service de Biologie de la Reproduction - CECOS, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris (AP-HP) Centre, Université de Paris, Paris, France
| | - Laura Chamouard
- Service de Biologie de la Reproduction - CECOS, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris (AP-HP) Centre, Université de Paris, Paris, France
| | - Jean-Philippe Wolf
- Service de Biologie de la Reproduction - CECOS, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris (AP-HP) Centre, Université de Paris, Paris, France.,Inserm U1016, Institut Cochin, Université de Paris, Paris, France
| | - Nicolas Thiounn
- Inserm U1016, Institut Cochin, Université de Paris, Paris, France.,Service d'Urologie, Centre Hospitalier Georges Pompidou, Assistance Publique - Hôpitaux de Paris (AP-HP) Centre, Université de Paris, Paris, France
| | - Agnès Condat
- Service de Psychiatrie de l'enfant et de l'adolescent, Hôpital Universitaire La Pitié - Salpétrière, Assistance Publique - Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France
| | - Céline Chalas
- Service de Biologie de la Reproduction - CECOS, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris (AP-HP) Centre, Université de Paris, Paris, France
| | - Catherine Patrat
- Service de Biologie de la Reproduction - CECOS, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris (AP-HP) Centre, Université de Paris, Paris, France.,Inserm U1016, Institut Cochin, Université de Paris, Paris, France
| | - Nicolas Mendes
- Service de Psychiatrie de l'enfant et de l'adolescent, Hôpital Universitaire La Pitié - Salpétrière, Assistance Publique - Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France
| | - Véronique Drouineaud
- Service de Biologie de la Reproduction - CECOS, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris (AP-HP) Centre, Université de Paris, Paris, France
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Metzler-Guillemain C, Saias-Magnan J, Carez S, Perrin J, Capelle M, Gnisci A, Bottin P, Daoud-Deveze C. [Disclosure to donor conceived offsprings after gamete donation or embryo donation: A major challenge for the future]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2021; 49:220-222. [PMID: 32992054 DOI: 10.1016/j.gofs.2020.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Indexed: 06/11/2023]
Affiliation(s)
- C Metzler-Guillemain
- Pôle femmes-parents-enfants, centre clinico-biologique d'assistance médicale à la procréation-CECOS, APHM, hôpital La Conception, 13385 Marseille cedex 5, France; Inserm, MMG, U1251, Marseille Medical Genetics, Aix-Marseille Université, 13385 Marseille, France.
| | - J Saias-Magnan
- Pôle femmes-parents-enfants, centre clinico-biologique d'assistance médicale à la procréation-CECOS, APHM, hôpital La Conception, 13385 Marseille cedex 5, France
| | - S Carez
- Pôle femmes-parents-enfants, centre clinico-biologique d'assistance médicale à la procréation-CECOS, APHM, hôpital La Conception, 13385 Marseille cedex 5, France; Pôle psychiatrie centre, APHM, Hôpital La Conception, 13385 Marseille, France
| | - J Perrin
- Pôle femmes-parents-enfants, centre clinico-biologique d'assistance médicale à la procréation-CECOS, APHM, hôpital La Conception, 13385 Marseille cedex 5, France; Institut méditerranéen de biodiversité et d'écologie marine et continentale (IMBE) UMR CNRS 7263 - IRD 237, Aix-Marseille Université, Marseille, France
| | - M Capelle
- Pôle femmes-parents-enfants, centre clinico-biologique d'assistance médicale à la procréation-CECOS, APHM, hôpital La Conception, 13385 Marseille cedex 5, France
| | - A Gnisci
- Pôle femmes-parents-enfants, centre clinico-biologique d'assistance médicale à la procréation-CECOS, APHM, hôpital La Conception, 13385 Marseille cedex 5, France
| | - P Bottin
- Pôle femmes-parents-enfants, centre clinico-biologique d'assistance médicale à la procréation-CECOS, APHM, hôpital La Conception, 13385 Marseille cedex 5, France
| | - C Daoud-Deveze
- Pôle femmes-parents-enfants, centre clinico-biologique d'assistance médicale à la procréation-CECOS, APHM, hôpital La Conception, 13385 Marseille cedex 5, France
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Lampic C, Skoog Svanberg A, Sorjonen K, Sydsjö G. Understanding parents' intention to disclose the donor conception to their child by application of the theory of planned behaviour. Hum Reprod 2021; 36:395-404. [PMID: 33367734 PMCID: PMC7829471 DOI: 10.1093/humrep/deaa299] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 10/06/2020] [Indexed: 11/28/2022] Open
Abstract
