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Carone N, Mirabella M, Innocenzi E, Quintigliano M, Antoniucci C, Manzi D, Fortunato A, Giovanardi G, Speranza AM, Lingiardi V. The intergenerational transmission of attachment during middle childhood in lesbian, gay, and heterosexual parent families through assisted reproduction: The mediating role of reflective functioning. Attach Hum Dev 2023:1-27. [PMID: 38078384 DOI: 10.1080/14616734.2023.2292053] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 12/04/2023] [Indexed: 12/20/2023]
Abstract
The present study examined the attachment patterns distribution of 60 lesbian mothers, 50 gay fathers, and 42 heterosexual parents through assisted reproduction and their 76 children, using the Adult Attachment Interview (AAI) and the Friends and Family Interview (FFI), respectively. The study also explored the intergenerational transmission of attachment through reflective functioning (AAI-RF). All families lived in Italy and children were aged 6-12 years (Myears = 8.11, SD = 2.17; 48.68% assigned female at birth). The AAI patterns distribution was similar across family types and did not significantly differ from international and national normative data. Similarly, children's FFI attachment patterns were evenly distributed between family types, and no significant differences emerged in comparison to international and national normative data referring to middle childhood samples. Mediational models revealed that, in all three family types, parents with greater AAI coherence of mind exhibited higher AAI-RF, which, in turn, was associated with increased FFI attachment security in children. Furthermore, parents' AAI coherence of mind directly influenced children's FFI attachment security. The results support and expand hypotheses regarding the intergenerational transmission of attachment in lesbian, gay, and heterosexual parent families through assisted reproduction, while offering unique indications to support these families during middle childhood.
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Affiliation(s)
- Nicola Carone
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Marta Mirabella
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Eleonora Innocenzi
- Department of History, Culture and Society, "Tor Vergata" University of Rome, Rome, Italy
| | - Maria Quintigliano
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Chiara Antoniucci
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Demetria Manzi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Alexandro Fortunato
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Guido Giovanardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Anna Maria Speranza
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
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Lysons J, Imrie S, Jadva V, Golombok S. Families created via identity-release egg donation: disclosure and an exploration of donor threat in early childhood. Reprod Biomed Online 2023; 47:103235. [PMID: 37479604 DOI: 10.1016/j.rbmo.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 05/09/2023] [Indexed: 07/23/2023]
Abstract
RESEARCH QUESTION What are mothers' disclosure intentions and practices from infancy to early childhood, and is perceived donor threat associated with disclosure in identity-release egg donation families when the children are aged 5 years? DESIGN This longitudinal study included 73 heterosexual-couple families with infants born following IVF-egg donation at phase one, and 61 families with 5-year-old children at phase two. At both phases, mothers were interviewed about their disclosure intentions and practices. At phase two, mothers were interviewed about their feelings about future donor-child contact. RESULTS Most mothers (75.3%) intended to disclose their use of egg donation to their children at phase one; half had begun to do so when their children were aged 5. Most remaining mothers planned to tell, although a minority were uncertain or planned not to disclose. When the child was aged 5, four mothers had started telling them that they could access their donor's identifying information at age 18, and most (84%) intended to do so in the future. Most couples agreed on a disclosure strategy at phase two. Most mothers perceived at least some threat from future donor-child contact, but this was unrelated to their disclosure practices. CONCLUSIONS Disclosure intentions in infancy are borne out in early childhood. Despite perceiving some threat from future donor-child contact, most mothers intended telling their child that they could access the donor's identifying information at age 18. Revisiting these families as the children grow older will be important to understand how the mothers' perceived donor threat may change over time, and how this is related to family processes.
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Affiliation(s)
- Joanna Lysons
- Centre for Family Research, University of Cambridge, Cambridge, UK..
| | - Susan Imrie
- Centre for Family Research, University of Cambridge, Cambridge, UK
| | - Vasanti Jadva
- Centre for Family Research, University of Cambridge, Cambridge, UK.; Institute for Women's Health, Faculty of Population Health Sciences, University College London, London, UK
| | - Susan Golombok
- Centre for Family Research, University of Cambridge, Cambridge, UK
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Hershberger PE, Gallo AM, Adlam K, Driessnack M, Grotevant HD, Klock SC, Pasch L, Gruss V. Development of the Tool to Empower Parental Telling and Talking (TELL Tool): A digital decision aid intervention about children's origins from donated gametes or embryos. Digit Health 2023; 9:20552076231194934. [PMID: 37654721 PMCID: PMC10467186 DOI: 10.1177/20552076231194934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 07/28/2023] [Indexed: 09/02/2023] Open
Abstract
Objective This study aimed to create and develop a well-designed, theoretically driven, evidence-based, digital, decision Tool to Empower Parental Telling and Talking (TELL Tool) prototype. Methods This developmental study used an inclusive, systematic, and iterative process to formulate a prototype TELL Tool: the first digital decision aid for parents who have children 1 to 16 years of age and used donated gametes or embryos to establish their families. Recommendations from the International Patient Decision Aids Standards Collaboration and from experts in decision aid development, digital health interventions, design thinking, and instructional design guided the process. Results The extensive developmental process incorporated researchers, clinicians, parents, children, and other stakeholders, including donor-conceived adults. We determined the scope and target audience of the decision aid and formed a steering group. During design work, we used the decision-making process model as the guiding framework for selecting content. Parents' views and decisional needs were incorporated into the prototype through empirical research and review, appraisal, and synthesis of the literature. Clinicians' perspectives and insights were also incorporated. We used the experiential learning theory to guide the delivery of the content through a digital distribution plan. Following creation of initial content, including storyboards and scripts, an early prototype was redrafted and redesigned based on feedback from the steering group. A final TELL Tool prototype was then developed for alpha testing. Conclusions Detailing our early developmental processes provides transparency that can benefit the donor-conceived community as well as clinicians and researchers, especially those designing digital decision aids. Future research to evaluate the efficacy of the TELL Tool is planned.
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Affiliation(s)
- Patricia E. Hershberger
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Agatha M. Gallo
- Department of Human Development Nursing, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Kirby Adlam
- Department of Human Development Nursing, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Martha Driessnack
- School of Nursing, Oregon Health & Science University, Portland, OR, USA
| | - Harold D. Grotevant
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, USA
| | - Susan C. Klock
- Departments of Obstetrics and Gynecology and Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lauri Pasch
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Valerie Gruss
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
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Embryo donation: motivations, experiences, parenting, and child adjustment. Fertil Steril 2023; 119:11-14. [PMID: 36396495 DOI: 10.1016/j.fertnstert.2022.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 09/08/2022] [Accepted: 09/08/2022] [Indexed: 11/16/2022]
Abstract
Embryo donation raises unique challenges for donors, recipients, and the resultant child, yet little is known about the outcomes for those involved. This review summarizes research on the motivations for donating and receiving embryos from others and the experiences that follow, including the outcomes for parenting and child adjustment. Research has shown that given the varied ways in which embryo donation is practiced, understanding the outcomes within different legislative and cultural contexts is vital. The lack of information on outcomes means that counselors and psychologists have little empirical evidence to guide them. Gaps in existing knowledge are identified as well as areas for future research.
