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Jadva V, Jones C, Zadeh S. The Donor Conception Identity Questionnaire: associations with mental health and searching for and finding donor connections. Fertil Steril 2024:S0015-0282(24)01962-9. [PMID: 39182557 DOI: 10.1016/j.fertnstert.2024.08.331] [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: 04/15/2024] [Revised: 08/15/2024] [Accepted: 08/15/2024] [Indexed: 08/27/2024]
Abstract
OBJECTIVE To understand how the Donor Conception Identity Questionnaire (DCIQ) correlates with mental health and explore differences in the DCIQ between donor conceived people who were actively searching for donor connections to those who were not and those who had found their donor connections to those who had not. DESIGN Cross-sectional survey. SETTING Online survey conducted within United Kingdom. PATIENT(S) A total of 88 donor conceived adults ranging in age from 18 to 70 (mean, 34.27 years; median, 31 years). A total of 39 participants were actively searching for their donor connections, and 49 were not. INTERVENTION(S) Donor conception identity was measured using a questionnaire and scores were correlated with existing measures of mental health. MAIN OUTCOME MEASURE(S) Participants completed the DCIQ and measures of well-being, satisfaction with life, identity, pride, and stigma. RESULT(S) Factor analysis of items from the DCIQ identified four domains: concern and preoccupation; internalized stigma; pride and acceptance; and openness and understanding. The identified factors correlated with scales of psychological and social well-being. Active searchers scored higher than non-active searchers on "concern and preoccupation" and "internalized stigma". Donor conceived individuals who had found their donor connections scored lower on "internalized stigma" and higher on "openness and understanding" compared with those who had not found their donor connections. CONCLUSION(S) The findings of the present study show that scores on the DCIQ correlate with existing measures of psychological and social well-being. Furthermore, donor conceived individuals searching for their donor connections differ from those not actively searching on key domains of the DCIQ. Implications for future avenues of study and support for donor conceived people are discussed.
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Affiliation(s)
- Vasanti Jadva
- Department of Psychology, City, University of London, London, United Kingdom.
| | - Catherine Jones
- Social, Genetic and Developmental Psychology Centre, King's College London, London, United Kingdom
| | - Sophie Zadeh
- School of Psychology, University of Sussex, Brighton, United Kingdom
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Newton G, Drysdale K, Newman CE. Embodied sociotechnical imaginaries: how donor-conceived people imagine identity, family and reprodigital futures beyond regulation. Front Glob Womens Health 2024; 4:1221913. [PMID: 38283654 PMCID: PMC10811956 DOI: 10.3389/fgwh.2023.1221913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 11/27/2023] [Indexed: 01/30/2024] Open
Abstract
Sociological scholarship has begun to explore imaginaries of family and reproduction, yet less work has focused on the emerging social form of the donor family. In this article, we consider the embodied sociotechnical imaginaries of donor-conceived people, exploring their reflections, judgements, hopes, and predictions regarding donor conception. Combining reflexive thematic analysis of free-text survey responses from sperm donor-conceived (n = 90) and egg donor-conceived (n = 1) and data from semi-structured interviews with sperm donor-conceived people (n = 28), conceived in both clinical and non-clinical contexts in Australia, we analyse donor-conceived people's imaginings of family, identity, and the practice of donor conception in the digital age. Our analysis centres the donor-conceived body that imagines, and in doing so, highlights the entanglements of reproductive and digital technologies, and the humans and institutions that drive their uptake. We argue that leveraging the imaginative and political capacities of donor-conceived people is a productive approach that illuminates possible (re)directions of the assisted reproduction industry as well as illustrating potential policy futures.
