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Talbot C, Hodson N, Rose J, Bewley S. Comparing the psychological outcomes of donor and non-donor conceived people: A systematic review. BJOG 2024. [PMID: 38936405 DOI: 10.1111/1471-0528.17892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 03/26/2024] [Accepted: 05/29/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Over 70 000 donor-conceived (DC) people have been born in the UK since 1991. Little is known about their long-term psychological outcomes and no systematic review has assessed these. OBJECTIVES To conduct a systematic review of the psychological experiences of DC people through childhood and adulthood (Prospero: CRD42021257863). SEARCH STRATEGY Searches of Cumulative Index to Nursing and Allied Health Literature (CINHAL), the Excerpta Medica database (Embase), MEDLINE® and PsycINFO, conducted on 4 January 2024. SELECTION CRITERIA Quantitative and qualitative studies were included if: there were five or more participants; they were peer reviewed; and any DC psychological outcomes were assessed. No limits on date, language or country were applied. DATA COLLECTION AND ANALYSIS Double screening, selection, data extraction and quality assessment were performed, using Joanna Briggs Institute (JBI) scoring. MAIN RESULTS Fifty studies (with 4666 DC participants), mostly from high-income anglophone countries, with heterogeneity of design, populations and outcome measures, were included. Of 19 comparative studies, 14 found no difference in outcomes between DC and non-DC people, ten found better outcomes (in health, well-being, self-esteem and emotional warmth) and six found worse outcomes (increased autism spectrum disorder and attention deficit hyperactivity disorder, addiction issues, mental illness, disruptive behaviour and identity problems). Qualitative data revealed common themes relating to identity formation, mistrust and concerns regarding genetic heritage. The evidence regarding adulthood outcomes was very limited. CONCLUSIONS The research on DC individuals presents a nuanced picture, with most studies suggesting comparable or improved outcomes in terms of well-being and relationships, but with a notable minority indicating higher rates of mental health and identity struggles. Qualitative findings underscore common negative experiences, whereas the early disclosure of DC status appears beneficial for psychological well-being.
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Affiliation(s)
| | - Nathan Hodson
- Division of Mental Health and Wellbeing, Warwick Medical School, Coventry, UK
| | - Joanne Rose
- Centre for Paediatrics and Child Health & Department of Infectious Disease, Imperial College London, London, UK
| | - Susan Bewley
- Department of Women and Children's Health, King's College London, London, UK
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2
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Simana S, Ravitsky V, Cohen IG. The misplaced embryo: legal parenthood in 'embryo mix-up' cases. JOURNAL OF MEDICAL ETHICS 2023:jme-2023-109401. [PMID: 38050118 DOI: 10.1136/jme-2023-109401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/24/2023] [Indexed: 12/06/2023]
Abstract
Recently in Israel, a woman was mistakenly implanted with an embryo that is genetically related to another couple. Unfortunately, this case is not an isolated occurrence, as other cases of embryo mix-ups have been reported in several countries, including the USA, China, the UK and various other countries within the European Union. Cases of mixed-up embryos are ethically and legally complex: the woman who carried the pregnancy and the woman who is genetically related to the resulting child-both of whom endured emotionally and physically demanding infertility treatments-along with their partners, may be unwilling to relinquish parental rights over the child.This article explores four possible approaches, found in numerous common law jurisdictions, which can be used to address cases involving embryo mix-ups. Our analysis reveals several avenues through which legal parentage can be established. It can be done through gestation and the marital presumption, genetic connections, by adhering to the principle of the best interests of the child, or by recognising multiple individuals as legal parents. We review the advantages and disadvantages of each approach, but we have one clear recommendation: resolving embryo mix-up cases should be done proactively through the establishment of legislation and guidelines, rather than relying on post hoc individual court decisions. Such legislation and guidelines should guarantee the consistency of values throughout diverse reproductive contexts and mandate that fertility clinics and medical professionals provide individuals with comprehensive information regarding the potential risks associated with assisted reproductive treatments.
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Affiliation(s)
- Shelly Simana
- Stanford Law School, Stanford University, Stanford, California, USA
| | | | - I Glenn Cohen
- Harvard Law School, Harvard University, Cambridge, Massachusetts, USA
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3
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Ben-Kimhy R, Taubman–Ben-Ari O. Perceptions of Fertility Physicians Treating Women Undergoing IVF Using an Egg Donation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127159. [PMID: 35742403 PMCID: PMC9222713 DOI: 10.3390/ijerph19127159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 02/04/2023]
Abstract
In the course of their work, medical teams are routinely exposed to difficult and stressful situations. The few studies in the literature that have examined physicians’ perceptions and responses to such situations have focused primarily on the fields of emergency medicine and chronic and terminal illness. However, the field of fertility medicine can also evoke complex feelings among physicians. The present qualitative study examined the perceptions of fertility physicians treating women undergoing egg donation. Semi-structured in-depth interviews were conducted with 20 fertility physicians, and a categorical analysis was performed. The main category to emerge was the physicians’ perception of egg donation and its implications. Two prominent themes were identified within this category: doctor–patient communication surrounding egg donation and how the idea was presented to the patient; and doctors’ perception of the implications of egg donation, including maternal identity, the relationship between mother and infant, and the mother’s sense of the child’s identity. This is the first study to consider the response to fertility treatments, a contemporary and sensitive topic, from the perspective of the physicians. The findings can contribute to physicians’ understanding of themselves and can help to devise ways to assist them in managing their emotional responses to their work for the benefit of both themselves and their patients.
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Affiliation(s)
- Reut Ben-Kimhy
- IVF Unit, Department of Obstetrics & Gynecology, Meir Medical Center, Kfar Saba 4428164, Israel;
- The Gender Studies Program, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Orit Taubman–Ben-Ari
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan 5290002, Israel
- Correspondence:
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Imrie S, Lysons J, Jadva V, Shaw K, Grimmel J, Golombok S. Parent-child relationship quality and child psychological adjustment in families created using egg donation: children's perspectives at age 5 years. Hum Reprod 2022; 37:499-509. [PMID: 34928301 PMCID: PMC8888989 DOI: 10.1093/humrep/deab265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 11/08/2021] [Indexed: 11/19/2022] Open
Abstract
STUDY QUESTION What are children's perspectives of the quality of their relationships with their parents and their own psychological well-being in families created using egg donation? SUMMARY ANSWER Children's scores indicated good parent-child relationship quality and high levels of psychological well-being, with children in families created using egg donation rating their relationships with their mothers as higher in warmth/enjoyment than children in a comparison group of families created using IVF. WHAT IS KNOWN ALREADY Little is known about how children in families created through egg donation view their family relationships and their own psychological well-being. Research with 7-and-10-year-olds in anonymous egg donation families has indicated good parent-child relationship quality from children's perspectives, but studies have not involved younger children or those conceived following identity-release egg donation. STUDY DESIGN, SIZE, DURATION This study included 50 children who had been born through egg donation and a comparison group of 43 children conceived through IVF with the parents' own gametes. Data were collected between April 2018 and December 2019. The sample forms part of a larger longitudinal study examining family functioning in families created through fertility treatment. PARTICIPANTS/MATERIALS, SETTING, METHODS Children were aged 5 years old and had been born into families with different-sex couple parents. All families were visited at home. Children were administered the Berkeley Puppet Interview, a standardized assessment of parent-child relationship quality and psychological well-being. MAIN RESULTS AND THE ROLE OF CHANCE Children in egg donation families rated their relationships with their mothers as higher in warmth and enjoyment than did children in IVF families. No differences were found between the two family types in children's ratings of the father-child relationship, or in children's ratings of their own psychological well-being. LIMITATIONS, REASONS FOR CAUTION It is possible that children who did not consent to take part in the research had less positive perceptions of their family and themselves than children who participated. WIDER IMPLICATIONS OF THE FINDINGS The findings are relevant to UK clinics offering identity-release egg donation, to parents who have used egg donation to create their family and to individuals and couples considering their fertility treatment options. That children in egg donation families were more similar than different to children in IVF families in their self-concept and perception of their family relationships should prove reassuring. STUDY FUNDING/COMPETING INTEREST(S) This research was supported by a Wellcome Trust Collaborative Award [208013/Z/17]. 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, Cambridge, UK
| | - J Lysons
- Centre for Family Research, University of Cambridge, Cambridge, UK
| | - V Jadva
- Institute for Women’s Health, UCL, London, UK
| | - K Shaw
- Centre for Family Research, University of Cambridge, Cambridge, UK
| | - J Grimmel
- Centre for Family Research, University of Cambridge, Cambridge, UK
| | - S Golombok
- Centre for Family Research, University of Cambridge, Cambridge, UK
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Cabar FR, de Oliveira MA, Machado ANC. Critical Analysis of The Changes in CFM Resolution 2294/21 And Its Impacts on Assisted Human Reproduction. JBRA Assist Reprod 2022; 26:659-665. [PMID: 35416023 PMCID: PMC9635607 DOI: 10.5935/1518-0557.20220007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The Brazilian Federal Board of Medicine (CFM) issued resolution number 2294/21, which regulates human reproduction procedures in Brazil, bringing significant changes to clinical practice in assisted human reproduction, and it raised ethical, bioethical, and legal discussions between professionals and patients. This study aims to analyze these changes in different aspects, especially because some of them are controversial. Evidence-based knowledge resources were used to support the analyses of crucial points that were impacted by this change. A literature review was carried out to obtain information about guidelines and laws, as well as articles that contemplate ethical discussions on assisted reproduction. The search sites used were BVS, Pub Med, LILACS and Google Scholar. The keywords used were law, legislation, bioethics, reference guide and assisted human reproduction. Relevant official documents from the Brazilian State were also found and included in the survey. The new resolution regarding the use of assisted reproduction techniques brought important changes, with clinical implications for couples who wish to become pregnant, and there is a need for a broad discussion concerning these repercussions from clinical, ethical, bioethical, and legal points of view.