STUDY QUESTION Does the theory of planned behaviour (TPB) contribute to understanding parents’ intention to share information about genetic origin with their donor-conceived child? SUMMARY ANSWER Parents’ intention to start disclosure was associated with beliefs that disclosure would have desired consequences and a desire to act in accordance to societal norms. WHAT IS KNOWN ALREADY Despite a growing consensus on donor-conceived offspring’s right to information about their genetic origin, disclosure to the child remains a challenge for many parents, particularly heterosexual couples. TPB has successfully been applied to many health-related contexts and may contribute to increase understanding of parents’ decision-making about disclosing the genetic origin to their children. STUDY DESIGN, SIZE, DURATION A cross-sectional survey study of heterosexual couples with children aged 7–8 years following identity-release oocyte donation (OD, n = 83) or sperm donation (SD, n = 113). PARTICIPANTS/MATERIALS, SETTING, METHODS The study is part of the prospective longitudinal Swedish Study on Gamete Donation. Couples accepted for oocyte or sperm donation treatment at seven fertility clinics were recruited in 2005–2008 and requested to complete four postal surveys in the following 10 years. The present study sample includes heterosexual couples with donor-conceived children aged 7–8 years. Data were collected with the study-specific TPB Disclosure Questionnaire and analysed with path analysis. MAIN RESULTS AND THE ROLE OF CHANCE More than half of parents following OD or SD had already disclosed the donor conception to their child (OD 61%, SD 58%). Among parents who had not yet started the disclosure process, the belief that disclosure would have desired consequences (P < 0.05) and a desire to act in accordance to social norms favouring disclosure (P < 0.01) were positively associated with their intention to talk with their child about the donor conception during the upcoming year. In contrast, perceived confidence to talk with the child about his/her genetic origin was found to be negatively associated with the intention to start the disclosure process (P < 0.05). Type of treatment (OD/SD) and the existence or absence of a genetic link to the child were not directly associated with parents’ disclosure intentions. LIMITATIONS, REASONS FOR CAUTION The study was performed with heterosexual couples within the context of the Swedish legislation on identity-release donation, which limits the generalizability to other populations. Also, attrition may have introduced selection bias to the study findings. Future studies using the TPB Disclosure Questionnaire (TPB-DQ) with larger samples are needed to validate this measure. WIDER IMPLICATIONS OF THE FINDINGS Application of the theory of planned behaviour highlighted the importance of attitudes and social norms for parents’ intention to share information about the donor conception with their child. The present results add to the complexity of disclosure of donor conception, and may contribute to promote open communication and support family life following donor conception. STUDY FUNDING/COMPETING INTEREST(S) 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 Women's and Children's Health, Karolinska Institutet, 171 77 Stockholm, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, 751 22 Uppsala, Sweden
| | - Agneta Skoog Svanberg
- Department of Women's and Children's Health, Uppsala University, 751 85 Uppsala, Sweden
| | - Kimmo Sorjonen
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Gunilla Sydsjö
- Division of Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, 581 85 Linköping, Sweden
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Stuyver I, Somers S, Provoost V, Wierckx K, Verstraelen H, Wyverkens E, Van Glabeke L, T’Sjoen G, Buysse A, Pennings G, De Sutter P. Ten years of fertility treatment experience and reproductive options in transgender men. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2020; 22:294-303. [PMID: 34240072 PMCID: PMC8118233 DOI: 10.1080/26895269.2020.1827472] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Up to 2018, the Belgian law stated that transgender people who wanted to change their legal sex had to undergo physical gender affirming treatment. This included gonadectomy to a medically possible and justified extent, which entailed that they had to accept the fact that they could no longer reproduce. However, research has shown that many transgender people desire to have children. AIMS (1) to describe a cohort of transgender men and their respective cisgender female partners, to share our experiences with their request for donor conception, and to evaluate their disclosure intentions to the child, (2) to explore how the couples approach current and future reproductive options. METHODS This mixed method study presents data from a retrospective analysis of patient records and from a qualitative interview study. The couples were selected from the group of transgender men who - together with their respective cisgender female partners - applied for sperm donation at Ghent University Hospital between 2002 and 2012. RESULTS Forty-seven transgender men with a cisgender female partner requested treatment with anonymous donor sperm for a first child as a couple. Forty-one requests were accepted for treatment. We found that most couples requesting treatment intended to disclose the use of donor sperm to their future child (n = 34) while 24 couples were planning to inform the child about the parent's transgender identity. The six couples we interviewed saw donor conception as the preferred route to become parents. Adoption was seen as less obvious. The couples' attitudes toward stem cell-derived gametes reflected the significance of the genetic link with the child for both parents. DISCUSSION Not all participants in our study were aware of their reproductive options. To be able to make a well-informed decision, transgender people should be counseled about all options at the time of transition.