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Affiliation(s)
- Giselle Newton
- Digital Cultures and Societies, The University of Queensland, Brisbane, QLD, Australia
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Kerryn Drysdale
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Christy E. Newman
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
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Widbom A, Isaksson S, Sydsjö G, Skoog Svanberg A, Lampic C. The motives and experiences of donor-conceived persons requesting the identity of their sperm donors. Reprod Biomed Online 2024; 48:103413. [PMID: 37914558 DOI: 10.1016/j.rbmo.2023.103413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 09/01/2023] [Accepted: 09/11/2023] [Indexed: 11/03/2023]
Abstract
RESEARCH QUESTION What are the motives and experiences of donor-conceived persons (DCP) who search for and receive information about their identity-release sperm donor? DESIGN A qualitative interview study with 29 individuals (21 women, seven men, one non-binary) who were consecutively recruited after having requested information about their sperm donor at five Swedish University hospitals. All participants were conceived after donor insemination to heterosexual couples within an identity-release donation programme. Individual semi-structured interviews were conducted face-to-face or via telephone between September 2016 and November 2019, and transcribed audio recordings were analysed using reflexive thematic analysis. RESULTS The motives and experiences of DCP were described in two themes. The theme 'donor information can fill different needs' describes that varying motives, thoughts and feelings are related to searching for and obtaining donor information. Motives ranged from curiosity and a desire for agency over one's conception to hopes of finding a new father. The theme 'navigating donor information in a relational context' describes the process of obtaining donor information as interpersonal, highlighting that the DCP needs to balance the interests of different stakeholders, and that obtaining donor information can challenge the relationship quality with the father. CONCLUSIONS Obtaining the donor's identity has the potential to affect the understanding of DCP of themselves, and to influence relationships within their family in unexpected and challenging ways. Therefore, adequate resources should be allocated to support the growing number of families after identity-release donation.
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Affiliation(s)
- Andreas Widbom
- Department of Women's and Children's Health, Karolinska Institutet, 171 77 Stockholm, Sweden.
| | - Stina Isaksson
- Region Västra Götaland, Södra Älvsborg Hospital, Department of Research, Education and Innovation, 501 82 Borås, Sweden
| | - Gunilla Sydsjö
- Division of Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, 581 85 Linköping, Sweden
| | - Agneta Skoog Svanberg
- Department of Women's and Children's Health, Uppsala University, 751 85 Uppsala, Sweden
| | - Claudia Lampic
- Department of Women's and Children's Health, Karolinska Institutet, 171 77 Stockholm, Sweden; Department of Psychology, Umeå University, 901 87 Umeå, Sweden
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Gilman L, Redhead C, Hudson N, Fox M, Nordqvist P, MacCallum F, Kirkman-Brown J, Frith L. Direct-to-consumer genetic testing and the changing landscape of gamete donor conception: key issues for practitioners and stakeholders. Reprod Biomed Online 2024; 48:103421. [PMID: 37976658 DOI: 10.1016/j.rbmo.2023.103421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/14/2023] [Accepted: 09/18/2023] [Indexed: 11/19/2023]
Abstract
RESEARCH QUESTION What effect does direct-to-consumer genetic testing (DTCGT) have on information finding and sharing in relation to gamete donor conception? DESIGN This study used in-depth qualitative interviews with parents through donor conception, donors, the relatives of donors and donor-conceived people who have used, or considered using, DTCGT. Interviews were conducted between September 2021 and February 2023. Sixty people defined themselves as having been affected by donor conception and DTCGT. Fifty-seven of these were resident in the UK at the time of interview. The final sample included 19 (spermatozoa, egg or embryo) donors, 25 donor-conceived people, 20 parents through donor conception and two relatives of donors. Five participants occupied more than one of these roles. RESULTS The rise of DTCGT is affecting how information about donor conception is managed: it shifts patterns of knowledge about donor conception; increases flexibility regarding the age of access to information about donor relatives; can lead to a growing role for non-professionals, including wider family members, in gatekeeping information about donor conception; accentuates the effect of donor conception for donors' and the relatives of donor-conceived people; and shapes, and is shaped, by the formal regulatory donor information management systems. CONCLUSION Fertility professionals should inform people using, or considering, donor conception, or (potential) donors, about the different ways DTCGT can affect sharing information about donor conception. Support is needed for those affected by these changes.
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Affiliation(s)
- Leah Gilman
- Department of Sociological Studies, University of Sheffield, UK
| | - Caroline Redhead
- Centre for Social Ethics and Policy, University of Manchester, UK
| | - Nicky Hudson
- Centre for Reproduction Research - De Montfort, University, UK
| | - Marie Fox
- Law School, University of Liverpool, UK
| | | | | | | | - Lucy Frith
- Centre for Social Ethics and Policy, University of Manchester, UK..