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Affiliation(s)
- Fabio Roberto Cabar
- Faculdade de Medicina da Universidade de São Paulo -
Departamento de Obstetrícia e Ginecologia. São Paulo, SP, Brazil ,Corresponding Author: Fábio Roberto Cabar,
Secretaria da Divisão de Clínica Obstétrica, University of
Sao Paulo School of Medicine, São Paulo, SP, Brazil,
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6
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Golombok S. Love and Truth: What Really Matters for Children Born Through Third‐Party Assisted Reproduction. CHILD DEVELOPMENT PERSPECTIVES 2021. [DOI: 10.1111/cdep.12406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Golombok S. The psychological wellbeing of ART children: what have we learned from 40 years of research? Reprod Biomed Online 2020; 41:743-746. [PMID: 32891518 DOI: 10.1016/j.rbmo.2020.08.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 08/08/2020] [Indexed: 01/21/2023]
Abstract
Our understanding of what makes a family has changed dramatically in recent decades due to advances in reproductive technologies accompanied by changing social attitudes. But what has the impact been on children? This article presents a summary of research on parent-child relationships and the psychological adjustment of children in families created by assisted reproduction. The findings show that families with lesbian mothers, gay fathers, and single mothers by choice, and families created by donor conception and surrogacy, are just as likely to flourish as traditional families, and sometimes more so, although the children from these families will sometimes face prejudiced attitudes from others. It is concluded that the quality of family relationships and the wider social environment matter more for children's psychological wellbeing than the number, gender, sexual orientation, or biological relatedness of their parents.
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Affiliation(s)
- Susan Golombok
- Centre for Family Research, University of Cambridge, Free School Lane, Cambridge CB2 3RQ, UK.
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8
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Imrie S, Jadva V, Golombok S. "Making the child mine": Mothers' thoughts and feelings about the mother-infant relationship in egg donation families. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2020; 34:469-479. [PMID: 31944802 PMCID: PMC7192012 DOI: 10.1037/fam0000619] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 10/31/2019] [Accepted: 11/01/2019] [Indexed: 06/10/2023]
Abstract
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 U.K. fertility clinics. Mothers had at least 1 infant (6-18 months) and were living with the child's father. Interview data were analyzed according to the principles of thematic analysis. The results showed that egg donation mothers used a range of strategies across the transition to parenthood that 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 nongenetic parenthood. Most mothers felt secure and confident in their position as the child's mother by the end of the first year. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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9
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Jadva V. Postdelivery adjustment of gestational carriers, intended parents, and their children. Fertil Steril 2020; 113:903-907. [PMID: 32312560 DOI: 10.1016/j.fertnstert.2020.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 03/09/2020] [Indexed: 12/01/2022]
Abstract
Surrogacy raises a number of concerns about the psychological adjustment of the surrogate, the parents, and the child. Despite surrogacy becoming more common, research into the postdelivery psychological adjustment of the individuals involved has lagged far behind. This review examines research on the psychological adjustment of surrogates and their children. It then presents findings from studies assessing parents' psychological health and parent-child relationships, and children's adjustment within families formed through surrogacy. Finally, it examines how children born through surrogacy feel about their birth and toward their surrogate. Overall, studies have shown good psychological outcomes for surrogates, parents, and children, but research is still very limited, particularly in relation to the geographical location of the research, the ages of the children studied, and the lack of longitudinal projects. Different forms of surrogacy now exist under the umbrella term of "surrogacy." There is now greater diversity in terms of who is using surrogacy, their motivations for using it, whose gametes are used for the pregnancy, and how a surrogacy arrangement is managed. There is therefore a need for future studies to examine the consequences of these different forms of surrogacy on the postdelivery psychological health of surrogates, surrogacy parents, and their children.
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Affiliation(s)
- Vasanti Jadva
- Centre for Family Research, University of Cambridge, Cambridge, United Kingdom.
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10
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Flatscher-Thöni M, Böttcher B, Geser W, Lampe A, Werner-Felmayer G, Voithofer C, Schusterschitz C. Worlds apart or two sides of the same coin? Attitudes, meanings, and motives of potential oocyte and sperm donors in Austria. J Assist Reprod Genet 2020; 37:287-296. [PMID: 31916077 PMCID: PMC7056682 DOI: 10.1007/s10815-019-01683-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 12/27/2019] [Indexed: 11/29/2022] Open
Abstract
Purpose Gamete donors and recipients of such donations have been explored by previous studies, which mostly focus on post-donation scenarios. Our study analyses the general willingness to donate oocytes or sperm and focuses on differences between potential female and male donors in attitudes, meanings, and motives in a pre-donation setting. Methods An electronic survey (n = 555 students) was used in this anonymous observational study. To enable comparisons between men and women regarding their attitudes, meanings, and motives and their willingness to donate gametes, we designed two separate questionnaires. Results The sample was divided into three groups based on the willingness to donate: potential donors (n = 133; women: 48.1%, men: 51.9%); doubtful donors (n = 207; women: 75.8%, men: 24.2%); and non-donors (n = 215; women: 68.3%, men: 31.7%). The group of potential male donors (39.2%) was significantly larger than the group of potential female donors (16.9%). Significant differences regarding altruism, the meaning of one’s self-worth, and passing on the own genes were found between doubtful and potential donors. Potential donors attached less value to altruism but more value to the enhancement of one’s self-worth and passing on one’s genes than doubtful donors. The motive of passing on one’s genes and altruistic motives were more important to men than to women. Conclusion This study helps to create a better understanding of potential donors in the existing donation framework and supports the evaluation of the given regimes in the context of designing an improved framework.
