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Zadeh S, Jadva V, Jones C. Searching for and making genetic connections: recommendations for practice from donor conceived adults in the UK. Reprod Biomed Online 2024; 48:103418. [PMID: 37944257 DOI: 10.1016/j.rbmo.2023.103418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 09/15/2023] [Indexed: 11/12/2023]
Abstract
RESEARCH QUESTION What are the support needs of donor conceived individuals who are searching for or open to matching with genetic connections? DESIGN A total of 88 donor conceived adults in the UK participated in an online survey open between January and August 2022. Participants were asked about their level of awareness of current resource provision, recommendations for resources to support the process of searching for genetic connections, and recommendations for resources to support with feelings about searching for or being found by genetic connections. RESULTS Participants were found to have varying levels of awareness of the resources available to them, with 39% describing themselves as aware, 41% as partly aware and 20% as unaware. Their recommendations for practical and emotional resources also varied. The most recommended resources for practical support were DNA testing and changes to UK law. The most recommended resources for emotional support were counselling and peer and other support groups. CONCLUSIONS The impact of legal and technological changes such as direct-to-consumer DNA testing and the legal transition to identifiable donation may be felt by donor conceived individuals irrespective of their year of birth. The wishes of donor conceived individuals for different support resources should be borne in mind by practitioners, regulatory bodies, and policy makers going forward.
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Affiliation(s)
- Sophie Zadeh
- Thomas Coram Research Unit, University College London, London, UK.
| | - Vasanti Jadva
- Institute for Women's Health, University College London, London, UK
| | - Catherine Jones
- Social, Genetic and Developmental Psychiatry Centre, Kings College London, London, UK
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2
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Abstract
Egg donation in New Zealand is identity-release, with donor-conceived individuals having the right to access donors' identifying information at the age of 18. It also allows donors and previously unknown recipients to meet prior to donation. Further, donation is altruistic, although reimbursement of costs is possible. In our previous paper we explored the motivations of 21 egg donors in this context and reported that they are motivated to donate as an act of personal gift-giving to recipients who may become known to them through donation, and that they do not want to be compensated for this financially. In this paper, drawing on in-depth interviews, we report on donors' experiences of the donation process and subsequent to donation. Donors understood their donations to be a significant act, both for the recipients and their families, but also for themselves, particularly given the multiple sacrifices which they willingly made. Donors wished for their gift and their role to be valued and acknowledged through being appreciated, informed, involved and supported by recipients and clinics before, during and after their donations. These findings have implications for clinical practice and care, offering insight into how best to support donors prior and subsequent to donation.
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Affiliation(s)
- Sonja Goedeke
- Department of Psychology and Neuroscience, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Heather Gamble
- Department of Psychology and Neuroscience, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Rebecca Thurlow
- Department of Psychology and Neuroscience, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
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Sydsjö G, Lampic C, Bladh M, Nedstrand E, Svanberg AS. Long-term follow-up of mental health and satisfaction in a Swedish sample of sperm and egg donors after open-identity donation. Reprod Biomed Online 2023; 47:103417. [PMID: 37931369 DOI: 10.1016/j.rbmo.2023.103417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/14/2023] [Accepted: 09/15/2023] [Indexed: 11/08/2023]
Abstract
RESEARCH QUESTION How is the mental health of open-identity gamete donors and their satisfaction with their contributions 14-17 years after acceptance as a donor? DESIGN The Swedish Study on Gamete Donation is a longitudinal study comprising women and men who were accepted as donors at seven Swedish university clinics between 2005 and 2008. The latest (fifth) follow-up included 215 open-identity donors (response rate 87%): 123 oocyte donors and 92 sperm donors. The donors answered a questionnaire regarding their perceptions, experiences and expectations after gamete donation 14-17 years previously. RESULTS The donors were satisfied with the experience of donating, and no differences were detected between sperm and oocyte donors. Oocyte donors were more than twice as likely to feel that family and friends were proud of their donation compared with sperm donors (51% versus 23%, P < 0.001). In total, six donors regretted their donation: four oocyte donors and two sperm donors. Sperm donors were more frequently satisfied with the financial compensation compared with oocyte donors (P = 0.005). No difference in the development of symptoms of anxiety or depression was detected 14-17 years post-donation. CONCLUSION Long-term follow-up studies on donors are important for recruiting donors, and for recipients and the children who will be conceived with donated gametes. The results from the current study indicate that donors, generally, have good mental health and do not regret their decision to donate gametes. These findings are reassuring for all parties involved.
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Affiliation(s)
- Gunilla Sydsjö
- Department of Obstetrics and Gynaecology in Linköping and Division of Children's and Women's Health, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden.
| | - Claudia Lampic
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Department of Psychology, Umeå University, Umeå, Sweden
| | - Marie Bladh
- Department of Obstetrics and Gynaecology in Linköping and Division of Children's and Women's Health, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Elizabeth Nedstrand
- Department of Obstetrics and Gynaecology in Linköping and Division of Children's and Women's Health, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
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4
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Duncan JP, Caughey LE, White KM. Examining willingness to donate frozen oocytes among women of reproductive age. Reprod Biomed Online 2023; 47:103294. [PMID: 37734120 DOI: 10.1016/j.rbmo.2023.103294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/08/2023] [Accepted: 07/17/2023] [Indexed: 09/23/2023]
Abstract
RESEARCH QUESTION What are the predictors of willingness to donate frozen oocytes among women of reproductive age in Australia? DESIGN An online survey involving 303 women of reproductive age (18-49 years) in Australia who had not frozen their oocytes or planned to freeze their oocytes in the next 12 months. The survey assessed demographic variables, prototype willingness model variables (attitude, subjective norm, prototype similarity and prototype favourability) and additional variables (altruism, empathy and infertility awareness) as predictors of hypothetical scenarios of willingness to donate frozen oocytes. A multivariate repeated measures analysis of variance explored differences in willingness to donate frozen oocytes. Hierarchical multiple regression analysis examined predictors of donor willingness. RESULTS Women's willingness to donate their frozen oocytes was higher for donating to a friend or family member and to research compared with an egg bank or fertility clinic, or a couple advertising online for an egg donor (all P < 0.001). The prototype willingness model variables were significant predictors of willingness to donate showing slightly varied patterns across four scenarios. After accounting for demographics, regression models including prototype willingness model variables and additional variables accounted for 45-64% of variance in donor willingness. CONCLUSIONS Frozen oocyte donation may be facilitated by improving attitudes towards donation and establishing positive images of donors. Professionals requiring frozen oocytes for research could focus on creating a sense of social approval for donating in this context. Encouraging frozen oocyte donation could increase access to oocytes for IVF treatment and aid in reducing the psychological burdens associated with involuntary childlessness.
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Affiliation(s)
- Jordan P Duncan
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Lucy E Caughey
- Department of Obstetrics and Gynecology, University of Melbourne, Royal Women's Hospital, Victoria, Australia..
| | - Katherine M White
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
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5
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Chin AHB. Singapore needs to update regulation of frozen egg donation after permitting social egg freezing. J Assist Reprod Genet 2022; 39:1497-1500. [PMID: 35653043 DOI: 10.1007/s10815-022-02526-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 05/18/2022] [Indexed: 11/25/2022] Open
Abstract
With social egg freezing being permitted in Singapore, there is expected to be an accumulated surplus of unused frozen eggs (vitrified oocytes) available for donation in coming years. A comprehensive update of current healthcare regulations pertaining to frozen egg donation is needed to resolve various pertinent ethical issues. In particular, the issue of egg donor anonymity should be addressed, together with the lack of sharing of medical and family information about the donor to prospective recipient patients and donor-conceived offspring. Rigorous and comprehensive genetic testing of prospective egg donors must be mandated to protect the welfare of recipient patients. Older women above 35 years of age should be required to have at least one child, before being allowed to donate their unused frozen eggs, to prevent any future regret and psychological problems of remaining childless, while being unsure of whether they have an unknown genetic offspring out there. New regulations drafted to address these ethical issues must also prevent potential conflicts of interests. For example, fertility doctors soliciting and encouraging former patients to donate their unused frozen eggs face an obvious conflict of interest, because additional medical fees will be earned by performing the egg donation procedure on other patients. A centralized donor registry should be established by the Singapore government to oversee the distribution and allocation of donated unused frozen eggs to infertile IVF patients. Such a registry could also facilitate sharing of vital health information about the donor to recipient patients and donor-conceived offspring.