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Rodino IS, Sanders KA. The influence of avoidant attachment and perceived support on disclosure about involvement in donor-assisted conception to family and friends. Hum Reprod 2023; 38:644-654. [PMID: 36737051 DOI: 10.1093/humrep/dead019] [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: 09/12/2022] [Revised: 12/07/2022] [Indexed: 02/05/2023] Open
Abstract
STUDY QUESTION Do the attachment-related dimensions Anxiety and Avoidance and perceived partner and social support in recipients and donors influence disclosure to others about their involvement in donor-assisted conception (DAC)? SUMMARY ANSWER A higher global score on attachment Avoidance was associated with greater non-disclosure about involvement in DAC by participants to relationship-specific others. WHAT IS KNOWN ALREADY Within the context of DAC, the topic of disclosure has been investigated in terms of the 'if', 'when', and the 'how' to disclose about circumstances of conception. Less focus, however, has been directed to investigating psychological theoretical frameworks that influence disclosure decisions to others, i.e. to whom information is disclosed and to what extent details are transparently revealed about the donor programme. STUDY DESIGN, SIZE, DURATION The study was of a cross-sectional design and utilized a sample of 301 participants who were, or had been, involved in DAC, and were recruited across states of Australia. An online self-report questionnaire was completed between June 2014 and June 2017. PARTICIPANTS/MATERIALS, SETTING, METHODS English speaking participants consisting of 209 female recipients and 92 donors (36 sperm; 48 egg; 8 embryo donors). Of the recipients, 104 had successfully conceived children via donated gametes (68 sperm, 23 eggs, 6 embryos, and 7 recipients where both gametes were donated from 2 donors to create the embryo). Participants anonymously completed an online questionnaire consisting of five sections: Demographics, Donor Conception and Disclosure Practices, the Experiences in Close Relationships-Relationships Structure, the Quality of Relationship Inventory, and the Multidimensional Scale of Perceived Social Support. Pearson correlations, independent samples t-tests, Chi-square, and ANOVA were used to explore the association between attachment Anxiety and Avoidance scores and disclosure about involvement in a DAC programme to significant others (i.e. parents, siblings, in-laws, and friends). MAIN RESULTS AND THE ROLE OF CHANCE Compared to published community cohort data, participants reported lower global scores on attachment Anxiety and Avoidance and high levels of romantic partner and social network support, suggestive of secure relationships in the overall study sample. A higher score on attachment Avoidance was associated with less disclosure to significant others in their social network (i.e. parents, siblings, in-laws, and close friends), even in the presence of strong partner support (partial r = -0.248, P = 0.005). Higher scores on attachment Avoidance were inversely associated with level of perceived partner and social network support (all P < 0.05). Irrespective of attachment scores, more than 90% of all participants agreed that a child born of DAC should be told about mode of conception. LIMITATIONS, REASONS FOR CAUTION This study utilized a cross-sectional design precluding causal inferences between dimensions of insecure attachment and disclosure practices. Participants were required to self-report on the quality of their relationships with the potential for social desirability respondent bias. The study's self-selecting sample may limit generalization to participants who were dis-inclined to participate. Specifically, respondents who have an Avoidant attachment style, may have elected not to participate in the study. WIDER IMPLICATIONS OF THE FINDINGS Given the increased use of biotechnology and digital facial recognition enabling self-discovery of the donor and the donor's extended family, non-disclosure about involvement in DAC may have consequences. An 'Avoidant' attachment style is important to assess as a potential risk factor for non-disclosure about involvement in DAC across different relational contexts (e.g. close family members and friends). Fertility counsellors should consider introducing a measure of attachment screening as a pre-emptive psychoeducational strategy during donor implications counselling. This information could be used to offer patients insight into concerns they have about DAC disclosures to key important relationships, providing a target of clinical intervention. STUDY FUNDING/COMPETING INTEREST(S) No external funds were sought for this work. None of the authors have any competing interests to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Iolanda S Rodino
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Katherine A Sanders
- School of Human Sciences, The University of Western Australia, Perth, Western Australia, Australia
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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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Crawshaw M, Pericleous-Smith A, Dark S. Counselling challenges associated with donor conception and surrogacy treatments - time for debate. HUM FERTIL 2022; 25:806-812. [PMID: 34240666 DOI: 10.1080/14647273.2021.1950850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Fertility counselling services have had to respond to significant developments in fertility treatments in recent years, prompting increasingly complex personal and professional ethical challenges. This Commentary focuses on those rising from donor conception and/or surrogacy. The profile of those seeking such treatments has changed to include growing numbers of same sex couples, single people, people who are transitioning or have done, people seeking posthumous use of gametes, and people using cross-border services. Alongside, awareness has grown of life-span implications, the impact of commercial DNA testing, and the need for 'later-life' support. Responses vary internationally and the time for debate is overdue. Who should provide fertility counselling and how? Should specialist qualifications, training, continuing professional development, and regulation be required? Should counsellors play a role in assessing suitability to parents? What aspects of different contractual arrangements and conflicts of interest need attention? Has the time come for counselling to be mandatory as part of pre-treatment pathways? What should be the relationship between fertility counsellors and multi-disciplinary clinic teams? How might fertility counsellors be represented nationally and internationally? What should be their relationship to 'later life' professional support? What place should professional knowledge hold in the evidence base?