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Affiliation(s)
- Isabelle Stuyver
- Department of Reproductive Medicine, Ghent University Hospital, Gent, Belgium
| | - Sara Somers
- Department of Reproductive Medicine, Ghent University Hospital, Gent, Belgium
- Department of Human Structure and Repair, Ghent University, Gent, Belgium
| | - Veerle Provoost
- Bioethics Institute Ghent (BIG), Department of Philosophy and Moral Sciences, Ghent University, Gent, Belgium
| | - Katrien Wierckx
- Department of Endocrinology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
| | - Hans Verstraelen
- Department of Human Structure and Repair, Ghent University, Gent, Belgium
- Department of Gynaecology and Obstetrics, Ghent University Hospital, Gent, Belgium
| | - Elia Wyverkens
- Department of Applied Psychology, Howest University of Applied Sciences, Brugge, Belgium
| | - Lien Van Glabeke
- Department of Reproductive Medicine, Ghent University Hospital, Gent, Belgium
| | - Guy T’Sjoen
- Department of Endocrinology, Ghent University Hospital, Gent, Belgium
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
| | - Ann Buysse
- Department of Experimental-Clinical and Health Psychology, Ghent University, Gent, Belgium
| | - Guido Pennings
- Bioethics Institute Ghent (BIG), Department of Philosophy and Moral Sciences, Ghent University, Gent, Belgium
| | - Petra De Sutter
- Department of Reproductive Medicine, Ghent University Hospital, Gent, Belgium
- Department of Human Structure and Repair, Ghent University, Gent, Belgium
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7
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Pennings G. Genetic databases and the future of donor anonymity. Hum Reprod 2019; 34:786-790. [DOI: 10.1093/humrep/dez029] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 02/03/2019] [Accepted: 02/15/2019] [Indexed: 12/18/2022] Open
Affiliation(s)
- Guido Pennings
- Department of Philosophy and Moral Science, Bioethics Institute Ghent, Ghent University, Blandijnberg 2, Gent, Belgium
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Hershberger PE, Driessnack M, Kavanaugh K, Klock SC. Oocyte donation disclosure decisions: a longitudinal follow-up at middle childhood. HUM FERTIL 2019; 24:31-45. [PMID: 30724630 DOI: 10.1080/14647273.2019.1567945] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Few studies have captured oocyte donation (OD) parents' decision processes about intended and actual disclosure over time. Likewise, OD children's perceptions about their family composition during middle childhood are underexplored. To address these gaps, a longitudinally followed cohort of OD recipient families was invited to participate in a qualitative, follow-up study. With an 86% response rate after 12 years, families were composed of oocyte recipient mothers (n = 6) and biological fathers (n = 6) representing 12 donor-oocyte conceived children (10.33 ± 1.23 years; mean ± SD). Of the 12 children, two that were aware and two that were unaware of their conceptual origins completed conversational interviews. Only one family in the initial cohort had disclosed OD to their children by the 12-year follow-up, despite 43% of parents intending to disclose and another 43% undecided about disclosure during pregnancy. Four parental disclosure patterns emerged at 12 years: (i) wanting to disclose; (ii) conflicted about disclosure; (iii) not planning to disclose; and (iv) having disclosed. Children that were unaware of their conceptual origins displayed no knowledge of their method of conception. There is a need for family-centric interventions to assist 'wanting to disclose' parents in their disclosure process and 'conflicted about disclosure' parents in their decision-making process post-OD treatment.
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Affiliation(s)
- Patricia E Hershberger
- Department of Health Systems Science, College of Nursing, Chicago, IL, USA.,Department of Obstetrics and Gynecology, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Martha Driessnack
- School of Nursing, Oregon Health & Science University, Portland, OR, USA
| | - Karen Kavanaugh
- Department of Nursing Research, Children's Hospital of Wisconsin, Milwaukee, WI, USA
| | - Susan C Klock
- Departments of Obstetrics and Gynecology and Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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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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Sperm donor conception and disclosure to children: a 10-year retrospective follow-up study of parental attitudes in one French center for the study and preservation of eggs and sperm (CECOS). Fertil Steril 2017; 108:247-253. [DOI: 10.1016/j.fertnstert.2017.06.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 06/01/2017] [Accepted: 06/01/2017] [Indexed: 01/07/2023]
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12
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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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13
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Raes I, Ravelingien A, Pennings G. Donor Conception Disclosure: Directive or Non-Directive Counselling? JOURNAL OF BIOETHICAL INQUIRY 2016; 13:369-379. [PMID: 27116204 DOI: 10.1007/s11673-015-9686-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 06/17/2015] [Indexed: 06/05/2023]
Abstract
It is widely agreed among health professionals that couples using donor insemination should be offered counselling on the topic of donor conception disclosure. However, it is clear from the literature that there has long been a lack of agreement about which counselling approach should be used in this case: a directive or a non-directive approach. In this paper we investigate which approach is ethically justifiable by balancing the two underlying principles of autonomy (non-directive approach) and beneficence (directive approach). To overrule one principle in favour of another, six conditions should be fulfilled. We analyse the arguments in favour of the beneficence principle, and consequently, a directive approach. This analysis shows that two conditions are not met; the principle of autonomy should not be overridden. Therefore, at this moment, a directive counselling approach on donor conception disclosure cannot be ethically justified.