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Hershberger PE, Gallo AM, Adlam K, Steffen AD, Driessnack M, Grotevant HD, Klock SC, Pasch L, Gruss V. Alpha Test of the Donor Conception Tool to Empower Parental Telling and Talking. J Obstet Gynecol Neonatal Nurs 2022; 51:536-547. [PMID: 35922017 PMCID: PMC9474702 DOI: 10.1016/j.jogn.2022.06.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/22/2022] [Accepted: 06/24/2022] [Indexed: 10/16/2022] Open
Abstract
OBJECTIVE To conduct an alpha test of the prototype of a digital decision aid to help parents disclose donor conception to their children, the Donor Conception Tool to Empower Parental Telling and Talking (TELL Tool). DESIGN Convergent mixed-methods design. SETTING Virtual interviews in places convenient to the participants. PARTICIPANTS A purposeful sample (N = 16) of nine gamete-donor and embryo-recipient parents and eight clinicians, as one parent was also a clinician. METHODS We conducted cognitive interviews to explore participants' perceptions about the TELL Tool prototype and observe patterns of use. The International Patient Decision Aid Standards (i.e., usability, comprehensibility, and acceptability) guided the development of the qualitative interview guide and directed the qualitative analysis. We also collected data about participants' perceptions and ratings of the helpfulness of each of the prototype's webpages regarding parents' decision making about disclosure. Descriptive statistics were used to analyze the helpfulness ratings before we merged the two data sets to optimize understanding. RESULTS Participants reported that the TELL Tool was a helpful digital decision aid to help parents tell their children how they were conceived. Most (93.7%) webpage rating scores indicated that the content was very helpful or helpful. The participants identified content and technical areas that needed refinement and provided specific recommendations such as adding concise instructions (usability), tailoring adolescent language (comprehensibility), and softening verbiage (acceptability). CONCLUSION Alpha testing guided by the International Patient Decision Aid standards was an essential step in refining and improving the TELL Tool prototype before beta testing.
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Lysons J, Imrie S, Jadva V, Golombok S. 'I'm the only mum she knows': parents' understanding of, and feelings about, identity-release egg donation. Hum Reprod 2022; 37:2426-2437. [PMID: 36006027 PMCID: PMC9527462 DOI: 10.1093/humrep/deac174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 07/12/2022] [Indexed: 12/02/2022] Open
Abstract
STUDY QUESTION How do parents understand and feel about identity-release egg donation? SUMMARY ANSWER Almost one-third of mothers and fathers did not understand the identifiable nature of their egg donation; mothers expressed complex and sometimes difficult feelings about the prospect of future donor–child contact. WHAT IS KNOWN ALREADY Identity-release egg donation has been the only treatment option available to patients wishing to pursue this route to parenthood in the UK since 2005. However, little is known about how well parents understand this legislation, and how they feel about potential donor–child contact. STUDY DESIGN, SIZE, DURATION This qualitative interview study included 61 mothers and 51 fathers whose 5-year-old children were conceived via identity-release egg donation. Interviews were conducted between April 2018 and December 2019. PARTICIPANTS/MATERIALS, SETTING, METHODS Data are reported from phase two of a longitudinal study of families created using open-identity egg donation. In-depth, semi-structured interviews were conducted with mothers and fathers. The interviews contained a section on what parents understood about the identifiable nature of the donor. These data were analysed using qualitative content analysis. Mothers who understood the identifiable nature of their egg donation (n = 44) were then asked about their thoughts and feelings regarding the prospect of future donor–child contact. Mothers’ narratives were analysed using thematic analysis. MAIN RESULTS AND THE ROLE OF CHANCE Almost one-third of parents (28% of mothers, n = 17; 31% of fathers, n = 16) did not understand the identifiable nature of their egg donation. Mothers’ and fathers’ misunderstandings about identity-release egg donation fell into two categories: (i) Unclear about identity-release and (ii) Belief that the donor is anonymous. Reflexive thematic analysis revealed that egg donation mothers’ feelings about identity-release donation could be understood via three organizing themes: (i) identity-release as a threat, (ii) acceptance: it is what it is and (iii) embracing identity-release. The findings indicated that egg donation mothers utilized various strategies to manage their feelings about identity-release egg donation in day-to-day life, and each theme was associated with at least one coping strategy. LIMITATIONS, REASONS FOR CAUTION Participants were predominantly from White, middle-class backgrounds. Further research with a more diverse sample is needed to improve generalizability. WIDER IMPLICATIONS OF THE FINDINGS These findings indicate that parents would benefit from more comprehensive provision of information, both at time of treatment and following conception, to ensure they have fully understood the nature of the donation. Parents may also benefit from follow-up care to help manage any complex or difficult feelings about donor–child contact. STUDY FUNDING/COMPETING INTEREST(s) This research was supported by a Wellcome Trust Collaborative Award [208013/Z/17/Z]. The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- J Lysons
- Centre for Family Research, University of Cambridge, Cambridge, UK
| | - S Imrie
- Centre for Family Research, University of Cambridge, Cambridge, UK.,Thomas Coram Research Unit, University College London, London, UK
| | - V Jadva
- Centre for Family Research, University of Cambridge, Cambridge, UK.,Institute for Women's Health, University College London, London, UK
| | - S Golombok
- Centre for Family Research, University of Cambridge, Cambridge, UK
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Widbom A, Sydsjö G, Lampic C. Psychological adjustment in disclosing and non-disclosing heterosexual-couple families following conception with oocytes or sperm from identity-release donors. Reprod Biomed Online 2022; 45:1046-1053. [DOI: 10.1016/j.rbmo.2022.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/27/2022] [Accepted: 06/16/2022] [Indexed: 10/18/2022]
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Harper JC, Abdul I, Barnsley N, Ilan-Clarke Y. Telling donor-conceived children about their conception: Evaluation of the use of the Donor Conception Network children's books. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2022; 14:1-7. [PMID: 34604554 PMCID: PMC8463736 DOI: 10.1016/j.rbms.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 03/23/2021] [Accepted: 06/03/2021] [Indexed: 06/13/2023]
Abstract
If parents have used donated gametes, it is a personal choice whether they disclose to their children. For those that do, there is, however, little advice on how to tell their children. The Donor Conception Network (DCN) has made a series of books to help parents disclose. This study evaluated parents' experience of using these books. An online survey with both quantitative and qualitative questions was used. The DCN membership and social media were used to publicize the survey, and 108 responses were analysed. At the time of conception, the parents' family types were mainly mother and father (56.5%) and solo mothers (36.1%). The method of conception was mainly donor spermatozoa (55.6%) followed by donor egg (38.0%), double donation (8.3%) and one case of surrogacy. Most parents had read the book to their children before 2 years of age (76.9%). Before reading the books, some of the parents had some confidence in telling (43.5%) or were very confident in telling (30.6%). After reading the books, 60.2% reported having much more confidence in telling. Most parents felt their children had no understanding (76.8%) or only some understanding (22.3%) of donor conception before reading the books. After reading the books most parents felt their children's understanding had increased (71.3%). Most parents felt that reading the books had given them more confidence in using donor conception language (90.7%). The use of books to tell children about their conception may be a useful resource for parents wishing to be open with their children.
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Affiliation(s)
- Joyce C. Harper
- Institute for Women’s Health, University College London, London, UK
| | - Ishaq Abdul
- Institute for Women’s Health, University College London, London, UK
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Hershberger PE, Gallo AM, Adlam K, Driessnack M, Grotevant HD, Klock SC, Pasch L, Gruss V. Parents' experiences telling children conceived by gamete and embryo donation about their genetic origins. F S Rep 2021; 2:479-486. [PMID: 34934991 PMCID: PMC8655422 DOI: 10.1016/j.xfre.2021.08.002] [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] [Received: 04/02/2021] [Revised: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 11/02/2022] Open
Abstract
Objective To gain an in-depth understanding of parents' experiences telling children conceived by gamete and embryo donation about their genetic origins. Design Qualitative, descriptive. Setting Families' homes. Patients Gamete or embryo donation recipient parents living in the United States and who told their children, from birth to 16 years, about their genetic origins. Interventions Individual semistructured (n = 12) or dyadic (n = 2) parent interviews. Main Outcome Measures Directed qualitative content analysis. Results Fourteen families that comprised 16 gamete or embryo donation recipient parents and represented 24 donor-conceived children between the ages of 4 months and 16 years participated in the study. Single parents (n = 3) and both parents in most two-parent families (n = 9) led the initial telling conversations. Parents recounted personal short stories using language that was both developmentally and medically appropriate. Multiple strategies, including children's books, were used by parents to aid them in their telling. The oldest donor-conceived children in each family were first informed of their genetic origins at birth (n = 10 families) or at 6 months (n = 1 family; "practice runs") or from 3.5 to 12 years (n = 3 families). The telling conversations took place during routine family activities that naturally brought parents and children in close proximity, usually in the home. Conclusions Awareness of the nuances of parents' telling conversations with their children through the age of 16 years can help guide clinical counseling and the development of tools to aid parents in their telling conversations.