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Affiliation(s)
- Marilyn Crawshaw
- Department of Social Policy & Social Work, University of York, York, UK
| | | | - Suzanne Dark
- Jessop Fertility, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
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Sela T, Bat-Or M. ‘‘You have your eyesight and you do not see:" Representations of sight and blindness as manifested in the artistic and verbal expressions of adults who grew up in the shadow of a secret. ARTS IN PSYCHOTHERAPY 2022. [DOI: 10.1016/j.aip.2022.101941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Glidden EA, Thibaut D, Goodman J. The impact of the method of genetic identity disclosure on the donor conceived adult. J Psychosom Obstet Gynaecol 2022; 43:258-264. [PMID: 35077297 DOI: 10.1080/0167482x.2022.2030307] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Aim: 106 donor conceived people (DCP) responded to an anonymous survey study that examined the impact of the method of genetic identity disclosure and age at the time of the disclosure on their emotional wellbeing, familial relations, and perceptions of donor conception practices.Methods: Participants were asked to select the way in which they were informed they are DCP and the age group at which this occurred, and then were asked to select strongly agree, agree, neither agree or disagree, disagree, or strongly disagree in response to 26 statements that examined their perceptions of the topics listed above. Responses were grouped based on the age of genetic identity disclosure and the method of genetic identity disclosure, then numerically compared by assigning each type of response a number. Statistical analysis using repeatedmeasures ANOVA was performed to identify differences among these factors.Results: This analysis revealed that most participants 18 ≥ years and most participants who discovered their genetic identity through means other than through their parent(s) had worse emotional wellbeing and familial relations. However, most participants among all categories had a negative perception of donor conception practices.Conclusion: Continued work is needed to understand and support the growing DCP population.
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Affiliation(s)
- Emily Ann Glidden
- Lake Erie College of Osteopathic Medicine - Bradenton Campus, Bradenton, FL, USA
| | - Dylan Thibaut
- Lake Erie College of Osteopathic Medicine - Bradenton Campus, Bradenton, FL, USA.,Burnett School of Biomedical Sciences, University of Central Florida, Orlando, FL, USA
| | - Jerry Goodman
- Lake Erie College of Osteopathic Medicine - Bradenton Campus, Bradenton, FL, USA
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Kirkman-Brown J, Calhaz-Jorge C, Dancet EAF, Lundin K, Martins M, Tilleman K, Thorn P, Vermeulen N, Frith L. Good practice recommendations for information provision for those involved in reproductive donation †. Hum Reprod Open 2022; 2022:hoac001. [PMID: 35178481 PMCID: PMC8847071 DOI: 10.1093/hropen/hoac001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 12/14/2021] [Indexed: 11/26/2022] Open
Abstract
STUDY QUESTION What information and support should be offered to donors, intended parents and donor-conceived people, in general and in consideration of the availability of direct-to-consumer genetic testing and matching services? SUMMARY ANSWER For donors, intended parents and donor-conceived offspring, recommendations are made that cover information needs and informed consent, psychosocial implications and disclosure. WHAT IS KNOWN ALREADY Trends indicate that the use of donor-assisted conception is growing and guidance is needed to help these recipients/intended parents, the donors and offspring, navigate the rapidly changing environment in which donor-assisted conception takes place. STUDY DESIGN SIZE DURATION A working group (WG) collaborated on writing recommendations based, where available, on evidence collected from a literature search and expert opinion. Draft recommendations were published for stakeholder review and adapted where relevant based on the comments received. PARTICIPANTS/MATERIALS SETTING METHODS Papers retrieved from PUBMED were included from 1 January 2014 up to 31 August 2020, focusing on studies published since direct-to-consumer genetic testing has become more widespread and accessible. The current paper is limited to reproductive donation performed in medically assisted reproduction (MAR) centres (and gamete banks): donation outside the medical context was not considered. MAIN RESULTS AND THE ROLE OF CHANCE In total, 32 recommendations were made for information provision and support to donors, 32 for intended parents and 27 for donor-conceived offspring requesting