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Affiliation(s)
- Alexis Heng Boon Chin
- School of Medical & Life Sciences, Sunway University, 46150, Subang Jaya, Selangor Darul Ehsan, Malaysia.
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6
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Okafor NI, Ikechebelu JI, Joe-Ikechebelu NN, Okpala BC, Odo CC. 'Gift with a price tag': Nigerian egg donors' knowledge, experiences and motivations. Afr J Reprod Health 2022; 26:64-79. [PMID: 37585059 DOI: 10.29063/ajrh2022/v26i6.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
Research around the world has indicated that the demand for egg donation has grown considerably among young females. This study qualitatively examines the knowledge, experiences, and motivations of young egg donors at a Nigerian health facility. In-depth interviews were conducted in Igbo and English with consenting thirty-one egg donors attending a fertil-ity clinic in Anambra State, south-eastern Nigeria. Data were collected and analysed to generate themes with the aid of NVivo 10 software. Three themes were identified from the participants' motivations and include (a) monetary (93.6%), (b) altruistic (3.2%), and (c) both monetary and altruistic reasons (3.2%). Findings highlighted that the differences were based on a variety of reasons in Nigeria. All the participants were literate and single, and the majority received payment. The majority (77.4%) of those who received payment mentioned that the payment was not worth the donation program. The participants preferred to be anonymous because they had not discussed their donation with their family members, and the non-acceptance of egg donation program by the Nigerian society. Given that the market for egg donation has become a common method of infertility management in Nigeria, our findings have important implications for practices, policy actions, and future research.
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Affiliation(s)
- Nneka Ihuoma Okafor
- Department of Sociology/Anthropology, Faculty of Social Sciences, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
- Life Fertility Centre, Life International Hospital Awka, Anambra State Nigeria
| | - Joseph Ifeanyichukwu Ikechebelu
- Department of Obstetrics & Gynaecology, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria
- Life Fertility Centre, Life International Hospital Awka, Anambra State Nigeria
| | - Ngozi Nneka Joe-Ikechebelu
- Department of Community Medicine, Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Amaku Awka, Anambra State, Nigeria
| | - Boniface Chukwuneme Okpala
- Department of Obstetrics & Gynaecology, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria
- Life Fertility Centre, Life International Hospital Awka, Anambra State Nigeria
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7
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Peyser A, Brownridge S, Rausch M, Noyes N. The evolving landscape of donor egg treatment: success, women's choice, and anonymity. J Assist Reprod Genet 2021; 38:2327-2332. [PMID: 34148151 DOI: 10.1007/s10815-021-02262-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/07/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To analyze donor oocyte (DE) data across 6 years for oocyte usage efficiency, trends, and whether changes impacted outcomes. METHODS From 2014 to 2019, 323 DE embryo transfers were completed in 200 recipients using oocytes derived of 163 donors. We assessed data for oocytes being freshly retrieved (FRESH-EGG) vs. purchased frozen (FROZEN-EGG); embryos transferred fresh (FRESH-ET) vs. frozen (FROZEN-ET); cycles SHARED (two recipients) vs. SOLE (one recipient); single (SET) vs. double (DET) embryo transfers and usage of PGT-A. Primary outcome was ongoing pregnancy plus live birth (OP/LB) rate. RESULTS A total of 229 FRESH-EGG (70%) and 94 FROZEN-EGG (30%) cycles were completed. Overall, the use of FRESH-EGG yielded a higher OP/LB compared to FROZEN-EGG (49% vs. 30%, p = 0.001); within the FRESH-EGG group, OP/LB was similar when comparing FRESH-ET vs. FROZEN-ET (58% vs. 45%, p = 0.07). Within the FRESH-ET group, those using FRESH-EGG had a higher OP/LB than those using FROZEN-EGG (58% vs. 27%, p < 0.001). SHARED vs. SOLE cycles (p = 0.6), donor age (21-32 years; p = 0.4), and age of intended parents (maternal p = 0.3, paternal p = 0.2) did not significantly impact OP/LB. Notably, the use of PGT-A did not improve odds for an OP/LB (p = 0.7). CONCLUSION The use of FRESH-EGG with FRESH-ET without PGT-A remains superior to newer DE treatment combinations. Specifically, the use of FROZEN-EGG and PGT-A did not improve outcomes. Although changing DE practices may enhance experience and affordability, patients and providers must appreciate that choices do not always favorably impact success. Additionally, newly available genetic-ancestry testing may pose longer-term ramifications mandating change in treatment and/or counseling.
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Affiliation(s)
- Alexandra Peyser
- Zucker School of Medicine at Hofstra/Northwell, Northwell Fertility, New York, NY, 10065, USA.
| | - Stephanie Brownridge
- Zucker School of Medicine at Hofstra/Northwell, Northwell Fertility, New York, NY, 10065, USA
| | - Mary Rausch
- Zucker School of Medicine at Hofstra/Northwell, Northwell Fertility, New York, NY, 10065, USA
| | - Nicole Noyes
- Zucker School of Medicine at Hofstra/Northwell, Northwell Fertility, New York, NY, 10065, USA
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8
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Clua E, Roca-Feliu M, Tresánchez M, Latre L, Rodriguez I, Martínez F, Barri PN, Veiga A. Single or double embryo transfer? Decision-making process in patients participating in an oocyte donation program. Gynecol Endocrinol 2020; 36:365-369. [PMID: 31464145 DOI: 10.1080/09513590.2019.1653845] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
In IVF/ICSI programs, after receiving the information about the success results of single embryo transfer (SET) vs double embryo transfer (DET) and the risks of multiple pregnancy, a significant number of patients opt for SET. Up to date, no comparable studies have been published in oocyte recipients. The aim of this study was to evaluate if the counseling provided to oocyte recipients influence their decision on the number of embryos to be transferred. Fifty-five recipients expressed their preference and the relevance for the decision-making process that they attribute to certain factors through an anonymous questionnaire completed pre and post-counseling. Before counseling, 32 out of 55 recipients preferred DET, 13 preferred SET and 10 were undecided. From the 32 recipients who preferred DET, 16 (50%) maintained their preference after counseling, 13 (40.6%) changed their decision to SET and 3 (9.4%) changed to undecided (McNemar's test: p < .05). After counseling, the patients attached less importance to the probability of pregnancy and more importance to maternal and perinatal risks (p < .05). We conclude that after counseling, a significant number of recipients changed their preferences from DET to SET.
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Affiliation(s)
- Elisabet Clua
- Department of Gynecology, Obstetrics and Reproductive Medicine, Institut Universitari Dexeus, Barcelona, Spain
| | - Marta Roca-Feliu
- Department of Gynecology, Obstetrics and Reproductive Medicine, Institut Universitari Dexeus, Barcelona, Spain
| | - Marta Tresánchez
- Department of Gynecology, Obstetrics and Reproductive Medicine, Institut Universitari Dexeus, Barcelona, Spain
| | - Laura Latre
- Department of Gynecology, Obstetrics and Reproductive Medicine, Institut Universitari Dexeus, Barcelona, Spain
| | | | - Francisca Martínez
- Department of Gynecology, Obstetrics and Reproductive Medicine, Institut Universitari Dexeus, Barcelona, Spain
| | - Pedro Nolasco Barri
- Department of Gynecology, Obstetrics and Reproductive Medicine, Institut Universitari Dexeus, Barcelona, Spain
| | - Anna Veiga
- Department of Gynecology, Obstetrics and Reproductive Medicine, Institut Universitari Dexeus, Barcelona, Spain
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9
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Abstract
The objective of this study was to gain information from egg donors in South Africa (SA) which could be pertinent to policy development on egg donation. The study was conducted on egg donors in the database of a Cape Town-based egg donation agency who donated within a year preceding the study. 150 egg donors from the population of 226 participated in an online survey. The main results are: 95% of respondents experienced egg donation as being positive. However, 7% of respondents report not giving proper informed consent, and a similar percentage of respondents also report not knowing whether any medical risks actually materialised as sequelae to their donations. This is a cause for concern and should be investigated further. Regarding donor anonymity, which is currently the legal position in SA, 79% of respondents indicated that they would still have donated had they been legally required to release their identities. Accordingly, possible legal reform away from the current system of donor anonymity seems unlikely to significantly impact the supply of donated eggs. Regarding motivation, respondents report being primarily motivated by wanting to help infertile women. However, respondents believe that a fair and realistic amount of compensation would be about 60% higher than what is currently paid as the national standard fixed amount. This fixed-amount compensation system should be further investigated in terms of its legality, impact on donor profile, and its current amount.
