Embryo donation families : mothers' decisions regarding disclosure of donor conception

BACKGROUND: Previous data suggest that parents who adopt a child tend to support full disclosure while donor conception families prefer to keep the method of conception relatively private. It is not known whether parents in embryo donation families will tend towards the adoption model, therefore, we studied families with a child conceived using donated embryos. METHODS: A total of 21 embryo donation families with a child aged 2–5 years were recruited through UK fertility clinics. Mothers were administered a standardized semi-structured interview, obtaining data on the extent of their disclosure to children and other family members and their reasons for this decision. RESULTS: At the time of interview, 9% of mothers had told their child how they had conceived; 24% of mothers reported that they were planning to tell the child in future; 43% had decided that they would never tell the child, and the remaining 24% were undecided. However, nearly three-quarter of mothers (72%) had disclosed to other family members. Maternal grandparents were more likely to have been told than paternal grandparents (P < 0.025). Reasons cited for non-disclosure to the child included the desire to protect the child, the belief that disclosure is unnecessary, and the concern that family relationships would be damaged. Reasons in favour of disclosure included the desire to avoid accidental disclosure and the belief that the child has the right to know. CONCLUSIONS: Embryo donation mothers were similar to parents of donor insemination and oocyte donation children in their attitudes towards disclosure of donor conception

Parenting and child development in families with a child conceived through embryo donation

Concerns have been raised regarding the potentially negative effects of conception using donated embryos on parenting and child development. Findings are presented of an exploratory study of families with a child conceived through embryo donation. Twenty-one embryo donation families were compared with 28 adoptive families and 30 in vitro fertilization families on standardized interview and questionnaire measures of the parents' marital and psychological state, the quality of parent-child relationships, and the child's development. In all 3 groups, the children were aged 2-5 years. The differences indicated higher emotional overinvolvement and defensive responding in the embryo donation families, along with greater secrecy about the child's origins. The children were not at increased risk of psychological problems. The study provides interesting but preliminary findings on parent-child relationships and child development in a new family form

Parental attitudes toward disclosure of the mode of conception to their child conceived by in vitro fertilization

OBJECTIVES: To survey the level of disclosure of conception method within families of children conceived using conventional IVF or ICSI and to examine the factors that may influence parental attitudes and plans for disclosure. DESIGN: An in-depth questionnaire. SETTING: Participants recruited through UK fertility clinics. PATIENTS: Parents of IVF/ICSI children aged 5-6 years (n=181, 51%). INTERVENTION: Mothers and fathers of IVF/ICSI children were sent questionnaires to complete and return in a reply paid envelope. MAIN OUTCOME MEASURES: Completion of the questionnaire. RESULTS: Most parents had told somebody about their child’s method of conception, mostly close friends and family. Fewer (26% mothers/17% fathers) had already discussed the child’s mode of conception with their child. 58% mothers/57% fathers intended to tell their child at some point. 16% mothers/21% fathers were undecided. 4% fathers never wanted to discuss the subject with their child. Children were more likely to be told if conception was ICSI, rather than conventional IVF, and if an only child. 29% undecided fathers and 36% undecided mothers stated that they would tell their child if appropriate child-friendly explanatory literature was available. CONCLUSIONS: The majority of parents wish to tell their child at some point but are unsure about the most appropriate timing and method of disclosure. Fertility clinics may have a role in providing the necessary support. Child-friendly literature may be helpful

LEADING COMMENT: Children of lesbian mothers: From the 1970s to the new millennium

In both the popular and academic media, lesbian and gay parenting is the issue of the moment. Recent examples include the case of two gay men fathering twins with a surrogate mother in the US; the results of a study of gay fathers by Gill Dunne at the London School of Economics (Guardian, January 12, 2000); and comments from Dame Elizabeth Butler-Sloss, President of the Family Court, on the appropriateness of lesbian women and gay men as adoptive or foster parents (Guardian, October 16, 1999). These examples show that current debates focus on gay fathers, assisted reproduction and fostering/adoption. Does this mean that the concerns first raised in child custody disputes in the 1970's - that children raised in lesbian mother families would be at risk for psychological problems and atypical gender development – have been laid to rest? Psychological problems Concerns about the psychological well-being of children of lesbian mothers were based on the widely accepted view that some childhood experiences carry a risk of psychiatric disorder. This is predominately an argument about social acceptance; because lesbianism is not socially acceptable, the children of lesbian mothers will experience social disapproval. Thus, they will be likely to experience teasing and bullying by peers, which in turn may cause them to become socially withdrawn. Ultimately, it has been argued, the child will be unable to form and maintain friendships, an ability that has been shown to be important for self-esteem and psychological well-being in later life