information/support. LIMITATIONS REASONS FOR CAUTION The available evidence in the area of reproductive donation is limited and diverse with regards to the context and types of donation. General conclusions and recommendations are largely based on expert opinion and may need to be adapted in light of future research. WIDER IMPLICATIONS OF THE FINDINGS These recommendations provide guidance to MAR centres and gamete banks on good practice in information provision and support but should also be considered by regulatory bodies and policymakers at a national and international level to guide regulatory and legislative efforts towards the protection of donors and donor-conceived offspring. STUDY FUNDING/COMPETING INTERESTS The development of this good practice paper was funded by European Society of Human Reproduction and Embryology (ESHRE), covering expenses associated with the WG meetings, the literature searches and dissemination. The WG members did not receive any payment. The authors have no conflicts of interest to declare. DISCLAIMER This document represents the views of ESHRE, which are the result of consensus between the relevant ESHRE stakeholders and where relevant based on the scientific evidence available at the time of preparation. The recommendations should be used for informational and educational purposes. They should not be interpreted as setting a standard of care, or be deemed inclusive of all proper methods of care nor exclusive of other methods of care reasonably directed to obtaining the same results. They do not replace the need for application of clinical judgement to each individual presentation, nor variations based on locality and facility type. †ESHRE pages content is not externally peer reviewed. The manuscript has been approved by the Executive Committee of ESHRE.
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Affiliation(s)
| | - Jackson Kirkman-Brown
- Centre for Human Reproductive Science, University of Birmingham, IMSR, Birmingham, UK
| | | | - Eline A F Dancet
- KU Leuven, Department of Development and Regeneration, Leuven, Belgium
| | - Kersti Lundin
- Department of Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mariana Martins
- University of Porto, Faculty of Psychology and Education Sciences, Porto, Portugal
| | - Kelly Tilleman
- Department for Reproductive Medicine, Universitair Ziekenhuis Gent, Ghent, Belgium
| | - Petra Thorn
- Private Practice, Couple and Family Therapy, Infertility Counseling, Mörfelden, Germany
| | - Nathalie Vermeulen
- European Society of Human Reproduction and Embryology (ESHRE) Central Office, Strombeek-Bever, Belgium
| | - Lucy Frith
- Centre for Social Ethics and Policy, University of Manchester, Manchester, UK
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Kirkman-Brown JC, Martins MV. 'Genes versus children': if the goal is parenthood, are we using the optimal approach? Hum Reprod 2021; 35:5-11. [PMID: 31916579 PMCID: PMC6993870 DOI: 10.1093/humrep/dez256] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 10/27/2019] [Indexed: 01/02/2023] Open
Abstract
First medical contact for couples trying for a child will usually emphasise the array of assistance available to ‘help them have their own child’, usually with options involving ART, after diagnosis. For many poorer prognosis couples, this means repetitive unsuccessful cycles of invasive and stressful treatment. What is sometimes lost at this stage is a reflection on the likelihood of success of different options, which may lead patients to focus on hoping for their own ‘genetic’ progeny, but failing to consider the alternative and potentially more successful other options, including donation and adoption, for achieving parenthood of a child. Factors not only such as female age but also advanced requirements such as preimplantation genetic testing or even mitochondrial replacement therapies all have reduced chances of success but further tend to reinforce the importance of a genetic link. The financial, physical and psychosocial burden associated with cumulative failure also lead to a higher probability of dropout and consequently an even higher probability of remaining in involuntary childlessness. We advocate formulation of a detailed roadmap for discussion of parenthood, with reference explanation to genetics and epigenetics, which gives due consideration to the psychological effects from the beginning to end of the treatment process, alongside a balanced consideration of the likelihood of treatment success and discussion of other options. Only when we provide patients with the service of a clear and transparent discussion of these matters, we will really realise the true potential of our field, which may then be better considered as assisted families.
