Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

The Child's Right to Know Versus the Parents’ Right Not to Tell: The Attitudes of Couples Undergoing Fertility Treatments Towards Identity-Release Gamete Donation

Authors
Douglas Rocha 1
Rose Melamed 1
Daniela Braga 1
Amanada Setti 2
Assumpto Iaconelli 3
Edson Borges 3
1 Associação Instituto Sapientiae-Centro de Estudos e Pesquisa em Reprodução Assistida, São Paulo, Brazil
2 Associação Instituto Sapientiae-Centro de Estudos e Pesquisa em Reprodução Assistida, São Paulo, Brazil; Fertility Medical Group, São Paulo, Iran
3 Associação Instituto Sapientiae-Centro de Estudos e Pesquisa em Reprodução Assistida, São Paulo, Brazil; Fertility Medical Group, São Paulo, Brazil
10.18502/jri.v24i3.13276
Abstract
Background: In Brazil, donor anonymity is mandatory; however, the tendency of Brazilians towards the practice is unknown. In this study, an attempt was made to investigate whether couples undergoing assisted reproductive technology (ART) have a different perception of anonymous versus identity-release gamete donation than a target population in Brazil. Methods: This cross-sectional study was performed from September 1, 2020 to December 15, 2020. For that purpose, surveys through online platforms were conducted, including either patients undergoing ART (ART-group, n=400) or subjects interested in the theme (interested-group, n=100) randomized by age at a 1:4 ratio. The survey collected information on the participants’ attitudes towards anonymity of gamete donors, and answers were compared between the groups. Results: Most participants stated that the relationship between children and their parents would be affected by the child's knowledge of the origin of its conception. Most participants in the ART-group believed that the gamete donor’s identity should not be revealed to the child, while only half of the interested-group stated the same. Most of the participants stated that "the donor's identity should be revealed if the child questions its biological origin". "From birth" was the second most common response, while "when the child turns 18 years old" and "sometime during teenage years" were less common answers. Conclusion: The attitudes of ART patients about anonymity are conservative, with most participants believing that family relationships may be affected if the child is aware of the origin of his/her conception. These patients also believe that the identity of the gamete donor should not be revealed to the child.
Keywords
Donor
Donor conception
Sperm
Survey
Wang TK, Yuen KY, Wong SS. Asymptomatic Penicillium marneffei fungemia in an HIV-infected patient. Int J Infect Dis. 2007;11(3):280-1.
Ombelet W, Van Robays J. Artificial insemination history: hurdles and milestones. Facts Views Vis Obgyn. 2015;7(2):137-43.
Gerkowicz SA, Crawford SB, Hipp HS, Boulet SL, Kissin DM, Kawwass JF. Assisted reproductive technology with donor sperm: national trends and perinatal outcomes. Am J Obstet Gynecol. 2018;218(4):421.e1-10.
Bustillo M, Buster JE, Cohen SW, Hamilton F, Thorneycroft IH, Simon JA, et al. Delivery of a healthy infant following nonsurgical ovum transfer. JAMA. 1984;251(7):889.
Cobo A, Remohí J, Chang CC, Nagy ZP. Oocyte cryopreservation for donor egg banking. Reprod Biomed Online. 2011;23(3):341-6.
De Geyter Ch, Calhaz-Jorge C, Kupka MS, Wyns C, Mocanu E, Motrenko T, et al. ART in Europe, 2014: results generated from European registries by ESHRE: the European IVF-monitoring Consortium (EIM) for the European Society of Human Reproduction and Embryology (ESHRE). Hum Reprod. 2018;33(9):1586-601.
Skoog Svanberg A, Sydsjö G, Lampic C. Psychosocial aspects of identity-release gamete donation–perspectives of donors, recipients, and offspring. Ups J Med Sci. 2020;125(2):175-82.
Hibino Y, Allan S. Absence of laws regarding sperm and oocyte donation in Japan and the impacts on donors, parents, and the people born as a result. Reprod Med Biol. 2020;19(3):295-8.
Blyth E, Frith L. Donor-conceived people's access to genetic and biographical history: an analysis of provisions in different jurisdictions permitting disclosure of donor identity. Int J Law Policy Fam. 2009;23(2):174-91.