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Affiliation(s)
- Patricia E Hershberger
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago Illinois.,Department of Obstetrics and Gynecology, College of Medicine, University of Illinois Chicago, Chicago Illinois
| | - Agatha M Gallo
- Department of Human Development Nursing, College of Nursing, University of Illinois Chicago, Chicago Illinois
| | - Kirby Adlam
- Department of Human Development Nursing, College of Nursing, University of Illinois Chicago, Chicago Illinois
| | - Martha Driessnack
- School of Nursing, Oregon Health and Science University, Portland, Oregon
| | - Harold D Grotevant
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, Massachusetts
| | - Susan C Klock
- Departments of Obstetrics and Gynecology and Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Lauri Pasch
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California
| | - Valerie Gruss
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago Illinois
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Kentenich H. Überlegungen zum Verbot der Eizellspende. Geburtshilfe Frauenheilkd 2021. [DOI: 10.1055/a-1373-2533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Macmillan CM, Allan S, Johnstone M, Stokes MA. The motivations of donor-conceived adults for seeking information about, and contact with, sperm donors. Reprod Biomed Online 2021; 43:149-158. [PMID: 34006483 DOI: 10.1016/j.rbmo.2021.04.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 03/29/2021] [Accepted: 04/05/2021] [Indexed: 11/25/2022]
Abstract
RESEARCH QUESTION How do the demographic characteristics, mental health experiences and disclosure experiences of donor-conceived adults shape motivations for seeking information about their sperm donors, contact with them, or both? DESIGN Sixty-nine Australian adults who conceived through sperm donors completed an online survey. Uniquely, information and contact seeking were investigated as two distinct concepts. RESULTS Participants reported a variety of demographic, mental health, disclosure and discovery experiences. Most had been motivated to seek information about their donor (88%), contact with them (71%), or both. The most commonly reported motivations for each act were for medical information, expanding their identity and curiosity. Logistic regression findings were significant for wanting medical information as a motivation for seeking donor information (P = 0.03). Endorsement of this motivation was associated with self-reported anxiety (P = 0.02) and less likely as participant age increased (P = 0.02). Motivation to contact donors for medical information was associated with self-reported anxiety (P = 0.02) and depression (P = 0.01), and more likely when the participant was raised in a household that included the recipient co-parent (P = 0.04). As years since disclosure or discovery increased, participants were less likely to report wanting medical information as a motivation (P = 0.02). CONCLUSION Overall, participants were motivated to obtain information and seek contact with sperm donors. Motivations for each were similar despite participants varying in age and reporting a range of circumstances regarding disclosure, some of which were adverse.
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Affiliation(s)
- Caitlin M Macmillan
- Department of Health Systems and Populations, Faculty of Medicine and Health Sciences, Macquarie University, 2 Technology Pl, Macquarie Park NSW 2113, Australia.
| | - Sonia Allan
- Department of Health Systems and Populations, Faculty of Medicine and Health Sciences, Macquarie University, 2 Technology Pl, Macquarie Park NSW 2113, Australia
| | - Melissa Johnstone
- Department of Health and Human Sciences, Faculty of Human Sciences, Macquarie University, 29 Wally's Walk, Balaclava Rd, Macquarie Park NSW 2109, Australia
| | - Mark A Stokes
- School of Psychology, Faculty of Health, Deakin University, 221 Burwood Hwy, Burwood Vic 3125, Australia
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Golombok S, Zadeh S, Freeman T, Lysons J, Foley S. Single mothers by choice: Parenting and child adjustment in middle childhood. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2021; 35:192-202. [PMID: 32940489 PMCID: PMC8054653 DOI: 10.1037/fam0000797] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Findings are presented of the second phase of a longitudinal study of families created by single mothers by choice. Forty-four single heterosexual mothers were compared with 37 partnered heterosexual mothers, all with a donor-conceived child aged around 8-10 years. Standardized interview, observational, and questionnaire measures of maternal wellbeing, mother-child relationships and child adjustment were administered to mothers, children, and teachers. There were no differences in maternal mental health, the quality of mother-child relationships or children's emotional and behavioral problems between family types. However, higher levels of parenting stress and higher levels of children's prior adjustment difficulties were each associated with children's adjustment difficulties in middle childhood irrespective of family type. The findings suggest that the presence of two parents-or of a male parent-is not essential for children to flourish, and add to the growing body of evidence that family structure is less influential in children's adjustment than the quality of family relationships. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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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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Scheib JE, McCormick E, Benward J, Ruby A. Finding people like me: contact among young adults who share an open-identity sperm donor. Hum Reprod Open 2020; 2020:hoaa057. [PMID: 33585704 PMCID: PMC7872122 DOI: 10.1093/hropen/hoaa057] [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: 11/28/2019] [Revised: 10/08/2020] [Indexed: 01/31/2023] Open
Abstract
STUDY QUESTION What interests and experiences do donor-conceived adults have with respect to same-donor peers/siblings, when they share an open-identity sperm donor? SUMMARY ANSWER Donor-conceived young adults report considerable interest in, and primarily positive experiences with, their same-donor peers, with some finding ‘people like me’. WHAT IS KNOWN ALREADY Through mutual-consent contact registries, director-to-consumer DNA testing and other means, donor-conceived people with anonymous (i.e. closed-identity) sperm donors are gaining identity-related information from, and establishing relationships with, people who share their donor. STUDY DESIGN, SIZE, DURATION Semi-structured, in depth telephone and Skype interviews with 47 donor-conceived young adults were carried out over a 31-month period. Inclusion criteria were being one of the first adults for each donor to obtain their identity and being at least 1-year post donor-information release. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants (aged 19–29 years, 68.1% women) were born to female same-sex couple parents (46.8%), a single mother (29.8%) or heterosexual couple parents (23.4%); all parents had conceived through the same US open-identity sperm donation program. The dataset was analyzed thematically and included interviews from only one participant per family. Each participant had a different donor. MAIN RESULTS AND THE ROLE OF CHANCE Interest in, and experiences with, same-donor peers suggested that they occupy a unique position in the lives of donor-conceived young adults who share their open-identity donor. Contact can provide identity-relevant information and support through the availability of relationships (whether actualized or potential), shared experiences, and easier relationships than with their donor. Most donor-conceived young adults felt positively about their contact experiences. Of those not yet linked, almost all expressed an interest to do so. Some had met the children raised by their donor. When asked, all expressed an interest in doing so. LIMITATIONS, REASONS FOR CAUTION Interviews were conducted with donor-conceived young adults who were uncommon in their generation in terms of: having an open-identity sperm donor; the majority knowing about their family’s origins from childhood; and having parents that accessed at the time one of the only open-identity sperm donation programs. Further research is needed to assess applicability to all donor-conceived adults; findings may be more relevant to the growing number of people who have an open-identity donor and learned in childhood about their family’s origins. WIDER IMPLICATIONS OF THE FINDINGS Participants were among the first generation of donor-conceived adults with an open-identity sperm donor. Their experiences and perspectives can provide essential guidance to programs and others with similar origins. Early disclosure of family origins and identifying the donor did not diminish the young adults’ interest in their same-donor peers. Positive experiences suggest that the benefits of contact include not only identity-relevant information (through shared traits and experiences), but also relationships with and support from people who understand the uncommon experience of being donor conceived. Implications include the need to educate families and intended parents about the potential benefits of knowing others who are donor conceived, and the risk of unexpected linking across families by donors, regardless of donor-conceived person or family interest. STUDY FUNDING/COMPETING INTEREST(S) The study was funded by the Lesbian Health Fund of GLMA: Health Professionals Advancing LGBTQ Equality. The authors have no conflict of interest to declare.