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Affiliation(s)
- Jackson C Kirkman-Brown
- Centre for Human Reproductive Science, IMSR, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK.,Birmingham Women's Fertility Centre, Birmingham Women's & Children's NHS Foundation Trust, Birmingham B15 2TG, UK
| | - Mariana V Martins
- Faculty of Psychology and Educational Sciences, University of Porto, Porto 4200-135, Portugal.,Centre for Psychology at University of Porto, Porto 4200-135, Portugal
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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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Jadue T. Comunicación de orígenes en familias formadas por donación de gametos: del anonimato a la apertura como posibilidad. REVISTA MÉDICA CLÍNICA LAS CONDES 2021. [DOI: 10.1016/j.rmclc.2021.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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14
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Martin A. Être issu·e·s du même don : partager des
« origines » en assistance médicale à la procréation avec tiers donneur
(Royaume-Uni, France). ENFANCES, FAMILLES, GÉNÉRATIONS 2021. [DOI: 10.7202/1082326ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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15
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Neyroud AS, Roche M, Domin M, Jaillard S, Ravel C. [Anonymity of gamete donation and genetic testing]. ACTA ACUST UNITED AC 2020; 48:820-826. [PMID: 32565387 DOI: 10.1016/j.gofs.2020.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Indexed: 11/18/2022]
Abstract
Development of genetic testing direct-to-consumer (DTC) for recreational purposes, although prohibited in France, is a real challenge to the current practice of gamete donation. Indeed, anonymity is a fundamental principle contributing to the ethics of donation. This principle is weakened due to the availability to the general public of these tests on the Internet. Several thousands of people are conceived by gamete donation worldwide, some of whom do not know how they were conceived. Gamete donors should be informed that their anonymity is no longer guaranteed, as they can be found by homologies of their DNA, or that of a parent or a child, potentially available in databases. Thus, adults conceived by gamete donation but not informed by their parents can discover their way of conception. Recipients of gamete donation should also be informed that their child's DNA will establish the biological discrepancy and they should be encouraged to disclose the conception to their child. Several countries now allow children conceived by donation to obtain donor's identity. In France, the Bioethics Law is currently being finalized and will now allow access to donor's identity for people conceived by gamete donation.
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Affiliation(s)
- A-S Neyroud
- CHU Rennes, service de biologie de la reproduction-CECOS, 35000 Rennes, France; Univ Rennes, Inserm, EHESP, Irset (institut de recherche en santé, environnement et travail) - UMR_S 1085, 35000 Rennes, France
| | - M Roche
- CHU Rennes, service de biologie de la reproduction-CECOS, 35000 Rennes, France
| | - M Domin
- CHU Rennes, service de gynécologie, 35000 Rennes, France
| | - S Jaillard
- Univ Rennes, Inserm, EHESP, Irset (institut de recherche en santé, environnement et travail) - UMR_S 1085, 35000 Rennes, France; CHU Rennes, laboratoire de cytogénétique, 35000 Rennes, France
| | - C Ravel
- CHU Rennes, service de biologie de la reproduction-CECOS, 35000 Rennes, France; Univ Rennes, Inserm, EHESP, Irset (institut de recherche en santé, environnement et travail) - UMR_S 1085, 35000 Rennes, France.