Receiving, or ‘Adopting’, Donated Embryos to Have Children: Parents Narrate and Draw Kinship Boundaries

Existing research suggests that embryo donation (ED) may be seen as similar to adoption by those who donate or receive embryos, or it may not. Our qualitative study explored whether having a child via embryo donation initiated kinship connections between embryo donor and recipient families as interpreted by recipient parents. Interviews were conducted with five parents from four families whose child(ren) had been born via embryo donation. All four families had an open-contact relationship set up with the couples who donated their embryos through an agency in the USA. Narrative thematic analysis of interview data and visual family map drawings were used to explore kinship conceptualizations. We conclude that the dilemma experienced by parents who have a child via embryo donation is to decide how to reconcile their child’s different genetic heritage, when gestation and upbringing both clearly boundary family membership solely within the recipient family. While some families were still struggling with this dilemma, one solution embarked upon by some parents when drawing their family map was to expand family membership, not only on the basis of genetics, but also via an appreciation of shared family and community values too

Psychological adjustment in adolescents conceived by assisted reproduction techniques: a systematic review.

BACKGROUND: Adolescence is a transitional time for identity formation and relationships with parents. While people born through assisted reproduction techniques (ART) appear to be well adjusted in childhood, it is unclear whether these findings carry into adolescence, and whether diverse ART have different psychological outcomes. This review summarizes what is known about the psychological adjustment and family relationships of the growing number of children born through ART who are reaching adolescence. METHODS: The Pubmed, Web of Knowledge, PsycINFO and Scopus databases were searched systematically for peer reviewed papers focusing on adolescent psychological adjustment and parent-adolescent relationships in families created by ART. Key search inclusion criteria included all papers published in English relating to adolescents aged between 11 and 18 years. RESULTS: Seventeen publications with varied methodologies were identified by this review. Only papers relating to in vitro fertilization (IVF), egg donation and donor insemination were identified. Results were categorized according to ART that used the parents' own gametes (IVF) and those that involved reproductive donation (egg donation, and donor insemination). Compared with naturally conceived adolescents and standardized normative samples, adolescents born through all ARTs seemed to be equally well adjusted, and to have positive parent-adolescent relationships. Some differences were however identified based on the type of ART used. In particular, the sex of the parent and child, along with age and process of disclosure of the adolescent's conception were identified as key mediators of parent-adolescent relationships in families created by donor insemination. CONCLUSIONS: The studies in this review indicate that children born through ART have positive parent-adolescent relationships and are well adjusted, with some slight differences based on different ART. The generalizability of findings may be limited by the general low level of disclosure to adolescents in some of the publications, the small sample sizes of studies in the field, along with the large age range that encompasses adolescence. Findings should also be interpreted in light of the fact that many publications focus on singleton births. Future studies should also focus on egg donation, surrogacy and embryo donation, as well as the disclosure processes, and adolescents born into non-traditional families (same-sex or single parents) or those born using different types of donor (anonymous, identity-release or known).Wellcome TrustThis is the author accepted manuscript. The final version is available from Oxford University Press via http://dx.doi.org/10.1093/humupd/dmu05

‘Making the child mine’: mothers’ thoughts and feelings about the mother-infant relationship in egg donation families

The number of families being created through fertility treatment with donor eggs is increasing yearly. Women who conceive in this way share a gestational, but not genetic, relationship with their child, yet there is limited understanding of how mothers experience the mother-child relationship during its formative period, infancy. This study explored heterosexual mothers’ thoughts and feelings about the mother-infant relationship in families created through egg donation. Qualitative interviews were conducted with a sample of 85 women who had conceived following egg donation treatment at UK fertility clinics. Mothers had at least one infant (6-18 months) and were living with the child’s father. Interview data were analysed according to the principles of thematic analysis. The results showed that egg donation mothers used a range of strategies across the transition to parenthood which enabled them to establish their identity as the child’s mother and facilitated the process of helping them feel that the baby was their own. This process was individual to each woman, with the absent genetic connection varying in significance between mothers. The strategies employed enabled most mothers to adjust successfully to parenthood and manage any ambivalence and uncertainties associated with non-genetic parenthood. Most mothers felt secure and confident in their position as the child’s mother by the end of the first year.his research was supported by a Wellcome Trust Senior Investigator Award [097857/Z/11/Z] and a CHESS-ESRC studentshi