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Affiliation(s)
- Inez Raes
- Bioethics Institute Ghent (BIG), Department of Philosophy and Moral Science, Ghent University, Blandijnberg 2, B-9000, Gent, Belgium.
| | - An Ravelingien
- Bioethics Institute Ghent (BIG), Department of Philosophy and Moral Science, Ghent University, Blandijnberg 2, B-9000, Gent, Belgium
| | - Guido Pennings
- Bioethics Institute Ghent (BIG), Department of Philosophy and Moral Science, Ghent University, Blandijnberg 2, B-9000, Gent, Belgium
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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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Machin R. Anonimato e segredo na reprodução humana com participação de doador: mudanças em perspectivas. SAUDE E SOCIEDADE 2016. [DOI: 10.1590/s0104-12902016149132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo As tecnologias reprodutivas, ao separar a sexuali dade da reprodução, interferiram não somente nas relações entre os sexos, mas também nas relações de filiação, possibilitando o surgimento de configu rações familiares decorrentes do acesso a material genético de terceiros (doadores de óvulos, sêmen ou embrião). O segredo e o anonimato que sempre envolveram os doadores de gametas têm sido desa fiados. Nos últimos vinte anos, diversos países alte raram sua legislação adotando a identidade aberta do doador de material genético. A possibilidade de conhecer e ter acesso a esta identidade (chegando à maioridade) ou mesmo a busca por meios irmãos pode ser uma realidade em muitos países para crianças nascidas por meio do acesso à tecnologia reprodutiva. O artigo enfatiza a questão do segredo e do anonimato envolvendo o uso de material ge nético de terceiros em tecnologias reprodutivas. A discussão é explorada por meio do debate ocorrido no Reino Unido relativo à abolição do anonimato e suas implicações sob a perspectiva dos doadores, dos casais demandantes e da criança concebida. O estudo reflete ainda sobre as concepções de família envolvidas nessa discussão.
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Isaksson S, Skoog-Svanberg A, Sydsjö G, Linell L, Lampic C. It takes two to tango: information-sharing with offspring among heterosexual parents following identity-release sperm donation. Hum Reprod 2015; 31:125-32. [PMID: 26637490 PMCID: PMC4677967 DOI: 10.1093/humrep/dev293] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 10/29/2015] [Indexed: 11/28/2022] Open
Abstract
STUDY QUESTION How do heterosexual parents reason about and experience information-sharing with offspring following identity-release sperm donation? SUMMARY ANSWER Sharing information about using donor-conception with offspring is a complex process at several levels, with the parent's personal beliefs and the child's responses serving as driving or impeding forces for the information-sharing process. WHAT IS KNOWN ALREADY The overall view of disclosure in gamete donation has shifted from secrecy to openness, but there is still uncertainty among parents concerning how and when to tell the child about his/her genetic origin. Most research on donor-conceived families has focused on donation treatment under anonymous or known circumstances, and there is a lack of studies in settings with identity-release donations. STUDY DESIGN, SIZE, DURATION A qualitative interview study among 30 parents following identity-release sperm donation treatment. Interviews were conducted from February 2014 to March 2015. PARTICIPANTS/MATERIALS, SETTING, METHODS The present study is part of the prospective longitudinal Swedish Study on Gamete Donation (SSGD), including all fertility clinics performing gamete donation in Sweden. A sample of participants in the SSGD, consisting of heterosexual parents with children aged 7–8 years following identity-release sperm donation, participated in individual semi-structured interviews. MAIN RESULTS AND THE ROLE OF CHANCE The analysis revealed one main theme: information-sharing is a process, with three subthemes; (i) the parent as process manager, (ii) the child as force or friction and (iii) being in the process. The first two subthemes were viewed as being linked together and their content served as driving or impeding forces in the information-sharing process. LIMITATIONS, REASONS FOR CAUTION The fact that the study was performed within the context of the Swedish legislation on identity-release donation must be taken into consideration as regards transferability to other populations, as this may affect parents' reasoning concerning their information-sharing with the child. WIDER IMPLICATIONS OF THE FINDINGS The present findings highlight the role of the donor-conceived child in the information-sharing process and may contribute to develop counselling that increases parents' confidence in handling children's reactions to information about their genetic origin. STUDY FUNDING/COMPETING INTEREST(S) Financial support from The Swedish Research Council, The Family Planning Fund in Uppsala and Ferring Pharmaceuticals. There are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- S Isaksson
- Department of Public Health and Caring Sciences, Uppsala University, Box 564, S-751 22 Uppsala, Sweden
| | - A Skoog-Svanberg
- Department of Women's and Children's Health, Uppsala University, S-751 85 Uppsala, Sweden
| | - G Sydsjö
- Division of Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, S-581 85 Linköping, Sweden
| | - L Linell
- Department of Social Work, Karolinska University Hospital, S-141 86 Huddinge, Sweden
| | - C Lampic
- Department of Public Health and Caring Sciences, Uppsala University, Box 564, S-751 22 Uppsala, Sweden Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, S-141 83 Huddinge, Sweden
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17
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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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Kovacs GT, Wise S, Finch S. Keeping a child's donor sperm conception secret is not linked to family and child functioning during middle childhood: An Australian comparative study. Aust N Z J Obstet Gynaecol 2015. [PMID: 26223455 DOI: 10.1111/ajo.12349] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIM Controversy exists as to whether children conceived using donor sperm should be told about their origins and the possible deleterious effects of secrecy. MATERIALS AND METHODS The Follow-Up of Children Conceived through Donor Insemination research compares 'family functioning' and 'child well-being' in 62 families where donor-conceived children aged between 5 and 13 years had been 'told' (N = 29) and 'not told' (N = 33) of their genetic heritage. Couples were treated through the Prince Henry's Institute of Medical Research Reproductive Medicine Clinic. Standardised measures of family functioning and child well-being collected from mothers were modelled to estimate mean differences according to knowledge of conception. RESULTS Mean differences between the two 'knowledge of conception' groups were generally very small and not statistically significant; adjustment for covariates did not make a substantive difference to the interpretation of group differences. Scores on family functioning and child well-being measures were within normal limits for both the 'told' and 'not told' groups. CONCLUSION Further research on parents' experiences would usefully inform discussion on the forms of education and support that would encourage parents to engage with the issues of disclosure and nondisclosure, and promote transparency as well as societal awareness, acceptance and understanding of this method of family formation.
