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Duff MA, Goedeke S. Parents' disclosure to their donor-conceived children in the last 10 years and factors affecting disclosure: a narrative review. Hum Reprod Update 2024; 30:488-527. [PMID: 38687968 PMCID: PMC11215159 DOI: 10.1093/humupd/dmae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 03/18/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Disclosure of donor conception has been advocated in several jurisdictions in recent years, especially in those that practice identity-release donation. However, research on disclosure decisions has not been consolidated systematically in the last 10 years to review if parents are telling and what factors may be impacting their decisions. OBJECTIVE AND RATIONALE Are parents disclosing to their donor-conceived children, and what factors have influenced their disclosure decisions across different contexts and family forms in the last 10 years? SEARCH METHODS A bibliographic search of English-language, peer-reviewed journal articles published between 2012 and 2022 from seven databases was undertaken. References cited in included articles were manually scrutinized to identify additional references and references that cited the included articles were also manually searched. Inclusion criteria were articles focused on parents (including heterosexual, single mothers by choice, same-sex couples, and transsexual) of donor-conceived persons in both jurisdictions with or without identity-release provisions. Studies focused solely on surrogacy, donors, donor-conceived persons, or medical/fertility staff were excluded as were studies where it was not possible to extract donor-recipient parents' data separately. Both quantitative and qualitative studies were included. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed and Joanna Briggs Institute Critical Appraisal Tools for Systematic Reviews were used to assess article quality and bias. OUTCOMES Thirty-seven articles met the inclusion criteria representing 34 studies and 4248 parents (including heterosexual, single, same-sex, and transsexual parents although the majority were heterosexual) from countries with anonymous donation and those with identity-release provisions or who had subsequently enacted these provisions (Australia, Belgium, Finland, France, Hong Kong, Middle East, Spain, Sweden, the UK, and the USA) A general trend towards disclosure was noted across these groups of parents with most disclosing to their donor-conceived children before the age of 10 years. Further, the majority of those who had not yet told, reported planning to disclose, although delayed decisions were also associated with lower disclosure overall. Same-sex and single parents were more likely to disclose than heterosexual parents. There was recognition of disclosure as a process involving ongoing conversations and that decisions were impacted by multiple interacting intrapersonal, interpersonal, and external contextual and social factors. Methodological limitations, such as the different population groups and contexts from which participants were drawn (including that those parents who choose not to disclose may be less likely to participate in research), are acknowledged in integrating findings. WIDER IMPLICATIONS This review has reinforced the need for a theoretical model to explain parents' disclosure decisions and research exploring the role of legislative provisions, culture, and donor/family type in decision-making. Greater ongoing access to psychological support around disclosure may be important to promote parent and family well-being.
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Affiliation(s)
- Michelle A Duff
- Department of Psychology and Neuroscience, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Sonja Goedeke
- Department of Psychology and Neuroscience, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
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Mayeur A, Magnan F, Mathieu S, Rubens P, Sperelakis Beedham B, Sonigo C, Steffann J, Frydman N. What importance do donors and recipients attribute to the nuclear DNA-related genetic heritage of oocyte donation? Hum Reprod 2024; 39:770-778. [PMID: 38420661 DOI: 10.1093/humrep/deae030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/31/2024] [Indexed: 03/02/2024] Open
Abstract
STUDY QUESTION How do oocyte donors and recipients perceive the genetic link related to the transfer of nuclear DNA between donors and offspring? SUMMARY ANSWER Whether they are donors or recipients, individuals attach great importance to the transmission of their genetic heritage, since 94.5% would opt for the pronuclear transfer method to preserve this genetic link in the context of oocyte donation. WHAT IS KNOWN ALREADY Since 1983, the use of oocyte donation has increased worldwide. Performed in France since the late 1980s and initially offered to women with premature ovarian insufficiency, its indications have progressively expanded and now it is proposed in many indications to prevent the transmission of genetically inherited diseases. This has resulted in an increase in the waiting time for access to oocyte donation due to the difficulty in recruiting oocyte donors in French ART centres. Several articles have discussed how to fairly distribute donor oocytes to couples, but few have interviewed women in the general population to record their feelings about oocyte donation, as either the donor or recipient and the importance given to the genetic link between the oocyte donors and the children born. Mitochondrial replacement therapy (MRT) is a technique originally developed for women at risk of transmitting a mitochondrial DNA mutation. Recently, MRT has been considered for embryo arrest and oocyte rejuvenation as it could help females to reproduce with their own genetic material through the transfer of their oocyte nucleus into a healthy donor oocyte cytoplasm. STUDY DESIGN, SIZE, DURATION We conducted an opinion survey from January 2021 to December 2021, during which 1956 women completed the questionnaire. Thirteen participants were excluded from the analysis due to incomplete responses to all the questions. Consequently, 1943 women were included in the study. PARTICIPANTS/MATERIALS, SETTING, METHODS We specifically