Lampic C, Skoog Svanberg A, Gudmundsson J, Leandersson P, Solensten NG, Thurin-Kjellberg A, et al. National survey of donor-conceived individuals who requested information about their sperm donor-experiences from 17 years of identity releases in Sweden. Hum Reprod. 2022;37(3):510-21.
Miettinen A, Rotkirch A, Suikkari AM, Söderström-Anttila V. Attitudes of anonymous and identity-release oocyte donors towards future contact with donor offspring. Hum Reprod. 2019;34(4):672-8.
Ethics committee of the American society for reproductive medicine. Informing offspring of their conception by gamete or embryo donation: an ethics committee opinion. Fertil Steril. 2018;109(4):601-5.
Scheib JE, Ruby A, Benward J. Who requests their sperm donor's identity? the first ten years of information releases to adults with open-identity donors. Fertil Steril. 2017;107(2):483-93.
Anvisa. Resolution of the Collegiate Board - RDC No. 771. 2022 Jul [cited 2022 Dec 28]; 1 (244) p 306-313. Available: http://antigo.anvisa.gov.br/ legislacao/?inheritRedirect=true#/visualizar/500343.
Cheib JE, Riordan M, Shaver PR. Choosing between anonymous and identity-release sperm donors: recipient and donor characteristics. Reprod Technol. 2000;10(1):50.
Brewaeys A, De Bruyn JK, Louwe LA, Helmerhorst FM. Anonymous or identity-registered sperm donors? a study of Dutch recipients' choices. Hum Reprod. 2005;20(3):820-4.
Daniels K. Donor gametes: anonymous or identified? Best Pract Res Clin Obstet Gynaecol. 2007;21(1):113-28.
Nordqvist P, Smart C. Relative strangers. Relative strangers and the paradoxes of genetic Kinship. In: Nordqvist P, Smart C, editors. Family life, genes and donor conception. London: Springer; 2014. p. 144-66.
Indekeu A, Dierickx K, Schotsmans P, Daniels K, Rober P, D'Hooghe T. Factors contributing to parental decision-making in disclosing donor conception: a systematic review. Hum Reprod Update. 2013;19(6):714-33.
Kovacs GT, Wise S, Finch S. Keeping a child's donor sperm conception secret is not linked to family and child functioning during middle childhood: an Australian comparative study. Aust N Z J Obstet Gynaecol. 2015;55(4):390-6.
Golombok S, Brewaeys A, Giavazzi M, Guerra D, MacCallum F, Rust J. The European study of assisted reproduction families: the transition to adolescence. Hum Reprod. 2002;17(3):830-40.
Golombok S, Blake L, Casey P, Roman G, Jadva V. Children born through reproductive donation: a longitudinal study of psychological adjustment. J Child Psychol Psychiatry. 2013;54(6):653-60.
Freeman T, Golombok S. Donor insemination: a follow-up study of disclosure decisions, family relationships and child adjustment at adolescence. Reprod Biomed Online. 2012;25(2):193-203.
Ilioi E, Blake L, Jadva V, Roman G, Golombok S. The role of age of disclosure of biological origins in the psychological wellbeing of adolescents conceived by reproductive donation: a longitudinal study from age 1 to age 14. J Child Psychol Psychiatry. 2017;58(3):315-24.
Isaksson S, Sydsjo G, Skoog Svanberg A, Lampic C. Disclosure behaviour and intentions among 111 couples following treatment with oocytes or sperm from identity-release donors: follow-up at offspring age 1–4 years. Hum Reprod. 2012;27(10):2998-3007.
Greenfeld DA, Klock SC. Disclosure decisions among known and anonymous oocyte donation recipients. Fertil Steril. 2004;81(6):1565-71.
Kalampalikis N, Haas V, Fieulaine N, Doumergue M, Deschamps G. Giving or giving back: new psychosocial insights from sperm donors in France. Psychol Health Med. 2013;18(1):1-9.
Salevaara M, Suikkari AM, Söderström-Anttila V. Attitudes and disclosure decisions of Finnish parents with children conceived using donor sperm. Hum Reprod. 2013;28(10):2746-54.