Indian egg donors’ characteristics, motivations and feelings towards the recipient and resultant child

This is the first study to examine characteristics, motivations and experiences of Indian egg donors. In-depth interviews were conducted with 25 egg donors who had donated during the previous 8 months at a fertility clinic in Mumbai. The semi-structured interviews were conducted in Hindi and English. In addition to demographic information, data were collected on donors’ motivations for donating, with whom they had discussed donation, and feelings towards the recipients. The response rate was 66%. All participants were literate and had attended school. Twenty (80%) egg donors had children and five (20%) did not. The most common motivation (19, 76%) for donating was financial need. Egg donors had discussed their donation with their husband or with close family/friends, with almost all mentioning that wider society would disapprove. The majority (20, 80%) had no information about the recipients and 11 (44%) preferred not to. The findings highlight the similarities and differences between egg donors from India and those from other countries and that egg donors are of a more varied demographic background than surrogates in India. Given that India has been a popular destination for fertility treatment, the findings have important implications for regulation and practice within India and internationally

Parent psychological adjustment, donor conception and disclosure: a follow-up over 10 years.

STUDY QUESTION: What is the relationship between parent psychological adjustment, type of gamete donation (donor insemination, egg donation) and parents' disclosure of their use of donated gametes to their children. SUMMARY ANSWER: Disclosure of donor origins to the child was not always associated with optimal levels of psychological adjustment, especially for fathers in donor insemination families. WHAT IS KNOWN ALREADY: Cross-sectional analyses have found mothers and fathers who conceived a child using donated sperm or eggs to be psychologically well-adjusted, with few differences emerging between parents in gamete donation families and parents in families in which parents conceived naturally. The relationship between mothers' and fathers' psychological well-being, type of gamete donation (donor insemination, egg donation) and parents' disclosure decisions has not yet been examined. STUDY DESIGN, SIZE, DURATION: In this follow-up study, data were obtained from mothers and fathers in donor insemination and egg donation families at 5 time points; when the children in the families were aged 1, 2, 3, 7 and 10. In the first phase of the study, 50 donor insemination families and 51 egg donation families with a 1-year-old child participated. By age 10, the study included 34 families with a child conceived by donor insemination and 30 families with a child conceived by egg donation, representing 68 and 58% of the original sample, respectively. PARTICIPANTS/MATERIALS, SETTING, METHODS: Families were recruited through nine fertility clinics in the UK. Standardized questionnaires assessing depression, stress and anxiety were administered to mothers and fathers in donor insemination and egg donation families. MAIN RESULTS AND THE ROLE OF CHANCE: Mothers and fathers in both donor insemination and egg donation families were found to be psychologically well-adjusted; for the vast majority of parents' levels of depression, anxiety and parenting stress were found to be within the normal range at all 5 time points. Disclosure of the child's donor origins to the child was not always associated with optimal levels of parental psychological adjustment. For example, disclosure was associated with lower levels of psychological well-being for certain groups in particular (such as fathers in donor insemination families), at certain times (when children are in middle childhood and have a more sophisticated understanding of their donor origins). LIMITATIONS, REASONS FOR CAUTION: Owing to small sample sizes, the value of this study lies not in its generalizability, but in its potential to point future research in new directions. WIDER IMPLICATIONS OF THE FINDINGS: Donor insemination and egg donation families are a heterogeneous group, and future research should endeavour to obtain data from fathers as well as mothers. Support and guidance in terms of disclosure and family functioning might be most beneficial for parents (and especially fathers) in donor insemination families, particularly as the child grows older. The more that is known about the process of disclosure over time, from the perspective of the different members of the family, the better supported parents and their children can be.The first three phases of this study were supported by funding from the Wellcome Trust. The final two phases of this study were supported by grant number RO1HD051621 from the National Institute of Child Health and Human Developmen