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Affiliation(s)
| | - Sarah Wise
- Department of Social Work, University of Melbourne, Carlton, Victoria, Australia
| | - Sue Finch
- Department of Mathematics and Statistics, University of Melbourne, Carlton, Victoria, Australia
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Lampic C, Skoog Svanberg A, Sydsjö G. Attitudes towards disclosure and relationship to donor offspring among a national cohort of identity-release oocyte and sperm donors. Hum Reprod 2014; 29:1978-86. [PMID: 25030191 PMCID: PMC4131739 DOI: 10.1093/humrep/deu152] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
STUDY QUESTION What are oocyte donors and sperm donors' attitudes towards disclosure and relationship to donor offspring? SUMMARY ANSWER Oocyte and sperm donors in an identity-release donor programme support disclosure to donor offspring and have overall positive or neutral attitudes towards future contact with offspring. WHAT IS KNOWN ALREADY There is a global trend towards open-identity gamete donation with an increasing number of countries introducing legislation allowing only identifiable donors. While women and men who enrol in identity-release donor programmes accept that they may be contacted by donor offspring, there is limited knowledge of their attitudes towards disclosure to donor offspring and how they perceive their relationship to potential donor offspring. STUDY DESIGN, SIZE AND DURATION The present study is part of the ‘Swedish study on gamete donation’, a prospective cohort study including donors at all fertility clinics performing donation treatment in Sweden. During a 3-year period (2005–2008), donors were recruited consecutively and a total of 157 oocyte donors and 113 sperm donors (who did not donate to a specific ‘known’ couple) were included prior to donation. Participants in the present study include 125 female (80%) and 80 male donors (71%) that completed two follow-up assessments. PARTICIPANTS/MATERIALS, SETTINGS AND METHODS Participants completed two postal questionnaires 2 months after donation and 14 months after donation. Attitudes towards disclosure to donor offspring were assessed with an established instrument. Perceptions of involvement with donor offspring and need for counselling was assessed with study-specific instruments. Statistical analyses were performed with non-parametric tests. MAIN RESULTS AND THE ROLE OF CHANCE A majority of oocyte and sperm donors supported disclosure to donor offspring (71–91%) and had positive or neutral attitudes towards future contact with offspring (80–87%). Sperm donors reported a higher level of involvement with potential donor offspring compared with oocyte donors (P = 0.005). Few donors reported a need for more counselling regarding the consequences of their donation. LIMITATIONS, REASONS FOR CAUTION While the multicentre study design strengthens external validity, attrition induced a risk of selection bias. In addition, the use of study-specific instruments that have not been psychometrically tested is a limitation. WIDER IMPLICATIONS OF THE FINDINGS The positive attitudes towards disclosure to offspring of female and male identity-release donors are in line with previous reports of anonymous and known donors. While our results on donors' general positive or neutral attitudes towards future contact with potential donor offspring are reassuring, a subset of donors with negative attitudes towards such contact warrants concern and suggests a need for counselling on long-term consequences of donating gametes. STUDY FUNDING The ‘Swedish study on gamete donation’ was funded by the Swedish Research Council, the Swedish Council for Health, Working Life and Welfare, and the Regional Research Council in Uppsala-Örebro. There are no conflicts of interest to declare.