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Affiliation(s)
- Donrich Thaldar
- School of Law, University of KwaZulu-Natal, Durban, South Africa
- * E-mail:
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10
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Abstract
STUDY QUESTION What are the psychological health, relationship quality and perceived social support outcomes of heterosexual couples who have conceived an infant through identity-release egg donation? SUMMARY ANSWER Parents' scores on all measures were within the normal range. Egg donation mothers had poorer perceived social support, and egg donation fathers had less optimal psychological health than a comparison group of IVF parents, although these differences were associated with the older age of egg donation parents, rather than being an effect of family type. WHAT IS KNOWN ALREADY There is limited understanding of the psychological health and couple relationship quality of egg donation parents, and no empirical data on parents' social support, during the first year of parenthood. No studies have included families who have used an identity-release egg donor. The study offers the first examination of the psychological well-being of identity-release egg donation parents. STUDY DESIGN, SIZE, DURATION This study included 57 families created through identity-release egg donation, and a comparison group of 56 families who had used IVF with their own gametes, recruited through UK fertility clinics. Families were visited at home between October 2013 and June 2015. The sample forms part of a larger study examining family functioning in families created following fertility treatment. PARTICIPANTS/MATERIALS, SETTING, METHOD All families were heterosexual two-parent families with an infant aged 6-18 months. Mothers and fathers were administered standardised questionnaires assessing psychological health (Edinburgh Postnatal Depression Scale, Trait Anxiety Inventory and Parenting Stress Index-short form), couple relationship quality (Golombok Rust Inventory of Marital State) and perceived social support (Multidimensional Scale of Perceived Social Support). MAIN RESULTS AND THE ROLE OF CHANCE Scores from the egg donation and IVF parents were within the normal range on all measures. Significant differences were found between the groups indicating less optimal social support in egg donation mothers compared to IVF mothers, and poorer psychological health in egg donation fathers compared to IVF fathers. These differences appeared to be related to the older age of egg donation parents or to twin parenthood, rather than to egg donation per se. No differences were found between the groups in the parents' relationship quality. LIMITATIONS, REASONS FOR CAUTION It is possible that families who were managing the transition to parenthood less well may have been less likely to participate in research. Fewer IVF than egg donation fathers participated in the study, so the statistical power was lower for comparisons between fathers. WIDER IMPLICATIONS OF THE FINDINGS The findings are of relevance to UK clinics offering identity-release egg donation. That scores of egg donation parents on measures of psychological well-being were more similar than different to those of IVF parents should prove reassuring to individuals considering this treatment type. As less optimal outcomes were found for egg donation parents on several measures, and these were associated with parental age rather than conception type, it is recommended that clinics discuss with older patients how they may establish a social support network and signpost patients to appropriate post-natal support. STUDY FUNDING, COMPETING INTERESTS This research was supported by a Wellcome Trust Senior Investigator Award [097857/Z/11/Z] and a CHESS-ESRC studentship. The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- S Imrie
- Centre for Family Research, University of Cambridge, UK
| | - V Jadva
- Centre for Family Research, University of Cambridge, UK
| | - S Golombok
- Centre for Family Research, University of Cambridge, UK
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11
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Blakemore JK, Voigt P, Schiffman MR, Lee S, Besser AG, Fino ME. Experiences and psychological outcomes of the oocyte donor: a survey of donors post-donation from one center. J Assist Reprod Genet 2019; 36:1999-2005. [PMID: 31300913 DOI: 10.1007/s10815-019-01527-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 07/08/2019] [Indexed: 12/18/2022] Open
Abstract
PURPOSE To assess the experiences and psychological outcomes of oocyte donors from one fertility center. METHODS An anonymous survey was distributed via a secure email to 161 donors who underwent oocyte donation-anonymous, directed/known, and recruited agency-between January 2008 and January 2019 at the NYU Langone Fertility Center. RESULTS Thirty-six donors completed the survey with the majority between 2 and 10 years since donation. Respondents reported a high prevalence of psychiatric symptoms or diagnoses post-donation. The majority of donors reported positive thoughts and feelings toward their donation process as well as to the knowledge of children born from their donation. Negative comments about donation were in the minority but focused on unexpected aspects about the process or outcome. Based on qualitative analysis, thoughts about family or "family-oriented thoughts" were the most frequent theme in respondent comments. 62.5% of respondents reporting that they would be open to identity-disclosure or open donation after experiencing the process. CONCLUSIONS Despite a high reported prevalence of psychiatric symptoms, the majority of respondents felt positively about the donation experience as well as the prospect of open donation or identity-disclosure post-donation. Further research on long-term psychological outcomes, related to all aspects of donation, is important as the counseling and informed consent of oocyte donors continues to evolve. These data will be particularly important with regard to the aspect of disclosure, both planned and unplanned, in the modern era of electronic information sharing.
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Affiliation(s)
- Jennifer K Blakemore
- NYU Langone Fertility Center, NYU Langone Health, 660 First Avenue, 5th Floor, New York, NY, 10016, USA.
| | - Paxton Voigt
- NYU Langone School of Medicine, 550 First Avenue, New York, 10016, NY, USA
| | - Mindy R Schiffman
- NYU Langone Fertility Center, NYU Langone Health, 660 First Avenue, 5th Floor, New York, NY, 10016, USA
| | - Shelley Lee
- NYU Langone Fertility Center, NYU Langone Health, 660 First Avenue, 5th Floor, New York, NY, 10016, USA
| | - Andria G Besser
- NYU Langone Fertility Center, NYU Langone Health, 660 First Avenue, 5th Floor, New York, NY, 10016, USA
| | - M Elizabeth Fino
- NYU Langone Fertility Center, NYU Langone Health, 660 First Avenue, 5th Floor, New York, NY, 10016, USA
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12
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Abstract
The development of oocyte donation has led to a reexamination of the facets of motherhood: the genetic, gestational, and psychosocial contributions. In addition, the practice of oocyte donation has prompted a consideration of the unique psychosocial and legal aspects of this form of family building. In this section of Views and Reviews a summary and discussion of the long-term psychosocial adjustment of oocyte donor-conceived children and their parents is presented. Next, the current permeability around donor anonymity is investigated and questions regarding whether donor anonymity can still exist is discussed. Third, the evolution of oocyte cryopreservation and banking is reviewed and the future of oocyte banking is explored. Finally, as oocyte donation continues to grow and evolve, so too does the legal landscape in which it is practiced. Seminal legal cases are presented to describe the legal landscape that has shaped the practice of oocyte donation.
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Affiliation(s)
- Susan Klock
- Departments of Obstetrics and Gynecology and Psychiatry, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
| | - Steven R Lindheim
- Department of Obstetrics and Gynecology, Boonshoft School of Medicine, Wright State University, Dayton, Ohio
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13
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Abstract
In recent decades, reproductive medicine has become a widespread global phenomenon. Within the field, donor conception, and the use of donated eggs, sperm or embryos from a third party, plays a key role. Despite the importance of those individuals who donate, there has been scant research exploring their experiences. Seeking to contribute to the growing, albeit still small, body of research on donors, this paper advocates bringing the process of donating into dialogue with a sociology of personal life. It suggests that important new insights about the donor experience can be achieved by utilising such a theoretical perspective. The paper applies a broad framework of a sociology of personal life to demonstrate that the decision to donate reverberates within donors' everyday lives and relationships, and explores, primarily theoretically, how it is that acts of donation bring such issues into play. To this end, the paper examines in detail three ways in which donating interacts with dimensions that are integral to personal life: "living" genetic connectedness, relationality and the intimate body. Ultimately, the paper suggests that a sociology of personal life shows light on new, unexplored questions for this field that demand greater scholarly attention.