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Affiliation(s)
- J E Scheib
- Psychology Department, University of California, Davis, Davis, CA, USA.,The Sperm Bank of California, Berkeley, CA, USA
| | - E McCormick
- University of California Davis Medical Center, Sacramento, CA, USA
| | - J Benward
- Private Practice, San Ramon, CA, USA
| | - A Ruby
- The Sperm Bank of California, Berkeley, CA, USA
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15
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Hodson N, Parker J. The ethical case for non-directed postmortem sperm donation. JOURNAL OF MEDICAL ETHICS 2020; 46:489-492. [PMID: 31959622 DOI: 10.1136/medethics-2019-105637] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 09/20/2019] [Accepted: 11/13/2019] [Indexed: 06/10/2023]
Abstract
In this article we outline and defend the concept of voluntary non-directed postmortem sperm donation. This approach offers a potential means of increasing the quantity and heterogeneity of donor sperm. This is pertinent given the present context of a donor sperm shortage in the UK. Beyond making the case that it is technically feasible for dead men to donate their sperm for use in reproduction, we argue that this is ethically permissible. The inability to access donor sperm and the suffering this causes, we argue, justifies allowing access to sperm donated after death. Moreover, it is known that individuals and couples have desires for certain sperm donor characteristics which may not be fulfilled when numbers of sperm donors are low. Enacting these preferences contributes significantly to the well-being of intended parents, so we argue that this provides a pro tanto reason for respecting them. Finally, we explore the benefits and possible disadvantages of such a system for the various parties affected.
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Affiliation(s)
- Nathan Hodson
- College of Life Sciences, University of Leicester, Leicester, United Kingdom
| | - Joshua Parker
- Department of Education and Research, Wythenshawe Hospital, Manchester, UK
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16
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Zadeh S, Ilioi EC, Jadva V, Golombok S. The perspectives of adolescents conceived using surrogacy, egg or sperm donation. Hum Reprod 2019; 33:1099-1106. [PMID: 29701833 PMCID: PMC5972639 DOI: 10.1093/humrep/dey088] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 03/28/2018] [Indexed: 01/31/2023] Open
Abstract
STUDY QUESTION What are the perspectives of adolescents conceived using surrogacy, egg or sperm donation regarding their conception and the third party involved? SUMMARY ANSWER The majority of adolescents described feeling indifferent about their conception, and yet simultaneously reported an interest in the third party involved, or were in contact with them. WHAT IS KNOWN ALREADY There is an assumption that children conceived through reproductive donation will feel negatively about their origins in adolescence. However, little is known about the views of adolescents who have been conceived through different types of reproductive donation. STUDY DESIGN, SIZE, DURATION Forty-four adolescents, all of whom had been told about their conception in childhood, participated in a semi-structured interview as part of the sixth phase of a longitudinal, multi-method, multi-informant study of assisted reproduction families in the UK. PARTICIPANTS/MATERIALS, SETTING, METHODS All adolescents were aged 14 years, had been conceived using surrogacy (n = 22), egg donation (n = 13) or sperm donation (n = 9) to heterosexual couples, and varied in terms of their information about, and contact with, the third party involved in their conception. Semi-structured interviews were conducted in participants' homes. Interviews were analysed qualitatively to determine adolescents' perceptions of their conception, and their thoughts and feelings about the surrogate or donor involved. MAIN RESULTS AND THE ROLE OF CHANCE Adolescents were found to feel positive (n = 7), indifferent (n = 32) or ambivalent (n = 5) about their conception. Amongst adolescents not in contact with the surrogate or donor, most were interested (n = 16) in the surrogate or donor, and others were ambivalent (n = 4), or not interested (n = 6) in them. Adolescents in contact with the surrogate or donor expressed positive (n = 14), ambivalent (n = 1) or negative (n = 1) feelings about them. LIMITATIONS, REASONS FOR CAUTION Of 56 adolescents invited to take part in the study, 47 consented to take part, giving a response rate of 84%. It was not possible to obtain information from adolescents who do not know about their conception. WIDER IMPLICATIONS OF THE FINDINGS The findings contradict the assumption that children conceived through reproductive donation will feel negatively about their origins in adolescence and suggest that it may be helpful to draw a distinction between adolescents' feelings about their conception in general, and their feelings about the surrogate or donor in particular. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by the Wellcome Trust [097857/Z/11/Z]. The authors have no conflicts of interest to declare.
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Affiliation(s)
- S Zadeh
- Centre for Family Research, University of Cambridge, Cambridge CB2 3RF, UK
| | - E C Ilioi
- Centre for Family Research, University of Cambridge, Cambridge CB2 3RF, UK
| | - V Jadva
- Centre for Family Research, University of Cambridge, Cambridge CB2 3RF, UK
| | - S Golombok
- Centre for Family Research, University of Cambridge, Cambridge CB2 3RF, UK
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17
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Canzi E, Accordini M, Facchin F. 'Is blood thicker than water?' Donor conceived offspring's subjective experiences of the donor: a systematic narrative review. Reprod Biomed Online 2019; 38:797-807. [PMID: 30904355 DOI: 10.1016/j.rbmo.2018.11.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 11/14/2018] [Accepted: 11/27/2018] [Indexed: 12/21/2022]
Abstract
The aim of this study was to provide a systematic narrative review of the published research articles on donor conceived offspring's subjective experiences of their donor. A systematic search of electronic databases (PsycINFO and PubMed) provided 29 published quantitative and qualitative studies matching the inclusion criteria. The analysis of the studies outcomes led to the identification of four main themes: (i) views/representations of the donor; (ii) desire to contact the donor (in terms of desire to meet the donor, reasons for wanting to contact the donor, type and frequency of contact); (iii) reactions to discovering the donor's identity and contacting the donor; (iv) identity issues. The findings revealed that genetic ties do matter to donor conceived people, especially during adolescence or adulthood. Many donor conceived people were interested in contacting the donor and all of them needed to make meaning of the role of the donor, as well as to integrate it into their family life and self-concept. Besides curiosity and medical reasons, many people reported wanting to contact the donor to see what he/she looked like, and to have access to their own ancestry and genetic history.
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Affiliation(s)
- Elena Canzi
- Family Studies and Research University Centre, Catholic University of Milan, Milan, Italy.
| | - Monica Accordini
- Family Studies and Research University Centre, Catholic University of Milan, Milan, Italy
| | - Federica Facchin
- Department of Psychology, Family Studies and Research University Centre, Catholic University of Milan, Milan, Italy
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18
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de Melo-Martín I, Rubin LR, Cholst IN. "I want us to be a normal family": Toward an understanding of the functions of anonymity among U.S. oocyte donors and recipients. AJOB Empir Bioeth 2018; 9:235-251. [PMID: 30398412 DOI: 10.1080/23294515.2018.1528308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Anonymity remains the more common practice in gamete donations, but legislation prohibiting anonymity with a goal of protecting donor-conceived children's right to know their genetic origins is becoming more common. However, given the dearth of research investigating the function of anonymity for donors and recipients, it is unclear whether these policies will accomplish their goals. The aim of this study was to explore experiences with anonymity among oocyte donors and recipients who participated in an anonymous donor oocyte program and to understand the ways in which anonymity functions for them. METHODS Semistructured interviews were conducted with 50 women: 28 oocyte donors and 22 recipients who were recruited from an academic center for reproductive medicine in the United States. RESULTS Donors and recipients view anonymity both as a mechanism to protect the interests of all parties (recipients, donors, and donor-conceived children) and as a point of conflict. Specifically, three key areas were identified where both donors and recipients saw anonymity as having an important role: relieving anxieties about family structures and obligations; protecting their interests and those of donor-conceived children (while acknowledging where interests conflict); and managing the future. CONCLUSION As gamete donation increasingly moves away from the practice of anonymity, examining why anonymity matters to stakeholders will be helpful in devising strategies to successfully implement identity-release options.