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Affiliation(s)
- M Flatscher-Thöni
- Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, 6060, Hall in Tyrol, Austria
| | - B Böttcher
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
| | - W Geser
- Institute of Psychology, University of Innsbruck, 6020, Innsbruck, Austria
| | - A Lampe
- University Clinic of Medical Psychology, Medical University of Innsbruck, 6020, Innsbruck, Austria
| | - G Werner-Felmayer
- Division of Biological Chemistry, Biocentre, Medical University of Innsbruck, bioethics network education, 6020, Innsbruck, Austria
| | - C Voithofer
- Department of Civil Law, University of Innsbruck, 6020, Innsbruck, Austria
| | - C Schusterschitz
- Department of Psychology and Medical Sciences, UMIT - University for Health Sciences, Medical Informatics and Technology, 6060, Hall in Tyrol, Austria
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Tsui EYL, Cheng JOY. The living experience of losing genetic continuity: Concealment tendency in Chinese recipients of donor-assisted conception. J Health Psychol 2019; 26:525-542. [PMID: 30618294 DOI: 10.1177/1359105318820667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study explored how Chinese women with donor-assisted conception experienced loss of genetic continuity and managed donor-assisted conception-related information. Through Interpretative Phenomenological Analysis, a thematic framework on women's beliefs, motivation, and behaviors in information management was constructed. Contrary to the Western trend toward disclosure, it was found that Chinese women strongly preferred to conceal, in order to protect their family members, the parent-child relationship, and family stability. Participants' strong preference was also indicated in specific behaviors that ensure information concealment. The findings of this study may contribute toward the development of culturally sensitive clinical guidelines for counseling practice that supports infertile couples' decision-making.
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12
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Canzi E, Accordini M, Facchin F. 'Is blood thicker than water?' Donor conceived offspring's subjective experiences of the donor: a systematic narrative review. Reprod Biomed Online 2019; 38:797-807. [PMID: 30904355 DOI: 10.1016/j.rbmo.2018.11.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 11/14/2018] [Accepted: 11/27/2018] [Indexed: 12/21/2022]
Abstract
The aim of this study was to provide a systematic narrative review of the published research articles on donor conceived offspring's subjective experiences of their donor. A systematic search of electronic databases (PsycINFO and PubMed) provided 29 published quantitative and qualitative studies matching the inclusion criteria. The analysis of the studies outcomes led to the identification of four main themes: (i) views/representations of the donor; (ii) desire to contact the donor (in terms of desire to meet the donor, reasons for wanting to contact the donor, type and frequency of contact); (iii) reactions to discovering the donor's identity and contacting the donor; (iv) identity issues. The findings revealed that genetic ties do matter to donor conceived people, especially during adolescence or adulthood. Many donor conceived people were interested in contacting the donor and all of them needed to make meaning of the role of the donor, as well as to integrate it into their family life and self-concept. Besides curiosity and medical reasons, many people reported wanting to contact the donor to see what he/she looked like, and to have access to their own ancestry and genetic history.
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Affiliation(s)
- Elena Canzi
- Family Studies and Research University Centre, Catholic University of Milan, Milan, Italy.
| | - Monica Accordini
- Family Studies and Research University Centre, Catholic University of Milan, Milan, Italy
| | - Federica Facchin
- Department of Psychology, Family Studies and Research University Centre, Catholic University of Milan, Milan, Italy
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13
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Jans V, Dondorp W, Goossens E, Mertes H, Pennings G, de Wert G. Balancing animal welfare and assisted reproduction: ethics of preclinical animal research for testing new reproductive technologies. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2018; 21:537-545. [PMID: 29417302 PMCID: PMC6267242 DOI: 10.1007/s11019-018-9827-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In the field of medically assisted reproduction (MAR), there is a growing emphasis on the importance of introducing new assisted reproductive technologies (ARTs) only after thorough preclinical safety research, including the use of animal models. At the same time, there is international support for the three R's (replace, reduce, refine), and the European Union even aims at the full replacement of animals for research. The apparent tension between these two trends underlines the urgency of an explicit justification of the use of animals for the development and preclinical testing of new ARTs. Considering that the use of animals remains necessary for specific forms of ART research and taking account of different views on the moral importance of helping people to have a genetically related child, we argue that, in principle, the importance of safety research as part of responsible innovation outweighs the limited infringement of animal wellbeing involved in ART research.
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Affiliation(s)
- Verna Jans
- Department of Health, Ethics and Society and Research School GROW for Oncology & Developmental Biology, Maastricht University, Maastricht, The Netherlands.
| | - Wybo Dondorp
- Department of Health, Ethics and Society and Research School GROW for Oncology & Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Ellen Goossens
- Department of Biology of the Testis (BITE), Vrije Universiteit Brussel, Brussels, Belgium
| | - Heidi Mertes
- Bioethics Institute Ghent (BIG), Department of Philosophy and Moral Sciences, Ghent University, Ghent, Belgium
| | - Guido Pennings
- Bioethics Institute Ghent (BIG), Department of Philosophy and Moral Sciences, Ghent University, Ghent, Belgium
| | - Guido de Wert
- Department of Health, Ethics and Society and Research School GROW for Oncology & Developmental Biology, Maastricht University, Maastricht, The Netherlands
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14
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Long-term outcomes of children conceived through egg donation and their parents: a review of the literature. Fertil Steril 2018; 110:1187-1193. [DOI: 10.1016/j.fertnstert.2018.08.040] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 08/09/2018] [Accepted: 08/13/2018] [Indexed: 02/06/2023]
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15
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Imrie S, Jadva V, Fishel S, Golombok S. Families Created by Egg Donation: Parent-Child Relationship Quality in Infancy. Child Dev 2018; 90:1333-1349. [PMID: 30015989 PMCID: PMC6640047 DOI: 10.1111/cdev.13124] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Increasing numbers of children are being born through egg donation and thus do not share a genetic relationship with their mother. Parent–infant relationship quality was examined in 85 egg donation families and a comparison group of 65 in vitro fertilization families (infant M = 11 months). Standardized interview and observational measures were used to assess mother–infant and father–infant relationship quality at the representational and behavioral levels. Few differences were found between family types in parents’ representations of the parent–infant relationship. Differences were found between family types in the observational assessment of mother–infant relationship quality, indicating less optimal interactions in egg donation families. Findings suggest that egg donation families function well in infancy overall, but there may be subtle yet meaningful differences in mother–infant interaction quality.
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Kalampalikis N, Doumergue M, Zadeh S. Sperm donor regulation and disclosure intentions: Results from a nationwide multi-centre study in France. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2018; 5:38-45. [PMID: 29774274 PMCID: PMC5952651 DOI: 10.1016/j.rbms.2018.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 11/30/2017] [Accepted: 02/12/2018] [Indexed: 05/11/2023]
Abstract
Gamete donation in Europe is not regulated by a common legal framework. Different laws regarding donor anonymity and remuneration exist in different countries. In France, gamete donation is characterized by a stable legal framework - the existing system of anonymous and non-remunerated donation remained unchanged following a period of public and parliamentary debate in 2011 - but little evidence is available concerning recipients' views and experiences of gamete donation. This article describes findings from a questionnaire completed individually by 714 heterosexual couple members undergoing a donor conception procedure at one of 20 national fertility centres in France. Participants were invited to report their attitudes towards the French legal framework, their perceptions of the anonymous donor, and their intentions to disclose donor conception to their child and to other people. The majority of respondents (93%) approved of the current legal framework. Participants indicated that they thought about the sperm donor in ways that emphasized his act of donation without describing him as a specific individual. A majority (71%) also stated that they intended to tell their child about their donor conception. Given that this is the largest nationwide study of French recipients of donor sperm, the findings make an important contribution to the research evidence currently available about prospective parents' perspectives in the increasingly uncommon context of donor anonymity in Europe.
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Ventura R, Rodríguez-Polo XR, Roca-Cuberes C. "Wealthy Gay Couples Buying Babies Produced in India by Poor Womb-Women: Audience Interpretations of Transnational Surrogacy in TV News. JOURNAL OF HOMOSEXUALITY 2018; 66:609-634. [PMID: 29297767 DOI: 10.1080/00918369.2017.1422947] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Surrogacy is beginning to generate public debate, and the way the media approach it may have negative effects on social attitudes toward gay parenting. The news media play a key role in informing society, especially about topics such as surrogacy, of which most audiences have no direct experience. The aim of our research is to explore opinion formation of surrogacy and gay parenting by analyzing the audience interpretation of a TV news story in Spain. To do this we conducted four focus groups that were analyzed using a qualitative content analysis based on the discourse produced by the participants. The results show that the framing strategies used in the news story contribute to advocating an attitude of repudiation toward surrogacy, with an adverse sentiment also extending to homosexual couples who wish to become parents. This leads us to discuss the role of media in shaping public opinion and the resulting potential consequences in the case of surrogacy and gay parenting.