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Goldberg AE, Manley MH, Frost RL, McCormick NM. Conceived Through Rape/Incest? Adoptive Parents' Experiences Managing Uncertainty and Disclosure Surrounding their Children's Origins. FAMILY PROCESS 2020; 59:191-208. [PMID: 31497884 DOI: 10.1111/famp.12491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Adoptive parents may be placed with children conceived under difficult circumstances, such as via rape or incest. At the same time, adoptive parents are generally encouraged to communicate openly with their children about their adoption stories and birth families. No research has examined the experiences of parents who adopt children who were conceived through rape or incest. This exploratory study examines how parents discuss their decision-making when adopting children conceived via rape or incest, how they manage varying levels of uncertainty about their children's origins, and whether and how they plan to disclose this information to children. The researchers used thematic analysis to examine the experiences of 11 couples (22 parents) interviewed at four time points after adopting children who were reportedly conceived via rape or incest. Findings revealed that even soon after adopting, parents discussed the need to eventually talk to their children about their conception circumstances. Parents generally struggled to determine how and when to disclose this information, particularly when they felt uncertain about the veracity of the conception stories they had been told. Some hoped to rely on professionals or birth mothers to guide them in these communications. Findings have implications for supporting adoptive families as they navigate the complexity of managing sensitive information and uncertainty when adopting children conceived through rape or incest. Practitioners should provide ongoing guidance to adoptive parents about how and when to disclose developmentally appropriate information to children about difficult conception circumstances.
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Ishii T, Beriain IDM. Safety of Germline Genome Editing for Genetically Related "Future" Children as Perceived by Parents. CRISPR J 2019; 2:370-375. [PMID: 31746634 PMCID: PMC6919246 DOI: 10.1089/crispr.2019.0010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The social acceptability of germline genome editing (GGE) depends on its perceived safety, as well as respect for reproductive autonomy. However, it is doubtful that prospective parents sufficiently understand the risks of GGE. In the future, the use of GGE in specific situations seems plausible, as it offers couples potential means to safeguard genetically related future children from a serious disease and overcome infertility due to a gene mutation. Should GGE fail, however, some couples may be obliged to abort affected fetuses, or give birth to adversely affected children, which would be a tragedy. Some children might develop diseases later in life due to overlooked off-target mutations. Compounding this, some parents are unlikely to inform their offspring about the details of conception, hampering necessary follow-up. Prospective parents, scientists and policy makers should carefully discuss the safety implications of GGE for genetically related future children.
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Affiliation(s)
- Tetsuya Ishii
- Office of Health and Safety, Hokkaido University, Sapporo, Japan
| | - Iñigo de Miguel Beriain
- Law and the Human Genome RG, University of the Basque Country UPV/EHU, Faculty of Law, Leioa, Spain.,IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
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18
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Isaksson S, Sydsjö G, Skoog Svanberg A, Lampic C. Managing absence and presence of child-parent resemblance: a challenge for heterosexual couples following sperm donation. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2019; 8:38-46. [PMID: 31453387 PMCID: PMC6702384 DOI: 10.1016/j.rbms.2019.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 05/28/2019] [Accepted: 07/03/2019] [Indexed: 05/08/2023]
Abstract
This qualitative interview study sought to gather and better understand heterosexual parents' experiences of managing resemblance and non-resemblance between child and parent in an identity-release donor programme. The 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 30 heterosexual parents with children aged 7-8 years following identity-release sperm donation, participated in individual semi-structured interviews. This study concerns a secondary analysis of the interview data. The results show how donor-conceiving parents experience the presence and absence of child-parent resemblance, and how they navigate between the importance of genetic connectedness and of 'doing parenthood' through social interactions. The analysis resulted in three categories: 'resemblance through nature or nurture', 'non-resemblance brings the donor to the front' and 'feelings about and coping with resemblance talk'. The first two categories deal with the intrapersonal aspects of physical and non-physical resemblance, while the last category includes aspects of resemblance in relation to persons outside the core family. The presence or absence of parent-child resemblance regarding both physical and non-physical characteristics appears to constitute a considerable challenge for heterosexual couples with school-aged children following sperm donation.
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Affiliation(s)
- Stina Isaksson
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Region Västra Götaland, Södra Älvsborg Hospital, Department of Research, Borås, Sweden
- Corresponding author.
| | - Gunilla Sydsjö
- Division of Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | | | - Claudia Lampic
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
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Dimond R, Machin L, Frith L. Editorial: Towards a sociology of donation. SOCIOLOGY OF HEALTH & ILLNESS 2019; 41:549-552. [PMID: 30843239 DOI: 10.1111/1467-9566.12840] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Rebecca Dimond
- School of Social Sciences, Cardiff University, Cardiff, UK
| | - Laura Machin
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | - Lucy Frith
- Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
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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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