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Affiliation(s)
- C Lampic
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE-141 83 Huddinge, Sweden
| | - A Skoog Svanberg
- Department of Women's and Children's Health, Uppsala University, SE-751 85 Uppsala, Sweden
| | - G Sydsjö
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, SE-581 85 Linköping, Sweden Department of Obstetrics and Gynecology in Linköping, County Council of Östergötland, SE-58183 Linköping, Sweden
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Crawshaw M, Montuschi O. It ‘did what it said on the tin’ – Participant's views of the content and process of donor conception parenthood preparation workshops. HUM FERTIL 2014; 17:11-20. [DOI: 10.3109/14647273.2014.881562] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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21
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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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22
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Baccino G, Salvadores P, Hernández ER. Disclosing their type of conception to offspring conceived by gamete or embryo donation in Spain. J Reprod Infant Psychol 2013. [DOI: 10.1080/02646838.2013.853171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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23
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Adams DH. Conceptualising a child-centric paradigm : do we have freedom of choice in donor conception reproduction? JOURNAL OF BIOETHICAL INQUIRY 2013; 10:369-381. [PMID: 23780686 DOI: 10.1007/s11673-013-9454-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Accepted: 04/05/2013] [Indexed: 06/02/2023]
Abstract
Since its inception, donor conception practices have been a reproductive choice for the infertile. Past and current practices have the potential to cause significant and lifelong harm to the offspring through loss of kinship, heritage, identity, and family health history, and possibly through introducing physical problems. Legislation and regulation in Australia that specifies that the welfare of the child born as a consequence of donor conception is paramount may therefore be in conflict with the outcomes. Altering the paradigm to a child-centric model, however, impinges on reproductive choice and rights of adults involved in the process. With some lobby groups pushing for increased reproductive choice while others emphasise offspring rights there is a dichotomy of interests that society and legislators need to address. Concepts pertaining to a shift toward a child-centric paradigm are discussed.
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Affiliation(s)
- Damian H Adams
- School of Nursing and Midwifery, Flinders University, Sturt Road, Bedford Park, South Australia, Australia, 5042,
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Sälevaara M, Suikkari AM, Söderström-Anttila V. Attitudes and disclosure decisions of Finnish parents with children conceived using donor sperm. Hum Reprod 2013; 28:2746-54. [PMID: 23906900 DOI: 10.1093/humrep/det313] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION What are disclosure intentions and experiences of heterosexual parents with children born after assisted donor insemination (DI) or IVF with donor sperm (dIVF)? SUMMARY ANSWER Only 16.5% of Finnish DI/dIVF heterosexual parents had told their child of his/her origin; 18% of all children above 3 years of age had received the information. Parents with older children were more unwilling to tell or were more uncertain regarding what to do than parents with younger children. WHAT IS KNOWN ALREADY In general, 10-35% of parents of DI offspring are willing to inform their child about their conception. Men who need donor sperm to become a father are more secretive than women who need donated oocytes and are less willing to participate in counselling about parenthood. In the past, couples conceiving through gamete donation were adviced to maintain secrecy or sufficient advice on information sharing was not available. Evidence suggests that parental attitudes are moving towards greater openness. In 2007, Finland enacted a law on assisted fertility treatments (1237/2006) stating that gamete donors have to register their identifying information in a registry so that at the age of 18 years, offspring can obtain information about their donor. STUDY DESIGN, SIZE AND DURATION This retrospective questionnaire study included 139 mothers and 127 fathers with altogether 240 children born after DI or dIVF during 1992-2007. PARTICIPANTS, SETTING AND METHODS Questionnaires were sent to heterosexual couples who had undergone DI/dIVF treatment at the Väestöliitto Fertility Clinic in Helsinki resulting in live birth (n = 277, 252 mothers and 239 fathers). The parents were asked to report their disclosure intentions towards the child and towards other people about the decision to use donated sperm, their concerns about donor characteristics, their evaluation of the counselling that they received and their views about the current Finnish assisted reproduction law. MAIN RESULTS AND THE ROLE OF CHANCE The response rate was 55% (139/252) among the mothers and 53% (127/239) among the fathers. Answers provided information on 58% (240/415) of the children born, 91% of whom were at least 3 years old at the time. Of all parents, 16.5% reported that they had already told their child of his/her conception. Of all 240 children, 16.3% had already received information about their conception. The children had been between 3 and 14 years of age (mean 6.8 years) when they were told. Parents of older children were significantly more unwilling to tell their child than parents of younger children (P < 0.005). No difference in disclosure between DI and dIVF emerged. Less than half of the parents (42%) had been satisfied with the psychological support offered to them, with parents of older children having been most dissatisfied. LIMITATIONS, REASONS FOR CAUTION Although the response rate was relatively high, more than 40% of the parents chose not to participate. As has been shown before, it is likely that those who do not take part are less inclined to disclose and this should be taken into consideration when conclusions are drawn. WIDER IMPLICATIONS OF THE FINDINGS Our results on disclosure rates are in agreement with previous studies. General attitudes have moved towards greater openness about the use of donated gametes. Furthermore, the availability of psychological counselling before treatment has increased the understanding of the importance of disclosure. People who have become parents after DI or dIVF should also be offered counselling after the child has been born. STUDY FUNDING/COMPETING INTERESTS This study was supported by grants from the Wilhelm and Else Stockmann Foundation and the Medical Society Life and Health. There are no competing interests to disclose. TRIAL REGISTRATION NUMBER None.