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Affiliation(s)
- Rafael Ventura
- a Department of Communication , Universitat Pompeu Fabra , Barcelona , Spain
| | | | - Carles Roca-Cuberes
- a Department of Communication , Universitat Pompeu Fabra , Barcelona , Spain
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Patel NH, Jadeja YD, Bhadarka HK, Patel MN, Patel NH, Sodagar NR. Insight into Different Aspects of Surrogacy Practices. J Hum Reprod Sci 2018; 11:212-218. [PMID: 30568349 PMCID: PMC6262674 DOI: 10.4103/jhrs.jhrs_138_17] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Surrogacy is an important method of assisted reproductive technology wherein a woman carries pregnancy for another couple. Number of couples around the world require surrogacy services for various reasons. Although this arrangement seems to be beneficial for all parties concerned, there are complex social, ethical, moral, and legal issues associated with it. It is these complexities that have made this practice unpopular in many parts of the world. Surrogacy in India has had its own journey from India becoming popular as a surrogacy center since 2002 to the Surrogacy (Regulation) Bill, 2016, which would restrict the option of surrogacy for many. Surrogacy is an important medical service for all those couples who would otherwise not have been able to produce a child. Surrogacy would be practiced harmoniously if delicate issues associated with surrogacy will be addressed properly through appropriately framed laws which would protect the rights of surrogate mothers, intended parents, and child born through surrogacy.
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Affiliation(s)
- Nayana Hitesh Patel
- Department of Reproductive Medicine, Akanksha Hospital and Research Institute, A Unit of Sat Kaival Hospital Pvt. Ltd., Lambhvel, Anand, Gujarat, India
| | - Yuvraj Digvijaysingh Jadeja
- Department of Reproductive Medicine, Akanksha Hospital and Research Institute, A Unit of Sat Kaival Hospital Pvt. Ltd., Lambhvel, Anand, Gujarat, India
| | - Harsha Karsan Bhadarka
- Department of Reproductive Medicine, Akanksha Hospital and Research Institute, A Unit of Sat Kaival Hospital Pvt. Ltd., Lambhvel, Anand, Gujarat, India
| | - Molina Niket Patel
- Department of Reproductive Medicine, Akanksha Hospital and Research Institute, A Unit of Sat Kaival Hospital Pvt. Ltd., Lambhvel, Anand, Gujarat, India
| | - Niket Hitesh Patel
- Department of Reproductive Medicine, Akanksha Hospital and Research Institute, A Unit of Sat Kaival Hospital Pvt. Ltd., Lambhvel, Anand, Gujarat, India
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Abstract
Azoospermia, the absence of any sperm cells from the ejaculated semen, poses a real challenge to the fertility urologist. While there are options to create happy families for azoospermic couples, such as the use of donor sperm and adoption, most couples still want to have genetically related offspring. Advances in urology, gynecology, and fertility laboratory technologies allow surgical sperm retrieval in azoospermic men and achievement of live births for many, but not all azoospermic couples. At present, there are extensive research efforts in several directions to create new fertility options by creating "artificial sperm cells." While these new horizons are exciting, there are significant obstacles that must be overcome before such innovative solutions can be offered to azoospermic couples. The present review article defines the problem, describes the theoretical basis for creation of artificial genetically related sperm cells, and provides an update on current successes and challenges in the long tortuous path to achieve the ultimate goal: enabling every azoospermic couple to have their own genetically related offspring. Hopefully, these research efforts will ripen in the foreseeable future, resulting in the ability to create artificial sperm cells and provide such couples with off-the-shelf solutions and fulfilling their desire to parent genetically related healthy babies.
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Affiliation(s)
| | - Raanan Tal
- Neuro-Urology Unit, Rambam Health Care Campus, Haifa, Israel
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Krastev R, Mitev V. Altruistic Surrogacy – Ethical Issues and Demographic Differences in Public Opinion. ACTA MEDICA BULGARICA 2017. [DOI: 10.1515/amb-2017-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
This is the first study of the attitude of Bulgarian people towards the allowing of altruistic surrogacy which is prohibited in Bulgaria. This study used an online survey which was active during one year (July 2010-June 2011) and which was answered by 951 respondents between 18-65 years of age. The majority of them (87%) are young people between 18-43 years. The respondents are men and women with secondary, university and medical university education from the capital and the countryside. They have different marital status. The data were treated with statistical package SPSS 16. The link between the demographic characteristics (gender, age, education, marital status and place of residence) and the answers of the respondents was identified. The majority of the respondents (73%) think that the altruistic surrogacy must be allowed in Bulgaria and the main supporters are the women and the residents in the countryside – married or living with partner. Only 38% of the respondents mostly divorced middle aged persons accept the access of same sex couples to surrogacy. The majority of the respondents (53%) fear that the surrogacy may transform poor women into incubators for babies. This opinion is shared by the men, by the youngest and the oldest respondents and by the unmarried persons.
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Affiliation(s)
- R. Krastev
- Department of Medical Chemistry and Biochemistry , Medical University – Sofia , Bulgaria
| | - V. Mitev
- Department of Medical Chemistry and Biochemistry , Medical University – Sofia , Bulgaria
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21
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Rausch MA, Wikoff HD. Addressing Concerns with Lesbian Couples Experiencing Fertility Treatment: Using Relational Cultural Theory. JOURNAL OF LGBTQ ISSUES IN COUNSELING 2017. [DOI: 10.1080/15538605.2017.1346494] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Meredith A. Rausch
- Department of Advanced Studies and Innovation, Augusta University, Augusta, Georgia, USA
| | - Haley D. Wikoff
- Rehabilitation and Counselor Education Department, The University of Iowa, Iowa, USA
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Golombok S, Ilioi E, Blake L, Roman G, Jadva V. A longitudinal study of families formed through reproductive donation: Parent-adolescent relationships and adolescent adjustment at age 14. Dev Psychol 2017; 53:1966-1977. [PMID: 28758779 PMCID: PMC5611761 DOI: 10.1037/dev0000372] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of the 6th phase of this longitudinal study was to establish whether children born through assisted reproduction involving reproductive donation were at risk for psychological problems following the transition to adolescence at age 14 and, if so, to examine the nature of these problems and the mechanisms involved. Eighty-seven families formed through reproductive donation, including 32 donor insemination families, 27 egg donation families, and 28 surrogacy families, were compared with 54 natural conception families. Standardized interviews, questionnaires, and observational assessments of the quality of parent-adolescent relationships and adolescent adjustment were administered to mothers, adolescents, and teachers. The mothers in surrogacy families showed less negative parenting and reported greater acceptance of their adolescent children and fewer problems in family relationships as a whole compared with gamete donation mothers. In addition, less positive relationships were found between mothers and adolescents in egg donation families than in donor insemination families as rated by both mothers and adolescents. There were no differences between family types for the adolescents themselves in terms of adjustment problems, psychological well-being, and self-esteem. Longitudinal analyses showed no differences between family types in negative parenting from age 7 to age 14, and a weaker association between negative parenting and adjustment difficulties for gamete donation than natural conception and surrogacy families. The findings suggest that the absence of a genetic link between mothers and their children is associated with less positive mother-adolescent relationships whereas the absence of a gestational link does not have an adverse effect.