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Affiliation(s)
| | - Lisa R Rubin
- b Department of Psychology , New School for Social Research
| | - Ina N Cholst
- c The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine , Weill Cornell Medical College
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19
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Informing offspring of their conception by gamete or embryo donation: an Ethics Committee opinion. Fertil Steril 2018; 109:601-605. [DOI: 10.1016/j.fertnstert.2018.01.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 01/03/2018] [Indexed: 11/19/2022]
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20
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Lima NS. Narrative Identity in Third Party Reproduction: Normative Aspects and Ethical Challenges. JOURNAL OF BIOETHICAL INQUIRY 2018; 15:57-70. [PMID: 29234993 DOI: 10.1007/s11673-017-9823-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 10/10/2017] [Indexed: 06/07/2023]
Abstract
In the last few decades, assisted reproduction has introduced new challenges to the way people conceive and build their families. While the numbers of donor-conceived (DC) individuals have increased worldwide, there are still many controversies concerning access to donor information. Is there a fundamental moral right to know one's genetic background? What does identity in DC families mean? Is there any relationship between identity formation and disclosure of genetic origins? These questions are addressed by analysing core regulatory discourse (ethical recommendations and codes of practice). This analysis shows that the notion of narrative identity is suitable for defining and answering these questions. This review analyses the meaning of resemblance in DC families and the way donors are selected following affinity-ties and discusses disclosure strategies and agreements. As a preliminary conclusion, it could be said that, in the field of third-party reproduction, knowing about the donor conception significantly contributes towards the development of a narrative identity and also serves as a moral basis for the child's right to know.
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Affiliation(s)
- Natacha Salomé Lima
- Universidad de Buenos Aires, Facultad de Psicología, Práctica Profesional 824 El Rol del Psicólogo en el Ámbito de las Tecnologías de Reproducción Humana Asistida, Buenos Aires, Argentina.
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) - Universidad de Buenos Aires, Instituto de Investigaciones en Psicología, Buenos Aires, Argentina.
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21
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Frith L, Blyth E, Crawshaw M, van den Akker O. Secrets and disclosure in donor conception. SOCIOLOGY OF HEALTH & ILLNESS 2018; 40:188-203. [PMID: 29143343 DOI: 10.1111/1467-9566.12633] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This article considers the disclosure, sharing and exchange of information on being donor conceived within families, drawing on data from a study undertaken with donor-conceived adults registered with UK Donor Link (a voluntary DNA-linking register). This paper considers the narratives of how respondents found out they were donor-conceived and what events triggered disclosure of this information. This paper then goes on to examine the role secrecy played in their family life and uses the concept of 'display' to explore how secrecy affected their relationships with their immediate and extended family. Secrets are notoriously 'leaky' and we found complex patterns of knowing and uncertainty about whom in the family knew that the person was donor-conceived. We argue that what is kept secret and from whom provides insights into the multifaceted web of social relationships that can be created by donor-conception, and how knowledge can be managed and controlled in attempts to display and maintain family narratives of biogenetic connection.
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Affiliation(s)
- Lucy Frith
- Health Services Research, University of Liverpool, UK
| | - Eric Blyth
- School of Human and Health Sciences, University of Huddersfield, UK
| | - Marilyn Crawshaw
- Department of Social Policy and Social Work, University of York, UK
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22
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Carone N, Baiocco R, Manzi D, Antoniucci C, Caricato V, Pagliarulo E, Lingiardi V. Surrogacy families headed by gay men: relationships with surrogates and egg donors, fathers’ decisions over disclosure and children’s views on their surrogacy origins. Hum Reprod 2017; 33:248-257. [DOI: 10.1093/humrep/dex362] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 11/19/2017] [Indexed: 11/12/2022] Open
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23
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Zadeh S, Freeman T, Golombok S. 'What Does Donor Mean to a Four-Year-Old?': Initial Insights into Young Children's Perspectives in Solo Mother Families. CHILDREN & SOCIETY 2017; 31:194-205. [PMID: 28450763 PMCID: PMC5396304 DOI: 10.1111/chso.12181] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/21/2016] [Indexed: 05/08/2023]
Abstract
This study reports on the questions, thoughts and feelings of children aged 4-9 conceived by donor insemination to single mothers. Fifty-one mothers and 47 children from the same families were each administered a semi-structured interview. Mothers generally reported that while children either lack understanding, or have not yet been told, about their donor conception, they may be thinking and talking about the absence of a father. Most children did not mention either donor conception or father absence and reported positive feelings about their families and friendships. Possible explanations for the discrepancy between mothers' and children's reports are discussed.
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Affiliation(s)
- Sophie Zadeh
- Centre for Family ResearchUniversity of CambridgeCambridgeUK
| | - Tabitha Freeman
- Centre for Family ResearchUniversity of CambridgeCambridgeUK
| | - Susan Golombok
- Centre for Family ResearchUniversity of CambridgeCambridgeUK
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24
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Italian gay fathers' experiences of transnational surrogacy and their relationship with the surrogate pre- and post-birth. Reprod Biomed Online 2017; 34:181-190. [DOI: 10.1016/j.rbmo.2016.10.010] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 10/18/2016] [Accepted: 10/19/2016] [Indexed: 11/20/2022]
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25
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Van Parys H, Provoost V, Wyverkens E, De Sutter P, Pennings G, Buysse A. Family Communication About the Donor Conception: A Multi-Perspective Qualitative Study With Lesbian Parents and Their Children. QUALITATIVE HEALTH RESEARCH 2016; 26:1998-2008. [PMID: 26386025 DOI: 10.1177/1049732315606684] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
In literature, disclosure of donor conception in lesbian families has been considered an obvious and straightforward event. However, little is known about the ways in which donor conception is discussed in planned lesbian co-mother families. This study focuses on the process of parent-child communication about the donor conception on a within-family level. Six families, including 7 children and 12 parents, were interviewed about their family communication with regard to donor conception. A dyadic interview analysis revealed that family members managed the space taken up by the topic of donor conception in their daily conversations. Within these conversations, they also took care of each other and of their family relationships. In addition, children had an active position in the co-construction of the donor conception narrative. Linking these findings to the concepts of relational management and functionality of donor conception narratives, this study informs practitioners in the field of medically assisted reproduction.
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Affiliation(s)
- H Van Parys
- Faculty of Psychology and Educational Sciences, Ghent University, Belgium
| | - V Provoost
- Bioethics Institute Ghent, Ghent University, Belgium
| | - E Wyverkens
- Faculty of Psychology and Educational Sciences, Ghent University, Belgium
| | - P De Sutter
- Department of Reproductive Medicine, Ghent University Hospital, Belgium
| | - G Pennings
- Bioethics Institute Ghent, Ghent University, Belgium
| | - A Buysse
- Faculty of Psychology and Educational Sciences, Ghent University, Belgium
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26
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Zadeh S. Disclosure of donor conception in the era of non-anonymity: safeguarding and promoting the interests of donor-conceived individuals? Hum Reprod 2016; 31:2416-2420. [PMID: 27698073 DOI: 10.1093/humrep/dew240] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 08/07/2016] [Accepted: 08/22/2016] [Indexed: 12/15/2022] Open
Abstract
This article responds to a debate article published in Human Reproduction earlier this year. In that article, the authors suggested that parents should be encouraged to disclose the use of donor gametes to their children given rapid and widespread advances in genetic testing and sequencing. However, there is an urgent need to engage with the assertion that in this context, telling children about their donor conception both safeguards and promotes their interests, particularly if such disclosure is motivated by parents' anxieties about accidental discovery. Disclosure that is motivated by the notion of non-anonymity may also encourage parents to share misinformation about donors and encourage their children to have unrealistic expectations. Fertility professionals must remain mindful of these outcomes when discussing disclosure and the future implications of increasing access to genetic information with both prospective and current parents. It is strongly advised that future discussions about the end of donor anonymity are not conflated with the debate on disclosure.