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14
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Webster KLW. Framing Egg Donation: A Dichotomous Split. Health Commun 2018; 33:1445-1447. [PMID: 28850261 DOI: 10.1080/10410236.2017.1358242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Reproductive medicine has depended upon the altruistic motivations of women to donate eggs. Donors are lauded for these self-sacrificing actions but are treated as a product during the selection and donation process. This process highlights the contradictory behaviors as evidence to the dichotomous split of the definition of women as "virgins" or "whores," by attracting women to donate as the former and treating them as the latter.
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Abstract
There are growing debates about the appropriateness of offering money in exchange for the provision of bodily materials for clinical treatment and research. The bioethics literature and many practice guidelines have generally been opposed to such entanglement, depicting the use of money as contaminating, creating undue inducement, exploitation and commodification of the human body. However, two elements have been missing from these debates: (i) the perspectives of those people providing bodily materials when money is offered; and (ii) systematic empirical engagement with the notion of 'money' itself. This article seeks to fill those gaps in knowledge by providing detailed insights from a project investigating the views and experiences of women who volunteered to provide eggs for research in exchange for reduced fees for fertility treatment. Analysis of 29 semi-structured interviews reveals multiple ways in which volunteers reason through the involvement of 'money' in this domain and shows how their accounts diverge from pessimistic understandings of the role of monies in everyday life. When volunteers speak in detail about the monetary aspects of their participation they draw major, recurring, distinctions in five overlapping areas: their depiction of the monetized world of fertility treatment; their views of the different forms that money can take; a distancing of their actions from their understandings of how markets and commodities work; their location of the transactions within a particular clinic, and the ongoing importance of their eggs, post-transaction. This article: (i) responds to calls for concrete case studies to assist understandings of the inter-relationships of money and specific aspects of social life; (ii) adds to the sociology of money literature by providing empirical insights into how notions of money are deployed; (iii) presents much-needed perspectives from providers of bodily materials; and (iv) contributes to ongoing conversations between bioethics and sociology.
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Abstract
OBJECTIVE Despite poor clinic communication and staff treatment being reported by donors, high rates of overall satisfaction are still reported in surveys. This study will evaluate the importance of communication and interaction between donors and fertility clinic staff in gamete donor care. METHODS We report on 120 egg and sperm donors' responses to a UK-wide online satisfaction survey. The survey focused on donors' interactions with fertility clinic staff pre-, during, and post- donation. Basic cross-tabulation was performed on the data using online survey software. Textual data was read and extracts identified, which illustrated and expanded on the findings from the numerical data. Diagrammatic modeling was also utilised to analyse the textual data, with particular focus to relationships between the donors and clinic staff, the main activities within the gamete donation process, and how these activities may affect donor satisfaction with the gamete donation process. RESULTS Donors expressed concern for the infertile couple and the resulting child; conveyed frustration at not receiving information on the expenses they could claim; felt lost in the system regarding the ease of making clinic appointments, and once made they were routinely not seen on time for these appointments. Donors also negatively commented on aftercare, the location and condition of the donation room, and information on contraception. In addition, Ovarian Hyperstimulation Syndrome was frequently reported, with these egg donors believing that clinic staff were not concerned with their physical or emotional well-being, but were instead disproportionately focused on extracting the eggs. CONCLUSIONS The multifaceted notion of donors highlights the complexity inherent to the gamete donation process, which comprises various aspects of uncertainty in the donation system, and ambiguity in the donation process. Categorising donors as Altruist, Customer, and Patient, conveys the particular importance of staff communication and treatment in donor care. These categories are not mutually exclusive however, in that an individual donor may experience more than one of these perspectives during the course of their gamete donation journey. Finally, there were a number of exemplar cases, where donors reported high satisfaction throughout, and these correlated with them being given a single point of contact at the clinic. Subject to resource constraints, we suggest that this practice should be implemented throughout clinics in the UK, so that donors have access to dedicated clinic staff who not only support them emotionally and physically throughout the gamete donation process, but also ensure that communication is open, clear, timely, and consistent.
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Affiliation(s)
- Richard A. Williams
- Department of Management Science, Management School, Lancaster University, Lancaster, United Kingdom
- Data Science Institute, Lancaster University, Lancaster, United Kingdom
| | - Laura L. Machin
- Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
- * E-mail:
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Abstract
The new reproductive technologies have significantly impacted definitions of motherhood. Historically, mothers were defined through the act of giving birth, but egg donation, embryo donation, and surrogacy disrupt this. Now multiple women can potentially claim maternity through gestational, genetic, legal, and social ties. Although there is some legal precedent for designating parentage, there is no simple solution to identify the 'true' mother. I address maternal claims-making in third party reproduction via a content analysis of US patient literature for infertile women. Major tensions arise over which link to privilege, especially regarding genetic versus gestational ties in egg donation versus surrogacy; however, adding embryo donation to the analysis illuminates another crucial dimension previously overlooked - that heterosexual women's maternal claims are supported by their partner's paternity claims. Ultimately, I argue that although reproductive organisational discourse carefully constructs credible options for maternal claims-making, contemporary reproductive medicine does not define maternity through assisted reproduction as a truly autonomous connection. Rather, maternity is highly contingent and thus potentially discreditable.
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Van Parys H, Provoost V, Zeiler K, De Sutter P, Pennings G, Buysse A. Constructing and enacting kinship in sister-to-sister egg donation families: a multi-family member interview study. Sociol Health Illn 2017; 39:847-862. [PMID: 27917504 DOI: 10.1111/1467-9566.12533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Although intra-familial egg donation has been practiced for more than 15 years in several countries, little is known about family relationships in this family type. Framed within the new kinship studies, this article focuses on the experiential dimension of kinship in sister-to-sister egg donation families: how is kinship 'unpacked' and 'reconstructed' in this specific family constellation? Qualitative data analysis of interviews with receiving parents, their donating sisters and the donor children revealed six themes: (1) being connected as an extended family; (2) disambiguating motherhood; (3) giving and receiving as structuring processes; (4) acknowledging and managing the 'special' link between donor and child; (5) making sense of the union between father and donor; and (6) kinship constructions being challenged. This study showed the complex and continuous balancing of meanings related to the mother-child dyad, the donor-child dyad and the donor-father dyad. What stood out was the complexity of, on the one hand cherishing the genetic link with the child allowed by the sisters' egg donation, while, on the other, managing the meanings related to this link, by, for instance, acknowledging, downsizing, symbolising, and differentiating it from the mother-child bond. (A Virtual Abstract of this paper can be accessed at: https://www.youtube.com/channel/UC_979cmCmR9rLrKuD7z0ycA).
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Affiliation(s)
- Hanna Van Parys
- Psychology and Educational Sciences, Ghent University, Belgium
| | | | - Kristin Zeiler
- Division of Health and Society Department of Medical and Health Sciences, Linköping University, Sweden
| | | | | | - Ann Buysse
- Psychology and Educational Sciences, Ghent University, Belgium
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Rauscher EA, Young SL, Durham WT, Barbour JB. "I'd Know That My Child Was Out There": Egg Donation, the Institutionalized "Ideal" Family, and Health Care Decision Making. Health Commun 2017; 32:550-559. [PMID: 27328283 DOI: 10.1080/10410236.2016.1140272] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study investigates how young women of egg-donating age perceive egg donation. Using institutional theory, this study demonstrates how participants frame a health care decision, such as egg donation, utilizing familial ideals. Results revealed that women expressed the importance of ownership over their genetic material and that familial ideals encourage an ideal way to create a family, which egg donation only fits as a last resort. Results show that familial ideals reach past the institution of family into broader decision making, such as that of health care. Further, results show that as more families are constructed through assisted reproductive technologies, attempts should be made to gradually alter the familial ideal to encompass novel medical technologies such as egg donation.