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Affiliation(s)
| | - Elena Ilioi
- Centre for Family Research, University of Cambridge
| | - Lucy Blake
- Centre for Family Research, University of Cambridge
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23
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Golombok S. Parenting in new family forms. Curr Opin Psychol 2017; 15:76-80. [DOI: 10.1016/j.copsyc.2017.02.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 02/10/2017] [Indexed: 11/24/2022]
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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; 96:968-975. [PMID: 28432827 PMCID: PMC5575676 DOI: 10.1111/aogs.13157] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION For many donor-conceiving heterosexual parents, the process of deciding whether and what to tell children about their genetic origin is challenging. We hypothesized that incomplete couple agreement about disclosure could be associated with parenting stress. The aim of the study was to investigate: (1) parenting stress levels among heterosexual parents of young children following gamete donation and (2) whether parenting stress is related to perceived agreement about disclosure of the donor conception to the children. MATERIAL AND METHODS This study is part of the longitudinal multicenter Swedish Study on Gamete Donation and included a total of 213 heterosexual parents with children aged 1-4 years following oocyte donation (n = 103) and sperm donation (n = 110). Parents individually completed a questionnaire that included validated instruments on parenting stress (SPSQ) and relationship quality (ENRICH), as well as a study-specific measure on disclosure agreement. Multiple regression analysis was applied. RESULTS Incomplete couple agreement on disclosure to the children was not statistically significantly associated with increased levels of parenting stress. Relationship satisfaction consistently and significantly accounted for variation in parenting stress levels, indicating that relationship satisfaction had a buffering impact on parenting stress. CONCLUSIONS Parental stress does not appear to be negatively influenced by incomplete couple agreement about disclosure to children. As children grow up, reaching agreement about what to tell the child about the donor conception might become more relevant for couples' stress related to parenthood.
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Affiliation(s)
- Anja J Gebhardt
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Stockholm, Sweden
| | - Gunilla Sydsjö
- Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | | | - Astrid Indekeu
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Stockholm, Sweden
| | - Claudia Lampic
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Stockholm, Sweden
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Golombok S, Blake L, Slutsky J, Raffanello E, Roman GD, Ehrhardt A. Parenting and the Adjustment of Children Born to Gay Fathers Through Surrogacy. Child Dev 2017; 89:1223-1233. [PMID: 28111745 PMCID: PMC6055684 DOI: 10.1111/cdev.12728] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Findings are presented on a study of 40 gay father families created through surrogacy and a comparison group of 55 lesbian mother families created through donor insemination with a child aged 3–9 years. Standardized interview, observational and questionnaire measures of stigmatization, quality of parent–child relationships, and children's adjustment were administered to parents, children, and teachers. Children in both family types showed high levels of adjustment with lower levels of children's internalizing problems reported by gay fathers. Irrespective of family type, children whose parents perceived greater stigmatization and children who experienced higher levels of negative parenting showed higher levels of parent‐reported externalizing problems. The findings contribute to theoretical understanding of the role of family structure and family processes in child adjustment.
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26
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Persaud S, Freeman T, Jadva V, Slutsky J, Kramer W, Steele M, Steele H, Golombok S. Adolescents Conceived through Donor Insemination in Mother-Headed Families: A Qualitative Study of Motivations and Experiences of Contacting and Meeting Same-donor Offspring. CHILDREN & SOCIETY 2017; 31:13-22. [PMID: 28042200 PMCID: PMC5157797 DOI: 10.1111/chso.12158] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/11/2016] [Indexed: 05/02/2023]
Abstract
This study interviewed adolescents conceived using sperm donation to examine their experiences of contacting and meeting 'same-donor offspring' (i.e. donor-conceived offspring raised in different families who share the same donor), their motivations for this contact, and how they make meaning of these relationships. This in-depth qualitative study involved semi-structured interviews with 23 young people aged 12-19 years (mean = 14 years). Interviewees were motivated by curiosity about their biological relations and by wanting to extend their family. Contact with same-donor offspring was described as being either normal/neutral or as a unique experience that was integrated into their identity. This study highlights the importance of contact between same donor offspring, particularly during adolescence, a developmental stage associated with identity formation. The findings have important policy implications as they suggest that donor-conceived individuals may benefit from contact with others conceived using the same donor prior to the age of 18 years.
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Affiliation(s)
- Sherina Persaud
- Center for Attachment ResearchDepartment of Clinical PsychologyThe New School for Social ResearchNew YorkNYUSA
| | - Tabitha Freeman
- Centre for Family ResearchDepartment of PsychologyUniversity of CambridgeCambridgeUK
| | - Vasanti Jadva
- Centre for Family ResearchDepartment of PsychologyUniversity of CambridgeCambridgeUK
| | - Jenna Slutsky
- Center for Attachment ResearchDepartment of Clinical PsychologyThe New School for Social ResearchNew YorkNYUSA
| | | | - Miriam Steele
- Center for Attachment ResearchDepartment of Clinical PsychologyThe New School for Social ResearchNew YorkNYUSA
| | - Howard Steele
- Center for Attachment ResearchDepartment of Clinical PsychologyThe New School for Social ResearchNew YorkNYUSA
| | - Susan Golombok
- Centre for Family ResearchDepartment of PsychologyUniversity of CambridgeCambridgeUK
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27
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Van Parys H, Provoost V, Wyverkens E, De Sutter P, Pennings G, Buysse A. Family Communication About the Donor Conception: A Multi-Perspective Qualitative Study With Lesbian Parents and Their Children. QUALITATIVE HEALTH RESEARCH 2016; 26:1998-2008. [PMID: 26386025 DOI: 10.1177/1049732315606684] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
In literature, disclosure of donor conception in lesbian families has been considered an obvious and straightforward event. However, little is known about the ways in which donor conception is discussed in planned lesbian co-mother families. This study focuses on the process of parent-child communication about the donor conception on a within-family level. Six families, including 7 children and 12 parents, were interviewed about their family communication with regard to donor conception. A dyadic interview analysis revealed that family members managed the space taken up by the topic of donor conception in their daily conversations. Within these conversations, they also took care of each other and of their family relationships. In addition, children had an active position in the co-construction of the donor conception narrative. Linking these findings to the concepts of relational management and functionality of donor conception narratives, this study informs practitioners in the field of medically assisted reproduction.
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Affiliation(s)
- H Van Parys
- Faculty of Psychology and Educational Sciences, Ghent University, Belgium
| | - V Provoost
- Bioethics Institute Ghent, Ghent University, Belgium
| | - E Wyverkens
- Faculty of Psychology and Educational Sciences, Ghent University, Belgium
| | - P De Sutter
- Department of Reproductive Medicine, Ghent University Hospital, Belgium
| | - G Pennings
- Bioethics Institute Ghent, Ghent University, Belgium
| | - A Buysse
- Faculty of Psychology and Educational Sciences, Ghent University, Belgium
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28
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Rizk M, Pawlak S. A case report of embryo donation: ethical and clinical implications for psychologists. JOURNAL OF MEDICAL ETHICS 2016; 42:659-664. [PMID: 27343285 DOI: 10.1136/medethics-2015-103304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 06/07/2016] [Indexed: 06/06/2023]
Abstract
Third-party reproduction is a growing field, and an increasing body of literature considers the ethics of embryo donation. Due to the psychosocial complexities that generally accompany the donation and/or use of donor embryos, psychologists can play a pivotal role in these specialised fertility cases. While laws in the USA are in place to regulate the medical procedures involved in embryo donation, only unenforceable guidelines exist for psychologists specialising in fertility cases. The presentation of this case study aims to: (1) clarify the ethical concerns that fertility psychologists should consider in similar situations by assessing whether American Society of Reproductive Medicine (ASRM) and the American Psychological Association (APA) guidelines compete or complement one another within this case of embryo donation and (2) consider the interests, obligations and rights of all parties involved. Several principles, standards and guidelines that must be considered are described. Overall, the APA Ethics Code and the ASRM Guidelines appear to complement one another for most aspects of this case. Fertility psychologists should consider the clinical implications of the interests, rights and duties of all involved parties, including themselves.
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Affiliation(s)
- Marianne Rizk
- Department of Psychology, University of Iowa, Iowa City, Iowa, USA
| | - Stacey Pawlak
- Department of Psychology, University of Iowa, Iowa City, Iowa, USA Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
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29
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Canneaux M, Kobilinsky N, Wolf JP, Golse B, Beauquier-Maccotta B. [Information, transmission, secrecy: What kind of discourse for children born by gamete donation?]. ACTA ACUST UNITED AC 2016; 44:410-6. [PMID: 27318771 DOI: 10.1016/j.gyobfe.2016.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 04/29/2016] [Indexed: 10/21/2022]
Abstract
The number of children born through gamete donation grows by the conceptions made abroad. All the couples engaging in this process do not benefit from of the same support around the issues raised by the information to the child and its terms. Through a literature review, the authors explore the data on information intentions from parents to child and to entourage, the influence of the issue of anonymity, the effective rate information, the influences of the age of the child, the terms information and links with family dynamics. The quantitative findings underscore the complexity of this task, since 10-90 % of couples report an intention to inform their child from conception through donation, while 5-30 % actually inform them after birth. Fifty-nine to 93 % of the relatives are nevertheless informed. The authors will highlight the psychopathological tracks that support the possibility of narration for parents: the internalization of their infertility, the representation of the gift, the development of rivalry towards donors, the secrecy and privacy. The objective of this article is to enable carers to accompany this reflection among future parents, a better listening of the issues raise by the couples allowing shoring their process.