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Affiliation(s)
- Sophie Zadeh
- Centre for Family Research, University of Cambridge, Free School Lane, Cambridge, CB2 3RQ, UK
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27
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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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28
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Canneaux M, Kobilinsky N, Wolf JP, Golse B, Beauquier-Maccotta B. [Information, transmission, secrecy: What kind of discourse for children born by gamete donation?]. ACTA ACUST UNITED AC 2016; 44:410-6. [PMID: 27318771 DOI: 10.1016/j.gyobfe.2016.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 04/29/2016] [Indexed: 10/21/2022]
Abstract
The number of children born through gamete donation grows by the conceptions made abroad. All the couples engaging in this process do not benefit from of the same support around the issues raised by the information to the child and its terms. Through a literature review, the authors explore the data on information intentions from parents to child and to entourage, the influence of the issue of anonymity, the effective rate information, the influences of the age of the child, the terms information and links with family dynamics. The quantitative findings underscore the complexity of this task, since 10-90 % of couples report an intention to inform their child from conception through donation, while 5-30 % actually inform them after birth. Fifty-nine to 93 % of the relatives are nevertheless informed. The authors will highlight the psychopathological tracks that support the possibility of narration for parents: the internalization of their infertility, the representation of the gift, the development of rivalry towards donors, the secrecy and privacy. The objective of this article is to enable carers to accompany this reflection among future parents, a better listening of the issues raise by the couples allowing shoring their process.
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Affiliation(s)
- M Canneaux
- Institut de psychologie, 71, avenue Édouard-Vaillant, 92100 Boulogne-Billancourt, France
| | - N Kobilinsky
- Institut Édouard-Claparède, 5, rue du Général-Cordonnier, 92200 Neuilly-sur-Seine, France
| | - J P Wolf
- Inserm U1016, service d'histologie embryologie biologie de la reproduction, CECOS, hôpital Cochin, université Paris Descartes, AP-HP, 75014 Paris, France
| | - B Golse
- Service de pédopsychiatrie, hôpital Necker-Enfants-Malades, AP-HP, 75015 Paris, France
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29
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Hudson N, Culley L, Blyth E, Norton W, Pacey A, Rapport F. Cross-border-assisted reproduction: a qualitative account of UK travellers' experiences. HUM FERTIL 2016; 19:102-10. [PMID: 27144511 DOI: 10.3109/14647273.2016.1168530] [Citation(s) in RCA: 11] [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
Surveys on patients' experiences of cross-border fertility treatment have reported a range of positive and challenging features. However, the number of such studies is limited, and there is no detailed qualitative account of the experiences of UK patients who travel overseas for fertility treatment. The present study used a cross-sectional, qualitative design and in-depth interviews. Fifty-one participants (41 women and 10 men, representing 41 treatment 'cases') participated in semi-structured interviews. The experiences reported were broadly positive with a large proportion of participants (39 cases, 95%) citing a favourable overall experience with only two cases (5%) reporting a more negative experience. Thematic analysis revealed 6 major categories and 20 sub-categories, which described the positive and challenging aspects of cross-border fertility travel. The positive aspects were represented by the categories: 'access', 'control' and 'care and respect'. The more challenging aspects were categorized as 'logistics and coordination of care', 'uncertainty' and 'cultural dissonance'. The study confirms findings from others that despite some challenges, there is a relatively high level of patient satisfaction with cross-border treatment with participants able to extend the boundaries of their fertility-seeking trajectories and in some cases, regain a sense of control over their treatment.
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Affiliation(s)
- Nicky Hudson
- a Applied Social Sciences , De Montfort University , Leicester , UK
| | - Lorraine Culley
- a Applied Social Sciences , De Montfort University , Leicester , UK
| | - Eric Blyth
- b School of Human and Health Sciences, University of Huddersfield , Huddersfield , UK
| | - Wendy Norton
- c School of Nursing & Midwifery, De Montfort University , Leicester , UK
| | - Allan Pacey
- d Reproductive & Developmental Medicine , University of Sheffield , Sheffield , UK
| | - Frances Rapport
- e Centre for Healthcare Resilience and Implementation Science (CHRIS) , Australian Institute of Healthcare Innovation, Macquarie University , Sydney , NSW , Australia
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30
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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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Appleby JB. The ethical challenges of the clinical introduction of mitochondrial replacement techniques. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2015; 18:501-14. [PMID: 26239841 PMCID: PMC4591199 DOI: 10.1007/s11019-015-9656-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Mitochondrial DNA (mtDNA) diseases are a group of neuromuscular diseases that often cause suffering and premature death. New mitochondrial replacement techniques (MRTs) may offer women with mtDNA diseases the opportunity to have healthy offspring to whom they are genetically related. MRTs will likely be ready to license for clinical use in the near future and a discussion of the ethics of the clinical introduction of MRTs is needed. This paper begins by evaluating three concerns about the safety of MRTs for clinical use on humans: (1) Is it ethical to use MRTs if safe alternatives exist? (2) Would persons with three genetic contributors be at risk of suffering? and (3) Can society trust that MRTs will be made available for humans only once adequate safety testing has taken place, and that MRTs will only be licensed for clinical use in a way that minimises risks? It is then argued that the ethics debate about MRTs should be reoriented towards recommending ways to reduce the possible risks of MRT use on humans. Two recommendations are made: (1) licensed clinical access to MRTs should only be granted to prospective parents if they intend to tell their children about their MRT conception by adulthood; and (2) sex selection should be used in conjunction with the clinical use of MRTs, in order to reduce transgenerational health risks.
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Affiliation(s)
- John B Appleby
- Centre of Medical Law and Ethics in the Dickson Poon School of Law, King's College London, London, UK.
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Wyverkens E, Van Parys H, Buysse A. Experiences of Family Relationships Among Donor-Conceived Families: A Meta-Ethnography. QUALITATIVE HEALTH RESEARCH 2015; 25:1223-1240. [PMID: 25316692 DOI: 10.1177/1049732314554096] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
In this qualitative evidence synthesis, we explore how family relationships are experienced by parents who used gamete donation to conceive. We systematically searched four databases (PubMed, Web of Science, PsycINFO, and ProQuest) for literature related to this topic and retrieved 25 studies. Through the analysis of the qualitative studies, a comprehensive synthesis and framework was constructed. Following the meta-ethnography approach of Noblit and Hare, four main themes were identified: (a) balancing the importance of genetic and social ties, (b) normalizing and legitimizing the family, (c) building strong family ties, and (d) minimizing the role of the donor. Underlying these four main themes, a sense of being "different" and "similar" at the same time was apparent. Findings are discussed in terms of their implications for studying and counseling donor-conceived families.
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Goldberg AE, Scheib JE. Female-partnered and single women's contact motivations and experiences with donor-linked families. Hum Reprod 2015; 30:1375-85. [PMID: 25883034 DOI: 10.1093/humrep/dev077] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 03/18/2015] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION What are female-partnered and single mothers' motivations and experiences at one donor insemination (DI) program with regard to contacting other families who share the same sperm donor? SUMMARY ANSWER By and large, women reported seeking contact to obtain (i) support for their children and/or themselves, and (ii) information about shared traits and medical problems, ultimately describing a range of contact experiences, both positive (e.g. special bond created) and negative (e.g. uncomfortable encounters). WHAT IS KNOWN ALREADY There is a growing phenomenon of donor insemination families-parents and/or offspring-seeking others who share their donor (i.e. are 'donor-linked'). There is limited understanding about parental motivations and experiences-especially in the presence of a second parent-due to the methodological constraints of previous quantitative studies. STUDY DESIGN, SIZE, DURATION Semi-structured telephone interviews were conducted with 50 donor insemination mothers (14 single, 36 female-partnered). Participants were recruited by email invitation to parent members of a family-matching service at one donor insemination program in the USA. The criterion for inclusion was having matched to at least one donor-linked family. PARTICIPANTS/MATERIALS, SETTING, METHODS Among the 50 mothers interviewed, all had at least one child conceived via donor insemination, who was between ages 0 and 15 years at first contact. Families matched with a median of three donor-linked families (range 1-10). Interview data were analyzed through qualitative (i.e. thematic) analysis. MAIN RESULTS AND THE ROLE OF CHANCE Overarching themes emerged of seeking contact to obtain (i) support and (ii) information about children's shared physical and psychological traits. Some wanted to increase their child's family network, through adding a sibling, but more often as extended family. Data, from partnered parents especially, revealed the challenges of balancing the boundaries of family formed without the genetic link with the perceived benefits of exploring the child's donor origins. LIMITATIONS, REASONS FOR CAUTION Interviews focused on openness and information-sharing were conducted with parents from one American donor insemination program. Findings are limited to individuals who were open enough to share their experiences and able to take the time to do so. WIDER IMPLICATIONS OF THE FINDINGS As donor-linking services become established independently (e.g. donor insemination program registries) or by the government (e.g. Victoria, Australia's Voluntary Register), these findings provide evidence that linking services are valued by individuals affected by donor conception. Caution is warranted, however, in that some participants reported mismatched expectations, both across donor-linked families and within families (e.g. between partners), suggesting the need for information and guidance both during and after matching. Overall, the range and balance of reported positives and negatives indicate that donor-linking can provide individuals with support and donor origins information-which are particularly important when these are not available elsewhere. STUDY FUNDING/COMPETING INTERESTS Clark University provided support. No competing interests.
