P–505 The right age to tell? The insufficiency of the age criteria for characterizing the experience of French donor conceived families in disclosing to their offspring

Study question

Is age a key criteria for characterizing the experience of families in telling donor offspring about the facts of their conception?

Summary answer

The study shows that, although donor offspring’s age at the time of disclosure has an impact, it is insufficient to describe these families’ experiences

What is known already

Secrecy was the norm for decades in donor conception, but “openness” has now become the new core value for institutions, professionals and interest groups. Accordingly, in recent years information-sharing practices have shifted in donor conceived families, but a proportion of parents, especially heterosexual couples, still appear to not inform their children about their being donor conceived. Disclosure recommendations seem difficult to apply in practice. A recurring question is: when should children be told? Age is presented as a key criteria: the younger the children are when their conception story is shared, the less of a problem it would create.

Study design, size, duration

The qualitative social science study includes two sets of semi-directive interviews conducted with 20 French sperm donor conceived adults (April-Dec. 2019) and 22 French parents by sperm, egg or double donation (Feb.-Oct. 2020). Calls for interviews aimed at donor conceived adults and parents by donation were shared on the Internet, in the media (press, radio, television) and through interest groups (PMAnonyme, BAMP!, MAIA) in France. The contact initiative was left to potential participants.

Participants/materials, setting, methods

Donor conceived participants include 17 women and 3 men conceived 1960–2000 through anonymous sperm donation in heteroparental families.

The parent participants include 20 families (20 mothers, 2 fathers) who used donor conception—mainly anonymous (19)—in France, Spain and the Czech Republic starting in the 1980s. 17 conceived as heteroparental couples, 2 as solo-mothers-by-choice and 1 as a same-sex couple. 17 have already informed their offspring of the facts of their conception.

Main results and the role of chance

The participants’ experiences of disclosure appear to be bound to their historical and social context, especially regarding the prevailing norms on secrecy. Older parents mention having been advised by clinic professionals to keep the facts of their conception from their child(ren). Some also feared the stigma related to infertility. In contrast, some younger donor conceived participants recall the use of a children’s book while being told of their conception as toddlers. Beyond age, the larger context thus affects information-sharing practices.

Furthermore, experiences of disclosure are impacted by the family context and history. Some are embedded within larger events such as divorces or the death of a family member. The story of the donation may be linked to narratives of diseases (such as cancer) or traumatic events (such as the loss of a fetus in utero) that may prevail over donor conception or make it untellable.

Age proves to be an insufficient criteria to qualify these experiences, all the more so since “disclosure” sometimes unfolds in several steps. Some parents have first talked about their fertility issues without mentioning the use of a donor. Behind the prevailing norm of “openness”, difficulties in actually disclosing are confirmed.

Limitations, reasons for caution

Being qualitative, the study only includes a small number of participants without claiming exhaustivity nor representativity. It imperfectly reports on the view of those who do not disclose, as all participants question the principle of secrecy, many being members of interest groups defending openness.

Wider implications of the findings: Our results complement existing studies that emphasize the weight of age in donor conceived families’ experience regarding disclosure. Age alone cannot describe information-sharing practices that are embedded within their historical and social context as well as the family context and history. Results thus inform familial difficulties related to disclosure.

Trial registration number

Not applicable

P–482 According to donor conceived adults, continuing the sharing-information process with parents about the donor conception is easier when the father took part in disclosure

Study question

The opinion and feelings of adults after disclosure of the use of donated gametes for their conception

Summary answer

Disclosure is beneficial for 85.1% of donor conceived participants. Continuing the sharing-information process with parents is significantly easier when the father took part in disclosure

What is known already

Sharing information about the use of donor-conception with offspring is a complex process at several levels, involving in particular the parents’ will, the circumstances of disclosure, the child’s reaction, or the age of the child at disclosure. In this process, the child has a central position, source of force or friction. However, little is known about the opinion and feelings of adults who have been conceived through gamete donation.

Study design, size, duration

An online survey between March 2019 and September 2020. The opening of investigation was announced in media (press, radio, television), social networks, professional websites (CECOS French Federation…) and through interest groups (PMAnonyme, BAMP!, MAIA, ADEDD…) in France.

Participants/materials, setting, methods

Participants completed a standardized questionnaire intended for (spermatozoa or oocyte) donor conceived adults, available on the AP-HM website

Main results and the role of chance

114 participants responded to the survey, 14 men and 100 women. The average age is 32.9 +/- 7.35 years old. Among them, 111 (97.4%) are born using sperm donation, 2 (1.8%) using oocyte donation, and 1 (0.9%) using double gamete donation. Their parents are 110 heterosexual couples, 3 single mothers, and 1 lesbian couple. For 113 (99.1%) of them, the parents had ART in France. Disclosure took place when they had 18.34+/–11.7 years old. The average time between disclosure and the survey participation is 14.58 +/- 8.77 years. Information was transmitted by the mother for 47.4%, the father for 8.8%, by both parents for 29.8%, and others for 14%.

The circumstances of information are: always knew it (11.4%), at a time chosen by the parents (36%), following a health event (7%), during a conflict (16%), following my questions (14%), by chance discovery (13.2%). A subsequent sharing process was possible after disclosure for 89 (78.1%) participants, and impossible for 25 (21.9%) of them. The sharing process is considered as not difficult for 49.5%, but difficult for 50.5%. It is significantly easier to repeat discussion about the donor conception with their parents when the father took part in disclosure (p = 0.02).

Limitations, reasons for caution

Most of the participants are members of interest groups. This may induce a risk of selection bias. Participants are primarily conceived using donated spermatozoa within heterosexual couples. This conclusion may not be applied to oocyte donation or other family models.

Wider implications of the findings: The present findings highlight the role of the father at the disclosure step, so that the subsequent information-sharing process is easier within the family.

Trial registration number

Not applicable