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Affiliation(s)
- M Canneaux
- Institut de psychologie, 71, avenue Édouard-Vaillant, 92100 Boulogne-Billancourt, France
| | - N Kobilinsky
- Institut Édouard-Claparède, 5, rue du Général-Cordonnier, 92200 Neuilly-sur-Seine, France
| | - J P Wolf
- Inserm U1016, service d'histologie embryologie biologie de la reproduction, CECOS, hôpital Cochin, université Paris Descartes, AP-HP, 75014 Paris, France
| | - B Golse
- Service de pédopsychiatrie, hôpital Necker-Enfants-Malades, AP-HP, 75015 Paris, France
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Tallandini MA, Zanchettin L, Gronchi G, Morsan V. Parental disclosure of assisted reproductive technology (ART) conception to their children: a systematic and meta-analytic review. Hum Reprod 2016; 31:1275-87. [DOI: 10.1093/humrep/dew068] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 02/22/2016] [Indexed: 11/12/2022] Open
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Hertz R, Nelson MK. Acceptance and Disclosure: Comparing genetic symmetry and genetic asymmetry in heterosexual couples between egg recipients and embryo recipients. Facts Views Vis Obgyn 2016; 8:11-22. [PMID: 27822347 PMCID: PMC5096423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
This paper explores the attitudes and experiences of 203 women in heterosexual couples who conceived via donated eggs (145) or donated embryos (58) in the last 5 years. Online surveys were sent to former patients (from many different countries) of a private Spanish clinic. By comparing the women in heterosexual couples who relied on donated eggs with those who relied on donated embryos, we examined the meaning of the absence of a genetic tie to a child in the two different situations - that of "genetic symmetry" where neither parent has a genetic tie to that of "genetic asymmetry" where only the mother does not have a genetic tie. No existing study has yet shown whether women who rely on donated eggs and women who rely on donated embryos have similar or different attitudes towards issues surrounding the experience of non-genetic motherhood. Three issues are discussed: (1) attitudes toward the importance of genetic ties and genetic information from the donor before and after the birth of their children, (2) patterns of disclosure, and (3) the relationship between attitudes toward genetic information and disclosure decisions. This study showed that although the two groups of women have many of the same attitudes, including attitudes toward the importance of genes as determinants of outcomes for the child, egg recipients are more likely than embryo recipients to agree that the genetic origins are important to them and that their children have a right to know genetic information. We also found that those who conceived with donated eggs more frequently disclose the nature of their conception to their child than do those who conceived with donated embryos.
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Affiliation(s)
- R Hertz
- Wellesley College, 106 Central Street, Department of Sociology, Wellesley, MA 02481, USA
| | - MK Nelson
- Middlebury College, Department of Sociology and Anthropology, Middlebury, VT 05753, USA
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Bracewell-Milnes T, Saso S, Bora S, Ismail AM, Al-Memar M, Hamed AH, Abdalla H, Thum MY. Investigating psychosocial attitudes, motivations and experiences of oocyte donors, recipients and egg sharers: a systematic review. Hum Reprod Update 2016; 22:450-65. [DOI: 10.1093/humupd/dmw006] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 02/15/2016] [Indexed: 11/12/2022] Open
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Söderström-Anttila V, Wennerholm UB, Loft A, Pinborg A, Aittomäki K, Romundstad LB, Bergh C. Surrogacy: outcomes for surrogate mothers, children and the resulting families—a systematic review. Hum Reprod Update 2015; 22:260-76. [DOI: 10.1093/humupd/dmv046] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 09/21/2015] [Indexed: 11/13/2022] Open
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34
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Effects and outcomes of third-party reproduction: parents. Fertil Steril 2015; 104:520-4. [DOI: 10.1016/j.fertnstert.2015.07.1128] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 07/03/2015] [Accepted: 07/09/2015] [Indexed: 11/20/2022]
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35
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Millbank J. Rethinking "Commercial" Surrogacy in Australia. JOURNAL OF BIOETHICAL INQUIRY 2015; 12:477-490. [PMID: 25015592 DOI: 10.1007/s11673-014-9557-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2013] [Accepted: 12/05/2013] [Indexed: 06/03/2023]
Abstract
This article proposes reconsideration of laws prohibiting paid surrogacy in Australia in light of increasing transnational commercial surrogacy. The social science evidence base concerning domestic surrogacy in developed economies demonstrates that payment alone cannot be used to differentiate "good" surrogacy arrangements from "bad" ones. Compensated domestic surrogacy and the introduction of professional intermediaries and mechanisms such as advertising are proposed as a feasible harm-minimisation approach. I contend that Australia can learn from commercial surrogacy practices elsewhere, without replicating them.
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Freeman T. Gamete donation, information sharing and the best interests of the child: an overview of the psychosocial evidence. Monash Bioeth Rev 2015; 33:45-63. [PMID: 25743051 PMCID: PMC4900443 DOI: 10.1007/s40592-015-0018-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This paper overviews key empirical findings from social science research regarding the impact of gamete donation on child wellbeing. In particular, the paper addresses current regulatory debates concerning information sharing and the best interests of the child by considering psychosocial aspects of telling--or not telling--children about their donor conception and the identity of their donor. The paper identifies three core sets of empirical, ethical and policy concerns underpinning these debates relating to (i) the psychosocial impact of gamete donation per se on child wellbeing, (ii) the psychosocial impact of parental disclosure decisions on child wellbeing, and (iii) the psychosocial implications of donor identification for donor-conceived offspring. The paper illustrates how these concerns are framed by ideas about the significance-or not-of 'genetic relatedness'; ideas which have come to the fore in contemporary discussions about the potential consequences of donor-conceived individuals gaining access to their donor's identity. By drawing together research findings that may be pertinent to the regulation of gamete donation and information sharing, a further aim of this paper is to explore the potential use and misuse of empirical 'evidence' in ethical and policy debates. Whilst this paper starts from the premise that psychosocial data has a vital role in grounding normative discussions, it seeks to contribute to this dialogue by highlighting both the value and limitations of social science research. In particular, the paper argues for a cautious approach to applying psychosocial evidence to ethical issues that is sensitive to the caveats and nuances of research findings and the changing cultural and regulatory context.