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Affiliation(s)
- M Sälevaara
- Väestöliitto Fertility Clinic, Fredrikinkatu 47, Helsinki FIN-00100, Finland
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Indekeu A, Dierickx K, Schotsmans P, Daniels K, Rober P, D'Hooghe T. Factors contributing to parental decision-making in disclosing donor conception: a systematic review. Hum Reprod Update 2013; 19:714-33. [DOI: 10.1093/humupd/dmt018] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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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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Ravelingien A, Pennings G. The right to know your genetic parents: from open-identity gamete donation to routine paternity testing. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2013; 13:33-41. [PMID: 23557045 DOI: 10.1080/15265161.2013.776128] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Over the years a number of countries have abolished anonymous gamete donation and shifted toward open-identity policies. Donor-conceived children are said to have a fundamental "right to know" the identity of their donor. In this article, we trace the arguments that underlie this claim and question its implications. We argue that, given the status attributed to the right to know one's gamete donor, it would be discriminatory not to extend this right to naturally conceived children with misattributed paternity. One way to facilitate this would be through routine paternity testing at birth. While this proposal is likely to raise concerns about the conflicting interests and rights of other people involved, we show that similar concerns apply to the context of open-identity gamete donation. Unless one can identify a rational basis for treating the two groups differently, one's stance toward both cases should be the same.
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Affiliation(s)
- An Ravelingien
- Bioethics Institute Ghent (BIG), Ghent University, Dept. of Philosophy, Blandijnberg 2, B-9000 Ghent, Belgium.
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Marital stability and quality in families created by assisted reproduction techniques: a follow-up study. Reprod Biomed Online 2012; 25:678-83. [DOI: 10.1016/j.rbmo.2012.09.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Revised: 07/30/2012] [Accepted: 09/05/2012] [Indexed: 11/21/2022]
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Isaksson S, Sydsjö G, Skoog Svanberg A, Lampic C. Disclosure behaviour and intentions among 111 couples following treatment with oocytes or sperm from identity-release donors: follow-up at offspring age 1-4 years. Hum Reprod 2012; 27:2998-3007. [PMID: 22859508 PMCID: PMC3442633 DOI: 10.1093/humrep/des285] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
STUDY QUESTION Do heterosexual parents of young children following oocyte donation (OD) and sperm
donation (SD) tell or intend to tell their offspring about the way he/she was
conceived? SUMMARY ANSWER Following successful treatment with oocytes or sperm from identity-release donors in
Sweden, almost all heterosexual couples intend to tell their offspring about the way
he/she was conceived and some start the information-sharing process very early. WHAT IS KNOWN AND WHAT THIS PAPER ADDS Although the Swedish legislation on identity-release gamete donors has been in effect
since 1985, there is a discrepancy between the behaviour of donor-insemination parents
and the legal intention that offspring be informed about their genetic origin. The
present study contributes data on a relatively large sample of oocyte and sperm
recipient couples' intended compliance with the Swedish legislation. DESIGN AND DATA COLLECTION METHOD The present study constitutes a follow-up assessment of heterosexual couples who had
given birth to a child following treatment with donated oocytes. Data collection was
performed during 2007–2011; participants individually completed a questionnaire
when the child was between 1 and 4 years of age. PARTICIPANTS AND SETTING The present study is part of the Swedish Study on Gamete Donation, a prospective
longitudinal cohort study including all fertility clinics performing gamete donation in
Sweden. For children conceived via OD, 107 individuals (including 52 couples and 3
individuals) agreed to participate (73% response). For children conceived via SD,
the response rate was 70% (n = 122 individuals, including
59 couples and 4 individuals). Mean age of participants was 34 years (SD 4.4) and they
reported a high level of education. MAIN RESULTS The majority of participants (78%) planned to tell the child about the donation,
16% had already started the information-sharing process and 6% planned not
to tell their child about the donation or were undecided. Many were unsure about a
suitable time to start the disclosure process and desired more information about
strategies and tools for information sharing. Agreement on disclosure to offspring
within the couple was related to the quality of the partner relationship. BIAS AND GENERALIZABILITY There is a risk of selection bias, with gamete recipients preferring secrecy and
non-disclosure declining study participation. The results may be regarded as partly
generalizable to heterosexual couples with young children following treatment with
gametes from legislatively mandated identity-release donors in an established donor
programme. STUDY FUNDING/COMPETING INTERESTS Study funding by Merck Serono, The Swedish Research Council and The Family Planning
Fund in Uppsala. No conflicts of interest to declare.