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Affiliation(s)
| | | | - Wesley T Durham
- b Communications Department , University of Southern Indiana
| | - Joshua B Barbour
- c Department of Communication Studies , University of Texas at Austin
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Wong KA. Donor Conception and "Passing," or; Why Australian Parents of Donor-Conceived Children Want Donors Who Look Like Them. J Bioeth Inq 2017; 14:77-86. [PMID: 28108866 DOI: 10.1007/s11673-016-9755-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 10/09/2016] [Indexed: 06/06/2023]
Abstract
This article explores the processes through which Australian recipients select unknown donors for use in assisted reproductive technologies and speculates on how those processes may affect the future life of the donor-conceived person. I will suggest that trust is an integral part of the exchange between donors, recipients, and gamete agencies in donor conception and heavily informs concepts of relatedness, race, ethnicity, kinship, class, and visibility. The decision to be transparent (or not) about a child's genetic parentage affects recipient parents' choices of donor, about who is allowed to "know" children's genetic backgrounds, and how important it is to be able to "pass" as an unassisted conception. In this way, recipients must trust the process, institutions, and individuals involved in their treatment, as well as place trust in the future they imagine for their child. The current market for donor gametes reproduces normative conceptions of the nuclear family, kinship, and relatedness by facilitating "matching" donors to recipients by phenotype and cultural affinities. Recipient parents who choose not to prioritize "matching," and actively disclose the process of children's conceptions, may embark on a project of queering heteronormative family structures and place great trust in both their own children and changing social attitudes to reduce stigma and generate acceptance for non-traditional families.
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Affiliation(s)
- Karen-Anne Wong
- School of Philosophical and Historical Inquiry, University of Sydney, Quadrangle A14, Sydney, NSW, 2006, Australia.
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21
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Druckenmiller S, DeVore S, Knopman JM, Noyes N. Young Women’s Attitudes Towards Modern Reproductive Practices: A Survey Study Assessing What Young Women Want. J Reprod Med 2017; 62:111-118. [PMID: 30230301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To assess young women’s preferences and attitudes towards various options to create families at a time when women are increasingly postponing childbearing due to greater career focus and widespread availability of contraceptives. STUDY DESIGN Reported data were obtained from an electronic survey distributed over 6 months to approximately 7,000 females enrolled in American universities. RESULTS Most respondents ranked preferable childbearing modalities as follows: natural conception, assisted reproductive technologies, adoption, anonymous oocyte donation, and directed oocyte donation. The majority would consider using autologous oocyte cryopreservation for childbearing, but only a minority saw oocyte donation as a viable option. When queried about donating oocytes, 61% said they would donate to a sibling/friend, 51% to research, and 40% for clinical usage. Most would prefer to receive donation outcome information and would be comfortable being contacted by offspring. Most believed selecting recipient characteristics would increase their likelihood of donation, and 43% felt donors should receive additional compensation for desirable characteristics. CONCLUSION Reproductive autonomy and fertility preservation are important to young educated females, a population sought-after for oocyte donation. Potential donors’ desires for additional rights merit consideration as oocyte demand increases and frozen-oocyte banks emerge.
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Rumpíková T, Oborná I, Bělašková S, Rumpík D. [How is the Czech oocyte donor? The analysis of their profile]. Ceska Gynekol 2017; 82:372-382. [PMID: 29020785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The aim of our study was to investigate (a) the basic socio-demographic characteristics of Czech oocytes donors, (b) their attitudes towards anonymous or nonanonymous donation and (c) their motivations to donate oocytes. DESIGN Original article. SETTING Clinic of Reproductive Medicine and Gynecology Zlin. METHODS A total of 215 oocytes donors participated in this study, which was undertaken in years 2015-2016. The data were obtained by an anonymous questionnaire. Descriptive and inferential statistics were used to analyzed the data. CONCLUSION The results show that (a) mean age of oocytes donors was 26 years. Single women (60%) with secondary level education (57%) prevailed. More than half of them (55%) had at least one child on their own. About 39% of donors were fully employed, 29% women on maternity leave and 16% students. (b) For the majority of participants the anonymity is very important. Almost 55% of oocyte donors prefer to stay in anonymity and 20% were not sure. In case that anonymity would be abolished, only 20% of the Czech oocyte donors would be willing to donate. There were no differences based on education (p = 0,358), age (p = 0,112), marital (p = 0,741) and maternal status (p = 0,691). (c) The main motivation to donation was altruism (helping infertile people), no less important factors were the finantial motivation and the testing own fertility. The altruistic motivation to donate was significantly related to the wish to remain anonymous (p = 0,0002). CONCLUSION The typical Czech oocyte donor is young, mainly altruistic woman with her own child who wants to stay in anonymous relation to the couple whom she is helping as well as to the possible genetic offspring.
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Rumpíková T, Oborná I, Konečná H. [Current trends in gamete donation - psychosocial and ethical issues]. Ceska Gynekol 2017; 82:293-299. [PMID: 28925273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To overview contemporary knowledge of legal and psychosocial rules in gamete donation. Previously, anonymous donation was preferred and recommended by experts but currently, with respect to the right to know the genetic origin of individuals, the relation to donor anonymity was reconsidered in many countries. There is a growing tendency to introduce the open identity system in gamete donation. Such system may guarantee that the child born after gamete donation may have receive the identification data of the donor of gametes. DESIGN A review. SETTING Clinic of Reproductive Medicine and Gynecology Zlin. METHODS An overview of recent literature evaluating the influence of donor anonymity vs. open identity on psychosocial development of children born after gamete donation as well as on the quality of the relationship between parents and children in such families. CONCLUSION New medical technologies usually overtake the developmental speed of ethics and psychology, and their impact on human society. Current trend to open identity is strong but there is no clear evidence that the open identity is of real importance for the healthy psychosocial development of a child born after gamete donation. Furthermore, there is no evidence that anonymity and secrecy of the gamete donation is harmful. In case of the consideration of the change in legal regulation in anonymity/open identity in gamete donation we would suggest the thorough consideration of all consequences.
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Blake L, Carone N, Slutsky J, Raffanello E, Ehrhardt AA, Golombok S. Gay father surrogacy families: relationships with surrogates and egg donors and parental disclosure of children's origins. Fertil Steril 2016; 106:1503-1509. [PMID: 27565261 PMCID: PMC5090043 DOI: 10.1016/j.fertnstert.2016.08.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 07/20/2016] [Accepted: 08/03/2016] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To study the nature and quality of relationships between gay father families and their surrogates and egg donors and parental disclosure of children's origins. DESIGN Cross-sectional study. SETTING Family homes. PATIENT(S) Parents in 40 gay father families with 3-9-year-old children born through surrogacy. INTERVENTION(S) Administration of a semistructured interview. MAIN OUTCOME MEASURE(S) Relationships between parents, children, surrogates, and egg donors and parental disclosure of children's origins were examined using a semistructured interview. RESULT(S) The majority of fathers were content with the level of contact they had with the surrogate, with those who were discontent wanting more contact. Fathers were more likely to maintain relationships with surrogates than egg donors, and almost all families had started the process of talking to their children about their origins, with the level of detail and children's understanding increasing with the age of the child. CONCLUSION(S) In gay father surrogacy families with young children, relationships between parents, children, surrogates, and egg donors are generally positive.
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Affiliation(s)
- Lucy Blake
- Centre for Family Research, University of Cambridge, Cambridge, United Kingdom.
| | - Nicola Carone
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Jenna Slutsky
- Division of Gender, Sexuality, and Health, New York Psychiatric Institute, Columbia University, New York, New York
| | - Elizabeth Raffanello
- Division of Gender, Sexuality, and Health, New York Psychiatric Institute, Columbia University, New York, New York
| | - Anke A Ehrhardt
- Division of Gender, Sexuality, and Health, New York Psychiatric Institute, Columbia University, New York, New York
| | - Susan Golombok
- Centre for Family Research, University of Cambridge, Cambridge, United Kingdom
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Gezinski LB, Karandikar S, Carter J, White M. Exploring Motivations, Awareness of Side Effects, and Attitudes among Potential Egg Donors. Health Soc Work 2016; 41:75-83. [PMID: 27263197 PMCID: PMC4888091 DOI: 10.1093/hsw/hlw005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 09/30/2014] [Accepted: 03/25/2015] [Indexed: 05/06/2023]
Abstract
This research study surveyed prospective egg donors at orientation to (a) understand women's motivations to donate eggs, (b) assess awareness and knowledge of egg donation prior to entry into the egg donation program, and (c) explore attitudes toward egg donation. Ninety-two women completed the questionnaire at one fertility clinic located in the Midwest between August 2011 and August 2012. Descriptive and inferential statistics as well as textual analysis were used to analyze the data. Three themes emerged regarding participant motivations: (1) altruistic, (2) financial, and (3) desire to pass on genetic material. The majority of participants were unconcerned with potential physical and psychological side effects; however, differences emerged based on motherhood status and educational level. Although potential donors felt recipients should receive some information about the donor, they tended to value privacy regarding information giving to resultant offspring. This research study has implications for social work practice, policy, and future research. It is crucial that women receive adequate procedural and side effect information prior to engaging in egg donation.