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Affiliation(s)
- Tabitha Freeman
- Centre for Family Research, Free School Lane, University of Cambridge, Cambridge, CB2 3RF, UK,
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37
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Hendriks S, Dancet EA, van Pelt AM, Hamer G, Repping S. Artificial gametes: a systematic review of biological progress towards clinical application. Hum Reprod Update 2015; 21:285-96. [DOI: 10.1093/humupd/dmv001] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 12/29/2014] [Indexed: 01/15/2023] Open
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Hendriks S, Dondorp W, de Wert G, Hamer G, Repping S, Dancet EAF. Potential consequences of clinical application of artificial gametes: a systematic review of stakeholder views. Hum Reprod Update 2015; 21:297-309. [PMID: 25609402 DOI: 10.1093/humupd/dmv002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 12/30/2014] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Recent progress in the formation of artificial gametes, i.e. gametes generated from progenitors or somatic cells, has led to scientific and societal discussion about their use in medically assisted reproduction. In animals, live births have already been achieved using artificial gametes of varying (cell type) sources and biological research seems to be progressing steadily toward clinical application in humans. Artificial gametes could potentially help not only infertile heterosexual couples of reproductive age of which one or both partners lacks functional gametes, but also post-menopausal women and same-sex couples, to conceive a child who will be genetically related to them. But as clinical application of these new technologies may have wider societal consequences, a proactive consideration of the possible impact seems timely and important. This review aims to contribute to this by providing a systematic overview of the potential consequences of clinical application of artificial gametes anticipated by different stakeholders. METHODS The electronic database 'Medline/Pubmed' was systematically searched with medical subject heading terms (MesH) for articles published in English between January 1970 and December 2013. Articles were selected based on eligibility and reference lists of eligible studies were hand searched. The reported potential consequences of clinical application of artificial gametes were extracted from the articles and were grouped into categories by content analysis. Per category, we noted which stakeholders referred to which potential consequences, based on author affiliations and, if applicable, study participants. RESULTS The systematic search yielded 2424 articles, and 84 studies were included after screening. Nine positive consequences, 21 specific consequences requiring consideration and 22 recommendations referring to clinical application of artificial gametes were documented. All positive consequences, consequences requiring consideration and recommendations could be categorized under the following eight objectives to be safeguarded during clinical application of artificial gametes: (i) timing the implementation of new treatments correctly, (ii) meeting 'plausible demands of patients', (iii) improving and safeguarding public health, (iv) promoting the progress of medical science in the interest of future patients, (v) providing treatments that are morally acceptable for the general public, (vi) controlling medical practice, (vii) offering treatments that allow acquisition of informed consent and (viii) funding treatments fairly. Professionals specialized in biomedical science, science journalists and professionals specialized in ethics all addressed these eight objectives on artificial gametes, whereas professionals specialized in law or political science addressed seven objectives. Although one study reported on the perspective of parents of under-aged patients on three objectives, the perspectives of patients themselves were not reported by the reviewed literature. CONCLUSION Of course, clinical introduction of artificial gametes should only be considered on the basis of reassuring outcomes of appropriate preclinical effectiveness and safety studies. In addition, potential users' views on the desirability and acceptability of artificial gametes should be studied before clinical introduction. A societal debate including all stakeholders is needed to determine the relative importance of all arguments in favor of and against the introduction of artificial gametes into clinical practice. More broadly, establishing pre-implementation processes for new medical techniques is relevant for all fields of medicine.
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Affiliation(s)
- Saskia Hendriks
- Center for Reproductive Medicine, Women's and Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Wybo Dondorp
- Department of Health, Ethics and Society, Research Schools GROW and CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Guido de Wert
- Department of Health, Ethics and Society, Research Schools GROW and CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Geert Hamer
- Center for Reproductive Medicine, Women's and Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Sjoerd Repping
- Center for Reproductive Medicine, Women's and Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Eline A F Dancet
- Center for Reproductive Medicine, Women's and Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands Leuven University Fertility Centre, Leuven University Hospital, Leuven, Belgium
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Bydlowski S. [The pains of medically assisted procreation: what place for psychic suffering?]. GYNECOLOGIE, OBSTETRIQUE & FERTILITE 2014; 42:861-864. [PMID: 25458808 DOI: 10.1016/j.gyobfe.2014.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 10/06/2014] [Indexed: 06/04/2023]
Abstract
Human fertility is very sensible to emotional motions. Some unconscious representations infiltrate the child's project, they can make it fail, and are sometimes in conflict with the consciously declared child's desire. In a not exceptionally way, professionals are faced with requests for termination of pregnancy, even though the child was very expected, and the pregnancy obtained after a long period of medically assisted procreation. The author offers some ideas to explore the psychological clinic for infertility, before to centre himself more specifically on the issues raised by situations of egg donation, and conclude by therapeutic proposals on a joint collaboration between gynecologists and child psychiatrists.
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Affiliation(s)
- S Bydlowski
- Département de psychiatrie de l'enfant et de l'adolescent de l'Association de santé mentale du XIII(e) arrondissement, 76, avenue Édison, 75013 Paris, France.
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Blake L, Jadva V, Golombok S. Parent psychological adjustment, donor conception and disclosure: a follow-up over 10 years. Hum Reprod 2014; 29:2487-96. [PMID: 25240010 DOI: 10.1093/humrep/deu231] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
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. STUDY FUNDING COMPETING INTERESTS The project described was supported by grant number RO1HD051621 from the National Institute of Child Health and Human Development. The content is solely the responsibility of the authors and does not represent the official views of the National Institute of Child Health and Human Development or the National Institutes of Health. The authors have no conflict of interest to declare.
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Affiliation(s)
- L Blake
- Centre for Family Research, Free School Lane, University of Cambridge, Cambridge CB2 3RQ, UK
| | - V Jadva
- Centre for Family Research, Free School Lane, University of Cambridge, Cambridge CB2 3RQ, UK
| | - S Golombok
- Centre for Family Research, Free School Lane, University of Cambridge, Cambridge CB2 3RQ, UK
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Borneskog C, Lampic C, Sydsjö G, Bladh M, Skoog Svanberg A. How do lesbian couples compare with heterosexual in vitro fertilization and spontaneously pregnant couples when it comes to parenting stress? Acta Paediatr 2014; 103:537-45. [PMID: 24456297 DOI: 10.1111/apa.12568] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Revised: 10/04/2013] [Accepted: 01/17/2014] [Indexed: 11/28/2022]
Abstract
AIM To study parenting stress in lesbian parents and to compare that stress with heterosexual parents following in vitro fertilisation (IVF) or spontaneous pregnancies. METHODS This survey took place during 2005-2008 and was part of the Swedish multicentre study on gamete donation. It comprised 131 lesbian parents, 83 heterosexual IVF parents, who used their own gametes, and 118 spontaneous pregnancy parents. The participants responded to the questionnaire when the child was between 12 and 36-months-old and parenting stress was measured by the Swedish Parenting Stress Questionnaire (SPSQ). RESULTS Lesbian parents experienced less parenting stress than heterosexual IVF parents when it came to the General Parenting Stress measure (p = 0.001) and the subareas of Incompetence (p < 0.001), Social Isolation (p = 0.033) and Role Restriction (p = 0.004). They also experienced less parenting stress than heterosexual spontaneous pregnancy couples, according to the Social Isolation subarea (p = 0.003). Birth mothers experienced higher stress than co-mothers and fathers, according to the Role Restriction measure (p = 0.041). CONCLUSION These are reassuring findings, considering the known challenges that lesbian families face in establishing their parental roles and, in particular, the challenges related to the lack of recognition of the co-mother.