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Affiliation(s)
- A E Goldberg
- Department of Psychology, Clark University, Worcester, MA 01610, USA
| | - J E Scheib
- Department of Psychology, University of California, Davis, CA 95616, USA The Sperm Bank of California, Berkeley, CA 94704, USA
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Nordqvist P. "I've Redeemed Myself by Being a 1950s 'Housewife' ": Parent-Grandparent Relationships in the Context of Lesbian Childbirth. JOURNAL OF FAMILY ISSUES 2015; 36:480-500. [PMID: 26089581 PMCID: PMC4452625 DOI: 10.1177/0192513x14563798] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
This article investigates the relationship between grandparents and lesbian daughters in the context of childbirth, looking specifically at the role that pregnancy plays in shaping kinship affinities. Gender, sex, and heterosexuality are fundamental to Euro-American kinship discourse and practice; lesbian couples' parenthood through donor conception represents a significant departure from prevailing tropes of kinship. Thus, questions arise about how lesbians experience becoming and being parents, and about how their own parents may respond to becoming a genetic or nongenetic grandparent. This article draws on original data from interviews conducted in the United Kingdom with lesbians who became parents by donor conception, and grandparents with lesbian daughters in those situations where the older generation was not originally supportive of their daughters. It explores the negotiated meaning of pregnancy and how relationships with grandparents may be shaped by whether or not it is the daughter of the family who gave birth.
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Freeman T. Gamete donation, information sharing and the best interests of the child: an overview of the psychosocial evidence. Monash Bioeth Rev 2015; 33:45-63. [PMID: 25743051 PMCID: PMC4900443 DOI: 10.1007/s40592-015-0018-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This paper overviews key empirical findings from social science research regarding the impact of gamete donation on child wellbeing. In particular, the paper addresses current regulatory debates concerning information sharing and the best interests of the child by considering psychosocial aspects of telling--or not telling--children about their donor conception and the identity of their donor. The paper identifies three core sets of empirical, ethical and policy concerns underpinning these debates relating to (i) the psychosocial impact of gamete donation per se on child wellbeing, (ii) the psychosocial impact of parental disclosure decisions on child wellbeing, and (iii) the psychosocial implications of donor identification for donor-conceived offspring. The paper illustrates how these concerns are framed by ideas about the significance-or not-of 'genetic relatedness'; ideas which have come to the fore in contemporary discussions about the potential consequences of donor-conceived individuals gaining access to their donor's identity. By drawing together research findings that may be pertinent to the regulation of gamete donation and information sharing, a further aim of this paper is to explore the potential use and misuse of empirical 'evidence' in ethical and policy debates. Whilst this paper starts from the premise that psychosocial data has a vital role in grounding normative discussions, it seeks to contribute to this dialogue by highlighting both the value and limitations of social science research. In particular, the paper argues for a cautious approach to applying psychosocial evidence to ethical issues that is sensitive to the caveats and nuances of research findings and the changing cultural and regulatory context.
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Affiliation(s)
- Tabitha Freeman
- Centre for Family Research, Free School Lane, University of Cambridge, Cambridge, CB2 3RF, UK,
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Abstract
Searching and finding supposedly anonymous sperm donors or half-siblings by diverting direct-to-consumer genetic testing is a novel phenomenon. I refer to such new forms of kinship as 'wayward relations,' because they are often officially unintended and do not correspond to established kinship roles. Drawing on data mostly from the United Kingdom, Germany and the United States, I argue that wayward relations are a highly contemporary means of asserting agency in a technological world characterized by tensions over knowledge acquisition. I make the case that such relations reaffirm the genetic grounding of kinship, but do not displace other ways of relating--they are complementary not colonizing. Wayward relations challenge the gate-keeper status of fertility clinics and regulators over genetic knowledge and classical notions of privacy.
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Affiliation(s)
- Maren Klotz
- a Department of European Ethnology , Humboldt University , Berlin , Germany
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Blake L, Jadva V, Golombok S. Parent psychological adjustment, donor conception and disclosure: a follow-up over 10 years. Hum Reprod 2014; 29:2487-96. [PMID: 25240010 DOI: 10.1093/humrep/deu231] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION What is the relationship between parent psychological adjustment, type of gamete donation (donor insemination, egg donation) and parents' disclosure of their use of donated gametes to their children. SUMMARY ANSWER Disclosure of donor origins to the child was not always associated with optimal levels of psychological adjustment, especially for fathers in donor insemination families. WHAT IS KNOWN ALREADY Cross-sectional analyses have found mothers and fathers who conceived a child using donated sperm or eggs to be psychologically well-adjusted, with few differences emerging between parents in gamete donation families and parents in families in which parents conceived naturally. The relationship between mothers' and fathers' psychological well-being, type of gamete donation (donor insemination, egg donation) and parents' disclosure decisions has not yet been examined. STUDY DESIGN, SIZE, DURATION In this follow-up study, data were obtained from mothers and fathers in donor insemination and egg donation families at 5 time points; when the children in the families were aged 1, 2, 3, 7 and 10. In the first phase of the study, 50 donor insemination families and 51 egg donation families with a 1-year-old child participated. By age 10, the study included 34 families with a child conceived by donor insemination and 30 families with a child conceived by egg donation, representing 68 and 58% of the original sample, respectively. PARTICIPANTS/MATERIALS, SETTING, METHODS Families were recruited through nine fertility clinics in the UK. Standardized questionnaires assessing depression, stress and anxiety were administered to mothers and fathers in donor insemination and egg donation families. MAIN RESULTS AND THE ROLE OF CHANCE Mothers and fathers in both donor insemination and egg donation families were found to be psychologically well-adjusted; for the vast majority of parents' levels of depression, anxiety and parenting stress were found to be within the normal range at all 5 time points. Disclosure of the child's donor origins to the child was not always associated with optimal levels of parental psychological adjustment. For example, disclosure was associated with lower levels of psychological well-being for certain groups in particular (such as fathers in donor insemination families), at certain times (when children are in middle childhood and have a more sophisticated understanding of their donor origins). LIMITATIONS, REASONS FOR CAUTION Owing to small sample sizes, the value of this study lies not in its generalizability, but in its potential to point future research in new directions. WIDER IMPLICATIONS OF THE FINDINGS Donor insemination and egg donation families are a heterogeneous group, and future research should endeavour to obtain data from fathers as well as mothers. Support and guidance in terms of disclosure and family functioning might be most beneficial for parents (and especially fathers) in donor insemination families, particularly as the child grows older. The more that is known about the process of disclosure over time, from the perspective of the different members of the family, the better supported parents and their children can be. STUDY FUNDING COMPETING INTERESTS The project described was supported by grant number RO1HD051621 from the National Institute of Child Health and Human Development. The content is solely the responsibility of the authors and does not represent the official views of the National Institute of Child Health and Human Development or the National Institutes of Health. The authors have no conflict of interest to declare.