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Alberta HB, Berry RM, Levine AD. Risk disclosure and the recruitment of oocyte donors: are advertisers telling the full story? J Law Med Ethics 2014; 42:232-243. [PMID: 25040386 DOI: 10.1111/jlme.12138] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study analyzes 435 oocyte donor recruitment advertisements to assess whether entities recruiting donors of oocytes to be used for in vitro fertilization (IVF) procedures include a disclosure of risks associated with the donation process in their advertisements. Such disclosure is required by the self-regulatory guidelines of the American Society for Reproductive Medicine (ASRM) and by law in California for advertisements placed in the state. We find very low rates of risk disclosure across entity types and regulatory regimes, although risk disclosure is more common in advertisements placed by entities subject to ASRM's self-regulatory guidelines. Advertisements placed in California are more likely to include risk disclosure, but disclosure rates are still quite low. California-based entities advertising outside the state are more likely to include risk disclosure than non-California entities, suggesting that California's law may have a modest "halo effect." Our results suggest that there is a significant ethical and policy problem with the status quo in light of the known and unknown risks of oocyte donation and the importance of risk disclosure to informed consent in the context of oocyte donation.
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Greenfeld DA. The evolving world of ART: who are the intended parents and how are their children doing? Minerva Ginecol 2012; 64:455-460. [PMID: 23232530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Treatment advances in assisted reproductive technology (ART) such as oocyte donation and gestational surrogacy have introduced a new cohort of intended parents and new family constellations. Who these parents are and how their children are doing is the focus of this paper. Special emphasis will be paid to the impact of delayed parenthood on oocyte donation, the increasing numbers of gestational surrogacy participants (intended parents and surrogates), and the growing numbers of gay male couples seeking fatherhood through ART. While it appears that children of these new family constellations are doing well, research is limited and longitudinal studies of their health and well being are needed.
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Affiliation(s)
- D A Greenfeld
- Department of Obstetrics, Gynecology and Reproductive Science, Yale University School of Medicine, New Haven, CT 06511, USA.
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Abstract
There is a growing global demand for human eggs for the treatment of sub-fertile women and for stem cell-related research. This demand provokes concerns for the women providing the eggs, including their possible exploitation, whether they should be paid, whether they can give properly informed consent and whether their eggs and bodies are becoming commodified. However, few of the debates have benefitted from insights from the women themselves. We address this gap in knowledge by reporting on a study investigating women's views and experiences of a scheme in which they can volunteer, in their capacity as fertility patients, to 'share' their eggs with researchers and receive a reduction in in vitro fertilisation fees. We focus our discussion on the question of exploitation, a concept central to many sociological and ethical interests. In brief, our analysis suggests that while interviewees acknowledge the potential of this scheme to be exploitative, they argue that this is not the case, emphasising their ability to act autonomously in deciding to volunteer. Nonetheless, these freely made decisions do not necessarily take place under circumstances of their choosing. We discuss the implications of this for egg provision in general and for understandings of exploitation.
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Affiliation(s)
- Erica Haimes
- Policy, Ethics and Life Sciences (PEALS) Research Centre, Newcastle University, Fourth Floor Claremont Bridge, Newcastle uponTyne, NE1 7RU.
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Waldby C, Carroll K. Egg donation for stem cell research: ideas of surplus and deficit in Australian IVF patients' and reproductive donors' accounts. Sociol Health Illn 2012; 34:513-528. [PMID: 21951180 DOI: 10.1111/j.1467-9566.2011.01399.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We report on a study undertaken with an Australian in vitro fertilisation (IVF) clinic to understand IVF patients' and reproductive donors' perceptions of oocyte (egg) donation for stem cell research. Such perspectives are particularly valuable because IVF patients form a major recruitment group for oocyte donation for research, and because patients and donors have direct experience of the medical procedures involved. Similar studies of oocyte donation have been carried out elsewhere in the world, but to date very little social science research has been published that reports on donation for research, as distinct from donation for reproduction. Our respondents expressed a distinct unwillingness to donate viable oocytes for stem cell research. In our analysis we consider a number of factors that explain this unwillingness. These include the labour of oocyte production, the inscrutability of oocytes (the lack of a test to identify degrees of fertility) and the extent to which the oocytes' fertility sets the parameters for all downstream reproductive possibilities. We draw on the science studies literature on affordances to make sense of the social intractability of oocytes, and compare them with the respondents' much greater willingness to donate frozen embryos for human embryonic stem cells research.
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Blyth E, Yee S, Tsang AKT. “They Were My Eggs; They Were Her Babies”: Known Oocyte Donors’ Conceptualizations of Their Reproductive Material. Journal of Obstetrics and Gynaecology Canada 2011; 33:1134-40. [PMID: 22082787 DOI: 10.1016/s1701-2163(16)35081-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Eric Blyth
- University of Huddersfield, Queensgate, Huddersfield UK
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31
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Golombok S, Readings J, Blake L, Casey P, Marks A, Jadva V. Families created through surrogacy: mother-child relationships and children's psychological adjustment at age 7. Dev Psychol 2011; 47:1579-88. [PMID: 21895360 PMCID: PMC3210890 DOI: 10.1037/a0025292] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Each year, an increasing number of children are born through surrogacy and thus lack a genetic and/or gestational link with their mother. This study examined the impact of surrogacy 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 surrogacy, 32 egg donation, and 54 natural conception families with a 7-year-old child. No differences were found for maternal negativity, maternal positivity, or child adjustment, although the surrogacy and egg donation families showed less positive mother-child interaction than the natural conception families. The findings suggest that both surrogacy and egg donation families function well in the early school years.
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Affiliation(s)
- Susan Golombok
- Centre for Family Research, Faculty of Politics, Psychology, Sociology, and International Studies, University of Cambridge, Cambridge, UK.
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Cochini A, Letur-Könirsch H, Granet P, Wainer R, Cupa D. [The experiences of patients and the maternal representations throughout the different steps of an oocyte donation]. Gynecol Obstet Fertil 2011; 39:533-537. [PMID: 21835670 DOI: 10.1016/j.gyobfe.2011.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Accepted: 06/06/2011] [Indexed: 05/31/2023]
Abstract
This research aims to study the experiences and the maternal representations of infertile women throughout the different steps of a medically assisted procreation (MAP) with oocyte donation. The analysis of collected data (interviews and questionnaires) shows that the resort of egg donation creates psychic adjustment (particularly in terms of maternal representations) that appear specific to this type of procreation.
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Affiliation(s)
- A Cochini
- Laboratoire de psychopathologie psychanalytique des atteintes somatiques et identitaires (LASI) EA 4430, université Paris Ouest Nanterre la Défense, 200 avenue de la République, Nanterre cedex, France.
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Dicken CL, Zapantis A, Illions E, Pollack S, Lieman HJ, Bevilacqua K, Jindal SK. Full-sibling embryos created by anonymous gamete donation in unrelated recipients. Fertil Steril 2011; 96:641-2. [PMID: 21763647 DOI: 10.1016/j.fertnstert.2011.06.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Revised: 06/03/2011] [Accepted: 06/16/2011] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To report the rare occurrence of full-sibling embryos in unrelated women using independently chosen donor sperm and donor oocytes in two different cycles unintentionally created at our IVF program, and to discuss the concept of disclosure to the patients. DESIGN Case report. SETTING Academic IVF program. PATIENT(S) Two women independently undergoing donor recipient cycles with anonymous donor oocytes and donor sperm. INTERVENTION(S) Both women received oocytes from the same donor several months apart and then by coincidence selected the same anonymous sperm donor to create anonymous full-sibling embryos. MAIN OUTCOME MEASURE(S) Clinical pregnancy after donor-recipient IVF cycle. RESULT(S) Both women conceived using the same donor sperm and donor oocytes in independent cycles, resulting in simultaneous pregnancy of full siblings. CONCLUSION(S) As providers with the knowledge that anonymous full sibling embryos have been created, we may have an obligation to disclose this information to the patients.