Freeman T, Zadeh S, Smith V, Golombok S. Disclosure of sperm donation: a comparison between solo mother and two-parent families with identifiable donors. Reprod Biomed Online. 2016;33(5):592-600.
Lycett E, Daniels K, Curson R, Golombok S. School-aged children of donor insemination: a study of parents' disclosure patterns. Hum Reprod. 2005;20(3):810-9.
Lalos A, Gottlieb C, Lalos O. Legislated right for donor-insemination children to know their genetic origin: a study of parental thinking. Hum Reprod. 2007;22(6):1759-68.
Golombok S, Murray C, Jadva V, Lycett E, MacCallum F, Rust J. Non-genetic and non-gestational parenthood: consequences for parent–child relationships and the psychological well-being of mothers, fathers and children at age 3. Hum Reprod. 2006;21(7):1918-24.
Söderström-Anttila V, Sälevaara M, Suikkari A. Increasing openness in oocyte donation families regarding disclosure over 15 years. Hum Reprod. 2010;25(10):2535-42.
Ethics ommittee of the American society for reproductive medicine. Informing offspring of their conception by gamete donation. Fertil Steril. 2004;81(3):527-31.
Indekeu A, Maas AJB, McCormick E, Benward J, Scheib JE. Factors associated with searching for people related through donor conception among donor-conceived people, parents, and donors: a systematic review. F&S Rev. 2021;2(2):93-119.
Practice committee of the American society for reproductive medicine. The clinical utility of sperm DNA integrity testing: a guideline. Fertil Steril. 2013;99(3):673-7.
Isaksson S, Skoog Svanberg A, Sydsjö G, Thurin-Kjellberg A, Karlström PO, Solensten NG, et al. Two decades after legislation on identifiable donors in Sweden: are recipient couples ready to be open about using gamete donation? Hum Reprod. 2011;26(4):853-60.
Gebhardt AJ, Sydsjö G, Skoog Svanberg A, Indekeu A, Lampic C. Parenting stress and its association with perceived agreement about the disclosure decision in parents following donor conception. Acta Obstet Gynecol Scand. 2017;96(8):968-75.
Daniels KR, Grace VM, Gillett WR. Factors associated with parents’ decisions to tell their adult offspring about the offspring's donor conception. Hum Reprod. 2011;26(10):2783-90.
Pennings G. Disclosure of donor conception, age of disclosure and the well-being of donor offspring. Hum Reprod. 2017;32(5):969-73.
Gottlieb C, Lalos O, Lindblad F. Disclosure of donor insemination to the child: the impact of Swedish legislation on couples' attitudes. Hum Reprod. 2000;15(9):2052-6.
Rumball A, Adair V. Telling the story: parents' scripts for donor offspring. Hum Reprod. 1999;14(5):1392-9.
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. 2007;87(3):524-33.
Turner AJ, Coyle A. What does it mean to be a donor offspring? The identity experiences of adults conceived by donor insemination and the implications for counselling and therapy. Hum Reprod. 2000;15(9):2041-51.
Jadva V, Freeman T, Kramer W, Golombok S. The experiences of adolescents and adults conceived by sperm donation: comparisons by age of disclosure and family type. Hum Reprod. 2009;24(8):1909-19.
Beeson DR, Jennings PK, Kramer W. Offspring searching for their sperm donors: how family type shapes the process. Hum Reprod. 2011;26(9):2415-24.
Hershberger PE, Driessnack M, Kavanaugh K, Klock SC. Oocyte donation disclosure decisions: a longitudinal follow-up at middle childhood. Hum Fertil (Camb). 2021;24(1):31-45.
Applegarth LD, Kaufman NL, Josephs-Sohan M, Christos PJ, Rosenwaks Z. Parental disclosure to offspring created with oocyte donation: intentions versus reality. Hum Reprod. 2016;31(8):1809-15.
Daniels KR, Grace VM, Gillett WR. Factors associated with parents' decisions to tell their adult offspring about the offspring's donor conception. Hum Reprod. 2011;26(10):2783-90.
Blyth E, Farrand A. Anonymity in donor-assisted conception and the UN Convention on the Rights of the Child. Int J Children's Rights. 2004;12(2):89-104.
Journal of Reproduction & Infertility
Volume 24, Issue 3
Summer 2023
Pages 198-205