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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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Freeman T, Golombok S. Donor insemination: a follow-up study of disclosure decisions, family relationships and child adjustment at adolescence. Reprod Biomed Online 2012; 25:193-203. [DOI: 10.1016/j.rbmo.2012.03.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Revised: 03/01/2012] [Accepted: 03/14/2012] [Indexed: 11/15/2022]
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31
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Bredenoord AL, Lock MTWT, Broekmans FJM. Ethics of intergenerational (father-to-son) sperm donation. Hum Reprod 2012; 27:1286-91. [DOI: 10.1093/humrep/des071] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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32
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Views of donors and recipients regarding disclosure to children following altruistic known oocyte donation. Reprod Biomed Online 2011; 23:851-9. [DOI: 10.1016/j.rbmo.2011.06.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2011] [Revised: 06/03/2011] [Accepted: 06/07/2011] [Indexed: 11/18/2022]
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Daniels KR, Grace VM, Gillett WR. Factors associated with parents' decisions to tell their adult offspring about the offspring's donor conception. Hum Reprod 2011; 26:2783-90. [DOI: 10.1093/humrep/der247] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Readings J, Blake L, Casey P, Jadva V, Golombok S. Secrecy, disclosure and everything in-between: decisions of parents of children conceived by donor insemination, egg donation and surrogacy. Reprod Biomed Online 2011; 22:485-95. [PMID: 21398181 DOI: 10.1016/j.rbmo.2011.01.014] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Revised: 01/25/2011] [Accepted: 01/26/2011] [Indexed: 11/30/2022]
Abstract
This study examined families where children lack a genetic and/or gestational link with their parents. A total of 101 families (36 donor insemination families, 32 egg donation families and 33 surrogacy families) were interviewed when the child was aged 7 years. Despite a shift in professional attitudes towards openness, about half of the children conceived by egg donation and nearly three-quarters of those conceived by donor insemination remained unaware that the person they know as their mother or father is not, in fact, their genetic parent. By contrast, almost all the surrogacy parents had told their child how they were born. A majority of parents who planned never to tell their child about their conception had told at least one other person. However, qualitative data indicated that to categorize families as 'secret' or 'open' is inadequate. In fact many parents engage in 'layers' of disclosure about their child's conception, both with their child and with family and friends.
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Affiliation(s)
- Jennifer Readings
- Centre for Family Research, Faculty of Politics, Psychology, Sociology and International Studies, University of Cambridge, Cambridge CB2 3RF, UK
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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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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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Rosholm R, Lund R, Molbo D, Schmidt L. Disclosure patterns of mode of conception among mothers and fathers-5-year follow-up of the Copenhagen Multi-centre Psychosocial Infertility (COMPI) cohort. Hum Reprod 2010; 25:2006-17. [DOI: 10.1093/humrep/deq153] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Jouannet P, Kunstmann JM, Juillard JC, Bresson JL. La majorité des couples procréant par don de sperme envisagent d’informer l’enfant de son mode de conception, mais la plupart souhaitent le maintien de l’anonymat du donneur. Basic Clin Androl 2010. [DOI: 10.1007/s12610-010-0067-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Résumé
L’anonymat du don de sperme est reconnu par la loi depuis 1994 en France, mais il a été supprimé par plusieurs pays. Nous présentons les résultats d’une étude qui a été réalisée dans 14 Cecos en 2006 auprès de 534 couples soit en phase d’attente ou en cours de réalisation de l’assistance médicale à la procréation, soit ayant déjà eu au moins un enfant par don de sperme. Les résultats sont très homogènes entre les hommes et les femmes et dans les différents groupes. Plus de 90 % des hommes et des femmes sont en accord avec l’anonymat du don de sperme, et moins de 10 % souhaitent que la loi change sur ce point. Environ un quart d’entre eux renoncerait à leur projet parental si la loi changeait. Plus de 50 % des couples envisagent d’informer l’enfant des modalités de sa conception. Près d’un tiers souhaiterait que des informations, concernant principalement la santé des donneurs, puissent leur être transmises ainsi qu’aux enfants. Les couples souhaitant devenir parents par don de sperme font une distinction claire entre l’anonymat du donneur et l’information de l’enfant sur les circonstances de sa conception.
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Landau R, Weissenberg R. Disclosure of donor conception in single-mother families: views and concerns. Hum Reprod 2010; 25:942-8. [PMID: 20129992 DOI: 10.1093/humrep/deq018] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Despite the prevalence of donor conception and the worldwide trend towards openness, there has been little research on whether parents do disclose the nature of the conception to their donor-conceived children. This analysis focuses on whether and how older Israeli single mothers disclose to their children that were conceived using a donor and whether the donor conception causes concern for them. METHODS Sixty-two single mothers of donor-conceived children in Israel were asked whether they would like to know the identity of the sperm donor; whether they would like their children to know the identity of the sperm donor when reaching the age of 18, whether they disclosed the circumstances of conception to their children or intend to do so in the future; and whether the sperm donation causes concern to them. RESULTS The mothers were divided on whether they wanted to know the identity of the sperm donor. However, less than one-fifth of them did not want their children to have identifying information about the genetic father at the age of 18. About two-thirds of the mothers had not yet disclosed the donor conception to their children but intended to do so in the future. A total of 77.4% of the mothers reported being concerned about the donor conception: for the psychosocial development of the child, fear of genetic disorders, fear of incest and lack of certainty of access to genetic information when needed. CONCLUSIONS The tendency to postpone the disclosure reveals the difficulty of these mothers in finding the appropriate way of sharing the information about the conception with their children. Given the importance attached to the age of disclosure and the mothers' concern for the psychosocial development of their children, more professional counselling in this area is warranted.
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Affiliation(s)
- Ruth Landau
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel.
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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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