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Affiliation(s)
- Cary L Dicken
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY 10530, USA
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Lewis G, Rice F, Harold GT, Collishaw S, Thapar A. Investigating environmental links between parent depression and child depressive/anxiety symptoms using an assisted conception design. J Am Acad Child Adolesc Psychiatry 2011; 50:451-459.e1. [PMID: 21515194 PMCID: PMC3136241 DOI: 10.1016/j.jaac.2011.01.015] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2010] [Revised: 01/11/2011] [Accepted: 01/19/2011] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Links between maternal and offspring depression symptoms could arise from inherited factors, direct environmental exposure, or shared adversity. A novel genetically sensitive design was used to test the extent of environmental links between maternal depression symptoms and child depression/anxiety symptoms, accounting for inherited effects, shared adversity, and child age and gender. METHOD Eight hundred fifty-two families with a child born by assisted conception provided questionnaire data. Mothers and fathers were genetically related or unrelated to the child depending on conception method. Parental depression symptoms were assessed using the Hospital Anxiety and Depression Scale. Child depression/anxiety symptoms were assessed using the Short Mood and Feelings questionnaire and six items tapping generalized anxiety disorder symptoms. Associations between maternal and child symptoms were examined separately for genetically unrelated and related mother-child pairs, adjusting for three measurements of shared adversity: negative life events, family income, and socioeconomic status. Analyses were then run separately for boys and girls and for children and adolescents, and the role of paternal depression symptoms was also examined. RESULTS Significant associations between parent and child symptoms were found for genetically unrelated mother-child (r = 0.32, p < .001) and father-child (r = 0.17, p < .05) pairs and genetically related mother-child (r = 0.31, p < .001) and father-child (r = 0.23, p < .001) pairs and were not explained by the shared adversity measurements. Environmental links were present for children and adolescents and were stronger for girls. CONCLUSIONS The transmission of depression symptoms is due in part to environmental processes independent of inherited effects and is not accounted for by shared adversity measurements. Girls may be more sensitive to the negative effects of maternal depression symptoms than boys through environmental processes.
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Affiliation(s)
- Gemma Lewis
- Child and Adolescent Psychiatry Section and the Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK.
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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. J Fam Psychol 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Abstract
Oocyte donation is a complex situation that requires the applicant couple to deal with the presence of the donor in the history of the child conception. Accepting the eggs is not the same thing than accepting the donor. Her place in the child's life depends on how his parents will accept her phantasmal reality beyond her real person. Paying attention to the story told by the donors on their motivations may help parents internalize this conception to three. We show from two clinical observations, that the generosity of donors is connected to personal issues that do not relate to unborn child or its parents. If there are two mothers in oocyte donation, they are not really in competition because there are also two children: the child conceived through donation is that of the project of the couple, the child to which the donor thinks, is and will remain in phantasmal domain, i.e. linked to the personal history of the donor. We also show that the psychological interview fully responds to the donor expectations when it seeks to highlight her motives.
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Affiliation(s)
- P Cauvin
- CECOS, hôpital l'Archet II, 151, route de Saint-Antoine-de-Ginestière, 06200 Nice, France.
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Abstract
INTRODUCTION This paper reports on a qualitative empirical study of the experiences of women (and their partners) attending one UK assisted conception unit, who have considered egg sharing. AIMS In the absence of any published research of the experiences of people contemplating egg sharing and the considerable concerns that egg sharing had generated (for an overview see Blyth, 2002), the major purpose of the study was to examine the experiences not only of those who had considered and proceeded with egg sharing but also those who had considered, but had then decided against, egg sharing. In addition, since the views of male partners are frequently overlooked in studies of assisted conception treatment (cf. Ahuja, Mostyn, & Simons, 1997) the project actively sought the involvement of the women's partners. The study was designed to explore couples' motivation for egg sharing, their experiences of treatment, attitudes regarding information about egg sharing treatment and outcomes, and attitudes towards egg sharing. METHODS The centre sent a written invitation to participate in the study to all women who had indicated an interest in egg sharing and who had received both information and counselling in advance of proceeding (n = 60). Of these, 43 had decided to proceed after the counselling session and 17 had decided not to do so. Expressions of interest in participating in the study were received from 20 women: (a) five women had proceeded with egg sharing but had not been successful with their own treatment at the time of interview--all husbands/partners also participated (n = 10); (b) seven women had proceeded with egg sharing and had conceived (one of whom had conceived unexpectedly without assisted conception services)--5 couples and 2 women participated (n = 12); (c) six women decided to proceed with egg sharing, however an insufficient number of eggs were available following egg retrieval to enable egg sharing to take place--all husbands/partners also participated (n = 12); (d) two women decided not to proceed--and both husbands/partners participated (n = 4). The study data were derived from retrospective semi-structured interviews conducted by the author with these 20 women and 18 husbands/partners. Respondents also completed a paper exercise following the interview indicating their level of agreement or disagreement with a number of statements relating to egg sharing that were derived from responses to the HFEA's consultation on the withdrawal of payment to donors (HFEA 1998a.). While there was an overall 33% response rate, the response rate for those who had decided to proceed with egg sharing (41.9%) was greater than for those who had decided not to proceed (11.8%). Consequently, this study under-represents the views of women and their partners who had considered, but then rejected, egg sharing. Couples agreeing to participate in the research were given a choice of being interviewed together or separately and in their own home or at an alternative venue. This choice of separate or joint interviews was offered as part of the explicit effort to involve men in the study and to maximize participant choice. Twelve couples agreed to be interviewed separately; six couples were interviewed together and two women whose partners did not take part in the study were interviewed alone. There was no evidence of any significant differences in interview data between joint and separate interviews. Indeed, there was little disagreement between partners at all; this is probably not surprising, given that they will have discussed their decision about egg sharing together and will be aware of each other's views about at least some of the issues discussed during interview. All except four interviews took place in respondents' own homes. Two interviews took place in the centre at the respondents' requests and two interviews were conducted by telephone because of geographical considerations. All interviews were audio-recorded with respondents' permission and subsequently transcribed verbatim. The research was conducted in accordance with the British Psychological Society Statement of Ethical Principles for Conducting Research with Human Subjects (British Psychological Society, 2002). Ethical approval was given by the University of Huddersfield Ethics Committee.
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Affiliation(s)
- Eric Blyth
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK.
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Abstract
Birth is not merely a biological event; it is also a social event in that it creates relationships. As a consequence of reproductive technologies, the boundaries between the biological and social basis of kinship have become blurred. Reproductive technologies challenge previously held cultural constructions of kinship and bring about new kinds of social relations in that kinship boundaries are redefined. This paper discusses the societal effects that reproductive technologies have had in challenging previously held notions of parenthood, kinship and relatedness.
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Abstract
This paper reviews the literature on "public" perceptions of the practice of gamete (egg and sperm) donation in the treatment of infertility. Despite regular "consultation" exercises in the UK on the manner in which infertility treatments should be regulated, there is little sense of how a range of public groups respond to developments in this area. The key themes from thirty-three articles, chapters and reports are discussed. The review reveals the limited nature of our current knowledge of public understandings of and attitudes towards gamete donation as a form of infertility treatment which has been readily available and widely practiced for many years. The review is critical of the methodological and epistemological basis of much of the work in this area and argues that there is a strong case for social scientific research to attempt to capture the perceptions of a wider range of people who are rarely included in formal public consultations and often similarly excluded from research studies.
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Affiliation(s)
- Nicky Hudson
- School of Applied Social Sciences, De Montfort University, Leicester, UK.
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Ethics Committee of the American Society for Reproductive Medicine. Interests, obligations, and rights of the donor in gamete donation. Fertil Steril. 2009;91:22-27. [PMID: 19084224 DOI: 10.1016/j.fertnstert.2008.09.062] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2008] [Accepted: 09/19/2008] [Indexed: 01/13/2023]
Abstract
This Ethics Committee report outlines the interests, obligations, and rights of both male and female donors who choose to provide gametes for use by others.