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Affiliation(s)
- L Blake
- Centre for Family Research, Free School Lane, University of Cambridge, Cambridge CB2 3RQ, UK
| | - V Jadva
- Centre for Family Research, Free School Lane, University of Cambridge, Cambridge CB2 3RQ, UK
| | - S Golombok
- Centre for Family Research, Free School Lane, University of Cambridge, Cambridge CB2 3RQ, UK
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De Melo-Martín I. The ethics of anonymous gamete donation: is there a right to know one's genetic origins? Hastings Cent Rep 2014; 44:28-35. [PMID: 24532424 DOI: 10.1002/hast.285] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A growing number of jurisdictions hold that gamete donors must be identifiable to the children born with their eggs or sperm, on grounds that being able to know about one's genetic origins is a fundamental moral right. But the argument for that belief has not yet been adequately made.
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Hammarberg K, Johnson L, Bourne K, Fisher J, Kirkman M. Proposed legislative change mandating retrospective release of identifying information: consultation with donors and Government response. Hum Reprod 2013; 29:286-92. [PMID: 24319103 PMCID: PMC3896224 DOI: 10.1093/humrep/det434] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
STUDY QUESTION How do gamete donors who presumed they could remain anonymous respond to proposed legislation to retrospectively remove anonymity? SUMMARY ANSWER A little more than half of the donors opposed the recommendation to introduce legislation to remove donor anonymity with retrospective effect. WHAT IS KNOWN ALREADY An increasing proportion of parents disclose their origins to their donor-conceived children and growing numbers of donor-conceived adults are aware of how they were conceived. Research indicates that access to information about the donor is important to donor-conceived people. However, worldwide most donor-conceived people are unable to find any identifying information about the donor because of the practice of anonymous gamete donation. STUDY DESIGN, SIZE, DURATION This study adopted a qualitative research model using semi-structured interviews with gamete donors that included open questions. Interviews with 42 volunteers were conducted between December 2012 and February 2013. PARTICIPANTS/MATERIALS, SETTING, METHODS Before 1998 gamete donors in Victoria, Australia, were able to remain anonymous. Pre-1998 donors were invited through an advertising campaign to be interviewed about their views on a recommendation that legislation mandating retrospective release of identifying information be introduced. MAIN RESULTS AND THE ROLE OF CHANCE Donors were almost evenly split between those who supported and those who rejected the recommendation to introduce legislation to remove donor anonymity with retrospective effect. About half of the donors who rejected the recommendation suggested the compromise of persuading donors voluntarily to release information (whether identifying or non-identifying) to donor-conceived people. These donors were themselves willing to supply information to their donor offspring. The findings of this study informed the Victorian Government's response to the proposed legislative change. While acknowledging donor-conceived people's right of access to information about their donors, the Government decided that identifying information should be released only with the consent of donors and that donors should be encouraged to allow themselves to be identifiable to their donor offspring. LIMITATIONS, REASONS FOR CAUTION There is no way of knowing whether participants were representative of all pre-1998 donors. WIDER IMPLICATIONS OF THE FINDINGS The balancing of donors' and donor-conceived people's rights requires utmost sensitivity. All over the world, increasing numbers of donor-conceived people are reaching adulthood; of those who are aware of their mode of conception, some are likely to have a strong wish to know the identity of their donors. Legislators and policy-makers in jurisdictions permitting anonymous gamete donations will need to respond when these desires are expressed, and may choose to be guided by the model of consultation described in this paper. STUDY FUNDING/COMPETING INTERESTS The study was funded by the Victorian Department of Health. The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER Not applicable.
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Affiliation(s)
- Karin Hammarberg
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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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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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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Golombok S, Blake L, Casey P, Roman G, Jadva V. Children born through reproductive donation: a longitudinal study of psychological adjustment. J Child Psychol Psychiatry 2013; 54:653-60. [PMID: 23176601 PMCID: PMC3586757 DOI: 10.1111/jcpp.12015] [Citation(s) in RCA: 118] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Parenting and children's adjustment were examined in 30 surrogacy families, 31 egg donation families, 35 donor insemination families, and 53 natural conception families. METHODS Parenting was assessed at age 3 by a standardized interview designed to assess quality of parenting and by questionnaire measures of anxiety, depression, and marital quality. Children's adjustment was assessed at ages 3, 7, and 10 using the Strengths and Difficulties Questionnaire (SDQ). RESULTS Although children born through reproductive donation obtained SDQ scores within the normal range, surrogacy children showed higher levels of adjustment difficulties at age 7 than children conceived by gamete donation. Mothers who had kept their child's origins secret showed elevated levels of distress. However, maternal distress had a more negative impact on children who were aware of their origins. CONCLUSIONS The absence of a gestational connection to the mother may be more problematic for children than the absence of a genetic link.
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Affiliation(s)
- Susan Golombok
- Centre for Family Research, University of Cambridge, Cambridge, UK.
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Golombok S. Families Created by Reproductive Donation: Issues and Research. CHILD DEVELOPMENT PERSPECTIVES 2012. [DOI: 10.1111/cdep.12015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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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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Jadva V, Blake L, Casey P, Golombok S. Surrogacy families 10 years on: relationship with the surrogate, decisions over disclosure and children's understanding of their surrogacy origins. Hum Reprod 2012; 27:3008-14. [PMID: 22814484 DOI: 10.1093/humrep/des273] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study aimed to prospectively examine families created using surrogacy over a 10-year period in the UK with respect to intending parents' and children's relationship with the surrogate mother, parents' decisions over disclosure and children's understanding of the nature of their conception. METHODS Semi-structured interviews were administered by trained researchers to intending mothers, intending fathers and children on four occasions over a 10-year period. Forty-two families (19 with a genetic surrogate mother) participated when the child was 1-year old and by age 10 years, 33 families remained in the study. Data were collected on the frequency of contact with the surrogate mother, relationship with the surrogate, disclosure of surrogacy to the child and the child's understanding of their surrogacy birth. RESULTS Frequency of contact between surrogacy families and their surrogate mother decreased over time, particularly for families whose surrogate was a previously unknown genetic carrier (P < 0.001) (i.e. where they had met through a third party and the surrogate mother's egg was used to conceive the child). Most families reported harmonious relationships with their surrogate mother. At age 10 years, 19 (90%) children who had been informed of the nature of their conception had a good understanding of this and 13 of the 14 children who were in contact with their surrogate reported that they liked her. CONCLUSIONS Surrogacy families maintained good relationships with the surrogate mother over time. Children felt positive about their surrogate mother and their surrogacy birth. The sample size of this study was small and further, larger investigations are needed before firm conclusions can be drawn.
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Affiliation(s)
- V Jadva
- Centre for Family Research, University of Cambridge, Cambridge CB2 3RF, UK.
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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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Inhorn MC, Gürtin ZB. Cross-border reproductive care: a future research agenda. Reprod Biomed Online 2011; 23:665-76. [DOI: 10.1016/j.rbmo.2011.08.002] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Accepted: 08/05/2011] [Indexed: 11/26/2022]
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Golombok S, Readings J, Blake L, Casey P, Mellish L, Marks A, Jadva V. Children conceived by gamete donation: psychological adjustment and mother-child relationships at age 7. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2011; 25:230-9. [PMID: 21401244 PMCID: PMC3075381 DOI: 10.1037/a0022769] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
An increasing number of babies are being born using donated sperm, where the child lacks a genetic link to the father, or donated eggs, where the child lacks a genetic link to the mother. This study examined the impact of telling children about their donor conception on mother-child relationships and children's psychological adjustment. Assessments of maternal positivity, maternal negativity, mother-child interaction, and child adjustment were administered to 32 egg donation, 36 donor insemination, and 54 natural conception families with a 7-year-old child. Although no differences were found for maternal negativity or child adjustment, mothers in nondisclosing gamete donation families showed less positive interaction than mothers in natural conception families, suggesting that families may benefit from openness about the child's genetic origins.
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Affiliation(s)
- Susan Golombok
- Centre for Family Research, Faculty of Politics Psychology Sociology and International Studies, University of Cambridge, UK.
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