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Affiliation(s)
- C Borneskog
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - C Lampic
- Neurobiology, Care Sciences and Society Karolinska Institutet Huddinge Sweden
| | - G Sydsjö
- Division of Obstetrics and Gynecology Department of Clinical and experimental Medicine Faculty of Health and Science Department of Gynecology and Obstetrics in Linköping Linköping University County Council of Östergötland Linköping Sweden
| | - M Bladh
- Division of Obstetrics and Gynecology Department of Clinical and experimental Medicine Faculty of Health and Science Department of Gynecology and Obstetrics in Linköping Linköping University County Council of Östergötland Linköping Sweden
| | - A Skoog Svanberg
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
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Sälevaara M, Suikkari AM, Söderström-Anttila V. Attitudes and disclosure decisions of Finnish parents with children conceived using donor sperm. Hum Reprod 2013; 28:2746-54. [PMID: 23906900 DOI: 10.1093/humrep/det313] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION What are disclosure intentions and experiences of heterosexual parents with children born after assisted donor insemination (DI) or IVF with donor sperm (dIVF)? SUMMARY ANSWER Only 16.5% of Finnish DI/dIVF heterosexual parents had told their child of his/her origin; 18% of all children above 3 years of age had received the information. Parents with older children were more unwilling to tell or were more uncertain regarding what to do than parents with younger children. WHAT IS KNOWN ALREADY In general, 10-35% of parents of DI offspring are willing to inform their child about their conception. Men who need donor sperm to become a father are more secretive than women who need donated oocytes and are less willing to participate in counselling about parenthood. In the past, couples conceiving through gamete donation were adviced to maintain secrecy or sufficient advice on information sharing was not available. Evidence suggests that parental attitudes are moving towards greater openness. In 2007, Finland enacted a law on assisted fertility treatments (1237/2006) stating that gamete donors have to register their identifying information in a registry so that at the age of 18 years, offspring can obtain information about their donor. STUDY DESIGN, SIZE AND DURATION This retrospective questionnaire study included 139 mothers and 127 fathers with altogether 240 children born after DI or dIVF during 1992-2007. PARTICIPANTS, SETTING AND METHODS Questionnaires were sent to heterosexual couples who had undergone DI/dIVF treatment at the Väestöliitto Fertility Clinic in Helsinki resulting in live birth (n = 277, 252 mothers and 239 fathers). The parents were asked to report their disclosure intentions towards the child and towards other people about the decision to use donated sperm, their concerns about donor characteristics, their evaluation of the counselling that they received and their views about the current Finnish assisted reproduction law. MAIN RESULTS AND THE ROLE OF CHANCE The response rate was 55% (139/252) among the mothers and 53% (127/239) among the fathers. Answers provided information on 58% (240/415) of the children born, 91% of whom were at least 3 years old at the time. Of all parents, 16.5% reported that they had already told their child of his/her conception. Of all 240 children, 16.3% had already received information about their conception. The children had been between 3 and 14 years of age (mean 6.8 years) when they were told. Parents of older children were significantly more unwilling to tell their child than parents of younger children (P < 0.005). No difference in disclosure between DI and dIVF emerged. Less than half of the parents (42%) had been satisfied with the psychological support offered to them, with parents of older children having been most dissatisfied. LIMITATIONS, REASONS FOR CAUTION Although the response rate was relatively high, more than 40% of the parents chose not to participate. As has been shown before, it is likely that those who do not take part are less inclined to disclose and this should be taken into consideration when conclusions are drawn. WIDER IMPLICATIONS OF THE FINDINGS Our results on disclosure rates are in agreement with previous studies. General attitudes have moved towards greater openness about the use of donated gametes. Furthermore, the availability of psychological counselling before treatment has increased the understanding of the importance of disclosure. People who have become parents after DI or dIVF should also be offered counselling after the child has been born. STUDY FUNDING/COMPETING INTERESTS This study was supported by grants from the Wilhelm and Else Stockmann Foundation and the Medical Society Life and Health. There are no competing interests to disclose. TRIAL REGISTRATION NUMBER None.
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Affiliation(s)
- M Sälevaara
- Väestöliitto Fertility Clinic, Fredrikinkatu 47, Helsinki FIN-00100, Finland
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Wischmann T, Thorn P. (Male) infertility: what does it mean to men? New evidence from quantitative and qualitative studies. Reprod Biomed Online 2013; 27:236-43. [PMID: 23876974 DOI: 10.1016/j.rbmo.2013.06.002] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 04/30/2013] [Accepted: 06/11/2013] [Indexed: 11/16/2022]
Abstract
Scientific knowledge of the emotional repercussions of infertility on men remains limited and has only recently become the focus of social science research. Firstly, the current developments in research on the psychosocial impact of infertility on men through a search of the literature over the last 10 years are outlined in this paper. In the second section, issues raised in pretreatment counselling for men and their partner who consider donor insemination are described as this treatment typically raises many emotional issues. The results of more recent studies with sophisticated methodological design show that the emotional impact of infertility may be nearly balanced, suggesting that men do suffer as well and that they have to be addressed in infertility counselling too. The emotional and clinical aspects of donor insemination support the hypothesis that the emotional repercussions of infertility affect both sexes. In general, male factor infertility seems to be more stigmatized than other infertility diagnoses. Forthcoming studies have to differentiate between the psychological impact of infertility on women and men and their respective abilities to communicate easily about this distress. More studies on infertile men in non-Western societies need to be conducted in order to understand the cultural impact on infertility.
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Affiliation(s)
- Tewes Wischmann
- Institute of Medical Psychology, Centre for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany.
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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; 54:653-60. [PMID: 23176601 PMCID: PMC3586757 DOI: 10.1111/jcpp.12015] [Citation(s) in RCA: 118] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Parenting and children's adjustment were examined in 30 surrogacy families, 31 egg donation families, 35 donor insemination families, and 53 natural conception families. METHODS Parenting was assessed at age 3 by a standardized interview designed to assess quality of parenting and by questionnaire measures of anxiety, depression, and marital quality. Children's adjustment was assessed at ages 3, 7, and 10 using the Strengths and Difficulties Questionnaire (SDQ). RESULTS Although children born through reproductive donation obtained SDQ scores within the normal range, surrogacy children showed higher levels of adjustment difficulties at age 7 than children conceived by gamete donation. Mothers who had kept their child's origins secret showed elevated levels of distress. However, maternal distress had a more negative impact on children who were aware of their origins. CONCLUSIONS The absence of a gestational connection to the mother may be more problematic for children than the absence of a genetic link.
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Affiliation(s)
- Susan Golombok
- Centre for Family Research, University of Cambridge, Cambridge, UK.
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Burr JA. Anonymous or known donors? A brief discussion of the psychosocial issues raised by removing anonymity from sperm donors. HUM FERTIL 2013; 16:44-7. [DOI: 10.3109/14647273.2013.780664] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Jennifer A. Burr
- School of Health and Related Research (ScHARR), University of Sheffield,
Sheffield, UK
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Thorn P. The shift from biological to social fatherhood--counselling men and their partners considering donor insemination. HUM FERTIL 2013; 16:40-3. [PMID: 23517455 DOI: 10.3109/14647273.2013.777476] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Men and women are likely to suffer from infertility in similar ways, but gender differences account for different ways in revealing--and not revealing--this emotional pain. The following article is based on this understanding. It seeks to describe counselling tasks and interventions that support men and their partners considering donor insemination. This pre-treatment counselling comprises a range of issues, including the provision of medical and legal information, supporting the grieving process, managing the taboo and stigma surrounding donor insemination, supporting disclosure, and last but not least raising awareness of the needs of the future child. The aim of counselling is to explore the short- and long-term implications and thus facilitate the shift from biological to social fatherhood for men and their partners.
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Examining the role of passive gene–environment correlation in childhood depression using a novel genetically sensitive design. Dev Psychopathol 2013; 25:37-50. [DOI: 10.1017/s0954579412000880] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractParental depression is associated with disruptions in the parent–child relationship, exposure to stressful family life events, and offspring depressive symptoms. Evidence suggests that intergenerational transmission of depression involves environmental and inherited contributions. We sought to evaluate the role of passive gene–environment correlation (rGE) in relation to depression, family life events that were due to parental behavior, and parental positivity in a sample where children varied in genetic relatedness to their rearing parents. Our study included 865 families with children born through assisted conception (444 related to both parents, 210 related to the mother only, 175 related to the father only, and 36 related to neither parent). Consistent with previous studies, the intergenerational transmission of depressive symptoms was largely due to environmental factors, although parent and child gender influenced results. Maternal and paternal depressive symptoms were associated with reduced positivity and increased parentally imposed life events regardless of parent–child relatedness. Results of path analysis were consistent with passive rGE for both maternal and paternal positivity in that positivity partially mediated the link between maternal/paternal depression and child depression only in genetically related parent–child pairs. Results also suggested passive rGE involving parentally imposed life events for mothers and fathers although passive rGE effects were smaller than for positivity.
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Blyth E, Kramer W, Schneider J. Perspectives, experiences, and choices of parents of children conceived following oocyte donation. Reprod Biomed Online 2013; 26:179-88. [DOI: 10.1016/j.rbmo.2012.10.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Revised: 10/15/2012] [Accepted: 10/16/2012] [Indexed: 11/30/2022]
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Canneaux M, Chabert C, Golse B, Wolf JP, Beauquier-Maccotta B. Comment devient-on mère grâce à un don d'ovocytes?? PSYCHIATRIE DE L ENFANT 2013. [DOI: 10.3917/psye.561.0067] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Golombok S. Families Created by Reproductive Donation: Issues and Research. CHILD DEVELOPMENT PERSPECTIVES 2012. [DOI: 10.1111/cdep.12015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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