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Dyer C. More than 100 sperm and egg donors prove ready to reveal identity to offspring. BMJ 2008; 337:a2110. [PMID: 18927176 DOI: 10.1136/bmj.a2110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
New reproductive technologies have the capacity to impact on both personal and healthcare relationships. This article utilizes a case study approach to unpack experiences of one couple who encountered immense and unforeseen difficulties as a result of treatment with assisted reproductive technology. Findings of this case reveal both difficulties and breaches in obtaining informed consent and the consequences these breaches have on relationships. Comprehensive information contributes to positive relationships between patients and healthcare providers. Maintaining supportive relationships between all parties concerned with assisted reproductive technology services is essential, as rifts in these relationships can be devastating and long-lasting.
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Affiliation(s)
- Kathleen Peters
- School of Nursing, College of Health and Science, University of Western Sydney, Sydney, New South Wales, Australia.
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Abstract
OBJECTIVE To describe the lived experience of pregnant women who used donor oocytes for conception. DESIGN Qualitative, using a descriptive phenomenologic approach. SETTING Interviews were completed at a location and setting selected by the participant. Of the 16 interviews, 13 were conducted at the participant's home, 1 was conducted at a private office, and 2 were conducted by telephone. PARTICIPANTS Eight women, between the ages of 33 and 46 years, were recruited at a large urban infertility center. The women were between 9 and 23 gestational weeks pregnant at the time of data collection. Each of the women participated in two open-ended, in-depth, audiotaped interviews and answered a demographic questionnaire. RESULTS Four themes emerged from the women's description of their experience, which were (a) acknowledging the desire for motherhood, (b) accepting and coming to terms with donor oocytes as a way to achieve motherhood, (c) navigating an intense period of decision making, and (d) living with the lasting legacy of achieving motherhood through oocyte donation. CONCLUSION Clinical practice can be improved by incorporating recognition, support, and communication of the experience to women contemplating or undergoing donor oocyte treatment.
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Abstract
BACKGROUND Current legislation in Canada allows for only altruistic gamete donation. Limited clinical data are available on the emotional and psychological impact of altruistic oocyte donation on known donors. METHODS Seventeen women who had donated oocytes to known parties without financial compensation agreed to receive the oocyte donation questionnaire (ODQ) to explore the psychological domains of altruistic oocyte donation. RESULTS Thirteen ODQ were returned, giving a response rate of 76%. All subjects indicated that they were primarily motivated by a 'desire to give and help' the recipient couple. Most subjects did not find the donation decision difficult but some found the post-donation psychological adjustments challenging. Subjects also indicated that mandatory counselling on the psychological implications of oocyte donation was an important component of cycle preparation. The majority of subjects had disclosed the donation to others and felt that disclosure to the presumptive child was essential. CONCLUSIONS The findings provide clinical materials for conceptualizing the dynamics entailed by known altruistic oocyte donation, with regards to motivation, relationship implications, donor satisfaction and plans for disclosure. The data support the provision of psycho-social support services to help donors dealing with any residual emotional difficulties regardless of the outcome of oocyte donation.
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Affiliation(s)
- Samantha Yee
- Department of Social Work, Mount Sinai Hospital, and Faculty of Medicine, University of Toronto, Ontario, Canada.
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Abstract
BACKGROUND In 2005, UK legislation was changed requiring any donor of gametes or embryos used in the treatment of others to agree to the disclosure of their identity to any offspring reaching the age of 18. METHODS AND RESULTS This paper analyses responses of a survey of existing donors' views on the removal of donor anonymity that was undertaken by the Department of Health (UK) as part of its review that preceded changes to the law on donor anonymity. The survey provides an insight into what it is about the loss of anonymity that some donors find problematic, indicating that although some donors will be reluctant to donate under conditions of non-anonymity, others have concerns about the removal of anonymity that can be addressed. CONCLUSIONS This paper identifies factors, in particular counselling, support and better information that could maintain gamete donor recruitment in the context of the UK's policy of non-anonymous and non-remunerated donation.
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Affiliation(s)
- Lucy Frith
- University of Liverpool-Primary Care, The Whelan Building, Brownlow Hill, Liverpool, UK.
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Abstract
The aim of this observational two-centre study was to investigate different aspects of pain in oocyte aspiration in conjunction with IVF, whether the preoperative information to women was sufficient, and which factor(s) influenced a woman's sense of security. The study group comprised 124 women who underwent IVF treatment. The visual analogue scale (VAS) was used to measure pain, and multiple-choice questions were used to evaluate satisfaction and sense of security. The women rated expected pain significantly higher than mean pain during surgery (P < 0.0001). They would have accepted significantly more pain than they experienced (P < 0.0001). In a stepwise linear regression analysis, total dose of alfentanil was the only variable that was independently associated with mean pain. Satisfaction with the preoperative information was high. Women considered staff competence to be important for their sense of security. In conclusion, women rated oocyte aspiration to be less painful than they expected before surgery. This is important information for women who are about to start IVF treatment, since it might reduce apprehension about the level of pain that could be expected during oocyte aspiration.
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Affiliation(s)
- Ann-Louise Gejervall
- Reproductive Medicine, Department of Obstetrics and Gynaecology, Institute for Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, Göteborg, Sweden.
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de Lacey S. Decisions for the fate of frozen embryos: fresh insights into patients' thinking and their rationales for donating or discarding embryos. Hum Reprod 2007; 22:1751-8. [PMID: 17416918 DOI: 10.1093/humrep/dem056] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND In the final decision for the disposition of unused IVF embryos patients must choose between options involving either donation or destruction, and this decision must be made in a context where there is tension about the status of embryos (i.e. whether viewed as potential children or as a base for further development) and whether embryo donation is adoption or tissue donation. This study explored the emotive experience of making a decision for either the destruction or donation of unused embryos. METHODS Thirty-three patients (9 women and 12 couples) who discarded embryos and 15 (7 women and 4 couples) who donated embryos were interviewed. Interview data were analysed with particular attention to elements of moral deliberation and use of analogy. RESULTS Adoption and tissue donation metaphors were both identified, and further, a metaphor of pregnancy termination was identified and found to be highly influential in the decision to donate embryos. Contrary to the majority of current evidence, this study found that participants who discarded embryos emphasized the adoption metaphor while embryo donors emphasized the metaphor of pregnancy termination. For each group the decision was driven by awareness of the option they did not want. CONCLUSIONS The pregnancy termination metaphor emerged as morally relevant and this holds implications for defining and discussing embryo discard in counselling and consent processes.
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Affiliation(s)
- Sheryl de Lacey
- Research Centre for Reproductive Health, Discipline of Obstetrics and Gynaecology, University of Adelaide, South Australia 5005, Australia
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Affiliation(s)
- H Letur
- Centre de Fertilité, Institut Mutualiste Montsouris (IMM), 42, boulevard Jourdan, 75014 Paris, France.
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Mac Dougall K, Becker G, Scheib JE, Nachtigall RD. Strategies for disclosure: how parents approach telling their children that they were conceived with donor gametes. Fertil Steril 2006; 87:524-33. [PMID: 17141770 PMCID: PMC1868489 DOI: 10.1016/j.fertnstert.2006.07.1514] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2006] [Revised: 07/27/2006] [Accepted: 07/27/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To describe how parents envision, plan, and enact disclosing to their children that they were conceived with donor gametes. DESIGN In-depth ethnographic interviews. SETTING Participants were recruited from 11 medical infertility practices and 1 sperm bank in Northern California. PATIENT(S) A total of 141 married couples who had conceived a child using donor gametes (62 with donor sperm and 79 with donor oocytes). INTERVENTION(S) Husbands and wives were interviewed together and separately. MAIN OUTCOME MEASURE(S) Thematic analysis of interview transcripts. RESULT(S) Disclosing parents predominantly subscribed to one of two disclosure strategies: the conviction that early disclosure is of paramount importance so that the child "always knows," or the belief that later disclosure is preferable after family routines have been established and the child has the maturity to understand biologic concepts and has developed a sense of discretion. No parent regretted disclosing, and many expressed relief. CONCLUSION(S) Parents choosing early disclosure were more at ease with the disclosure process, whereas parents choosing later disclosure reported greater uncertainty about how and when to disclose. Parents wished for more peer and/or professional support and guidance to assist them with disclosure, not only initially but continuing long after their children were born.
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Affiliation(s)
- Kirstin Mac Dougall
- Institute for Health and Aging, University of California, San Francisco, San Francisco, California 94118, USA
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