Parenthood motives, well-being and disclosure among men from couples ready to start treatment with intrauterine insemination using their own sperm or donor sperm

Sexual function in heterosexual couples undergoing assisted reproductive technology (ART) cycles with donor sperm

PURPOSE

Sexuality and the desire for children are closely linked, and infertility can increase the risk of sexual dysfunction (SD). Among heterosexual infertile couples undergoing assisted reproductive technology (ART) cycles, those referred for donor sperm cycles constitute a specific subgroup, potentially different than those undergoing ART with partner's sperm, as giving up on biological parenthood can be difficult to overcome. However, the impact of donor sperm ART on infertile couples' sexuality has been hardly explored in the literature. This study aimed to describe the sexual function in couples undergoing ART with donor sperm.

METHODS

This monocentric prospective observational study was conducted in heterosexual couples undergoing ART cycle with sperm donor, using the FSFI and the IIEF15 questionnaires. Seventy-nine couples were solicited to participate in the study.

RESULTS

In our sample, 39.3% (n = 24) of women had sexual dysfunction (SD). Among men, 26.5% (n = 13) had erectile dysfunction (ED). No statistically significant difference was found between both groups (with or without SD) in men and women in univariate analysis. Therefore, multivariate analysis was not performed and no specific predictor of SD could be identified.

CONCLUSION

Although this should be confirmed in a larger number of participants, our study demonstrates that a significant proportion of infertile patients undergoing ART with donor semen suffer from SD. No significant predictor could, however, be identified. Further research should focus on the evaluation of psychological interventions to treat or improve these disorders.

Ten years of fertility treatment experience and reproductive options in transgender men

BACKGROUND

Up to 2018, the Belgian law stated that transgender people who wanted to change their legal sex had to undergo physical gender affirming treatment. This included gonadectomy to a medically possible and justified extent, which entailed that they had to accept the fact that they could no longer reproduce. However, research has shown that many transgender people desire to have children.

AIMS

(1) to describe a cohort of transgender men and their respective cisgender female partners, to share our experiences with their request for donor conception, and to evaluate their disclosure intentions to the child, (2) to explore how the couples approach current and future reproductive options.

METHODS

This mixed method study presents data from a retrospective analysis of patient records and from a qualitative interview study. The couples were selected from the group of transgender men who - together with their respective cisgender female partners - applied for sperm donation at Ghent University Hospital between 2002 and 2012.

RESULTS

Forty-seven transgender men with a cisgender female partner requested treatment with anonymous donor sperm for a first child as a couple. Forty-one requests were accepted for treatment. We found that most couples requesting treatment intended to disclose the use of donor sperm to their future child (n = 34) while 24 couples were planning to inform the child about the parent's transgender identity. The six couples we interviewed saw donor conception as the preferred route to become parents. Adoption was seen as less obvious. The couples' attitudes toward stem cell-derived gametes reflected the significance of the genetic link with the child for both parents.

DISCUSSION

Not all participants in our study were aware of their reproductive options. To be able to make a well-informed decision, transgender people should be counseled about all options at the time of transition.

Gay Fatherhood in the NICU: Supporting the "Gayby" Boom

BACKGROUND

With advances in reproductive health, gay males are increasingly given the opportunity to reproduce. It is not a common occurrence for infants of gay male fathers to enter the neonatal intensive care unit (NICU); however, this may change and should be acknowledged.

PURPOSE

To give insight into the barriers, perspectives, and stresses of gay male caregivers (families) in their time spent in the NICU and to offer recommendations as to how better to serve them and their families.

METHODS/SEARCH STRATEGY

Searched using PubMed, CINAHL, SCOPUS, and Google Scholar. Key words used were "gay families," "fatherhood," "neonatal intensive care unit," "lesbians," and "surrogacy."

FINDINGS/RESULTS

There remains a very limited amount of data for healthcare providers as these relate to gay male fathers in the NICU, aside from narratives. Most of the research and literature that highlight potential barriers stem from heterosexual fatherhood in the NICU and lesbian parenting in the healthcare system.

IMPLICATIONS FOR PRACTICE

To have an understanding and knowledge to improve support for gay fathers in the NICU.

IMPLICATIONS FOR RESEARCH

Research on gay fathers in the NICU and further research on lower economic gay fatherhood and gay men of color and fatherhood are required. Because of the small sample size, multicentered studies may warranted to aid in clinical significance.

Donor insemination disclosure in social networks: heterosexual couples' experiences

The way in which heterosexual couples manage information about infertility and donor insemination within their social networks has not yet been explored in-depth. This study focuses on how parents and aspiring parents manage information about infertility and donor insemination within their social networks. Fifteen Belgian couples were interviewed as part of a parenthood research project. Thematic analysis resulted in the identification of four themes. The first of these reveals how the social context can best be understood as a continuous confrontation with social expectations. A second theme highlights the diverse ways in which couples manage personal information in this confronting context. The third theme stresses how couples manage information about donor insemination so as to be treated as a 'normal' family. The final theme shows how emotional regulation within the context of the extended family plays a role in couples' decisions about how to manage information with relatives. Results are analysed using the concept of 'systemic emotion management' and the importance of being seen by others as a 'normal' family. Study findings signal the importance of managing information within social networks and are of relevance to a range of practitioners.

When 'sperm' becomes 'donor': transitions in parents' views of the sperm donor

Abstract Little is known about recipients' views of their sperm donor. This study aimed to examine the possible transitions or consistencies in donor sperm recipients' (DSRs') view on the sperm donor over time. A longitudinal qualitative study of 19 Belgian heterosexual DSRs was undertaken. Interviews took place with both partners of the couple during pregnancy, at birth and 1.5-2 years after birth, and were analysed using a grounded theory approach. Recipients who intended to disclose exhibited a transition in their awareness of the donor from being of minimal importance to one who was increasingly seen as part of their family narrative. This was partly triggered by the offspring's life, remarks about resemblance and the socio-cultural context. The perceived position of the donor changed for most recipients from a threatening rival to a 'distractor'. This change was supported by the emerging father-child bond and the confidence that stemmed from it. These observations were applicable to those recipients who intended to disclose their donor conception; for those recipients who intended not to disclose, little or no transition was observed. This study describes and analyses the transitions and consistencies in recipients' views of the donor over different stages of the family life-cycle (pregnancy, birth, toddler stage) and could help the fertility clinics tailor their counselling to the specific stages of parenthood.

'Of course he's our child': transitions in social parenthood in donor sperm recipient families

This study examines transitions and consistencies in the views of donor sperm recipients on ‘parenthood’ and ‘family’ over time. A longitudinal qualitative study was carried out with 19 donor sperm recipients. Interviews took place during pregnancy, at birth and 1.5–2 years after birth and were analysed using a grounded theory approach. Participants intending to disclose the donor conception to their offspring (13/19) exhibited a transition from feeling anxious prior to birth to feeling more confident during the toddler stage about their parenthood. Previous anxieties about the lack of biological ties decreased as emerging social ties became more significant. Following birth, these participants (13/19) felt acknowledged by others as parents, which elicited feelings of normalization. Being able to engage in parenting and develop parental relations enhanced their confidence in their parental position. This confidence empowered donor sperm recipients to tackle future challenges and made them more convinced about their disclosure intention. Participants intending not to disclose the donor conception (6/19) reported viewing their parenthood as no different from parenthood experienced by naturally conceiving parents, no transitions were observed and insecurity about physical traits that could reveal the donor conception remained. These findings have implications for counselling throughout specific stages in parenthood.