developed a questionnaire for this study, which was created and distributed using the Drag'n Survey® software. The questionnaire consisted of 21 items presented alongside a video created with whiteboard animation software. The aim was to analyse whether certain factors, such as age, education level, marital status, number of children, use of ART for pregnancy, video viewing, and knowledge about oocyte donation, were associated with feelings towards oocyte donation, by using a univariate conditional logistic regression model. This statistical method was also used to assess whether women would be more inclined to consider oocyte donation with the pronuclear transfer technique rather than the whole oocyte donation. All parameters found to be statistically significant in the univariate analysis were subsequently tested in a multivariate model using logistic regression. MAIN RESULTS AND THE ROLE OF CHANCE Most women were concerned about the biological genetic contribution of the donated oocyte (94.8%). The most common reason for a women's reluctance to donate their oocytes was their unwillingness to pass on their genetic material (33.3%). Nearly 70% of women who were initially hesitant to donate their oocytes indicated that they would reconsider their decision if the oocyte donation was conducted using donated cytoplasm and the pronuclear transfer technique. Concomitantly, >75% of the respondents mentioned that it would be easier to receive a cytoplasm donation. The largest proportion of the population surveyed (94.5%) expressed their support for its legalization. LIMITATIONS, REASONS FOR CAUTION In this study, a substantial portion of the responses came from individuals with medical or paramedical backgrounds, potentially introducing a recruitment bias among potential donors. The rate of missing responses to the question regarding the desire to become an oocyte donor was 13.6%, while the question about becoming an oocyte cytoplasm donor had a missing response rate of 23%. These missing responses may introduce a bias in the interpretation of the data. WIDER IMPLICATIONS OF THE FINDINGS This study was the first to demonstrate that, for the French population studied, the combination of oocyte cytoplasm donation with pronuclear transfer could offer a promising approach to enhance the acceptance of oocyte donation for both the donor and the recipient. STUDY FUNDING/COMPETING INTEREST(S) No external funding was used for this study. The authors have no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- A Mayeur
- Service de Biologie de la Reproduction-CECOS, Assistance Publique Hôpitaux de Paris, Hôpital Antoine Béclère, Clamart, France
- Université de Paris Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - F Magnan
- Service de Biologie de la Reproduction-CECOS, Assistance Publique Hôpitaux de Paris, Hôpital Antoine Béclère, Clamart, France
| | - S Mathieu
- École Pratique des Hautes Études (EPHE), Paris Sciences Lettres (PSL), GSRL UMR8582, Paris, France
| | - P Rubens
- Service de Médecine Génomique des Maladies rares, Assistance Publique Hôpitaux de Paris, Groupe Hospitalier Necker-Enfants Malades, Paris, France
- Université Paris Cité, Institut Imagine, INSERM UMR1163, Paris, France
| | - B Sperelakis Beedham
- Service de Médecine Génomique des Maladies rares, Assistance Publique Hôpitaux de Paris, Groupe Hospitalier Necker-Enfants Malades, Paris, France
| | - C Sonigo
- Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Saclay, Service de Médecine de la Reproduction et Préservation de la Fertilité, Hôpital Antoine Béclère, Clamart, France
- France Université Paris Saclay, Inserm, Physiologie et physiopathologie endocrinienne, Le Kremlin-Bicêtre, France
| | - J Steffann
- Service de Médecine Génomique des Maladies rares, Assistance Publique Hôpitaux de Paris, Groupe Hospitalier Necker-Enfants Malades, Paris, France
- Université Paris Cité, Institut Imagine, INSERM UMR1163, Paris, France
| | - N Frydman
- Service de Biologie de la Reproduction-CECOS, Assistance Publique Hôpitaux de Paris, Hôpital Antoine Béclère, Clamart, France
- Université de Paris Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France
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Hershberger PE, Gallo AM, Adlam K, Driessnack M, Grotevant HD, Klock SC, Pasch L, Gruss V. Development of the Tool to Empower Parental Telling and Talking (TELL Tool): A digital decision aid intervention about children's origins from donated gametes or embryos. Digit Health 2023; 9:20552076231194934. [PMID: 37654721 PMCID: PMC10467186 DOI: 10.1177/20552076231194934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 07/28/2023] [Indexed: 09/02/2023] Open
Abstract
Objective This study aimed to create and develop a well-designed, theoretically driven, evidence-based, digital, decision Tool to Empower Parental Telling and Talking (TELL Tool) prototype. Methods This developmental study used an inclusive, systematic, and iterative process to formulate a prototype TELL Tool: the first digital decision aid for parents who have children 1 to 16 years of age and used donated gametes or embryos to establish their families. Recommendations from the International Patient Decision Aids Standards Collaboration and from experts in decision aid development, digital health interventions, design thinking, and instructional design guided the process. Results The extensive developmental process incorporated researchers, clinicians, parents, children, and other stakeholders, including donor-conceived adults. We determined the scope and target audience of the decision aid and formed a steering group. During design work, we used the decision-making process model as the guiding framework for selecting content. Parents' views and decisional needs were incorporated into the prototype through empirical research and review, appraisal, and synthesis of the literature. Clinicians' perspectives and insights were also incorporated. We used the experiential learning theory to guide the delivery of the content through a digital distribution plan. Following creation of initial content, including storyboards and scripts, an early prototype was redrafted and redesigned based on feedback from the steering group. A final TELL Tool prototype was then developed for alpha testing. Conclusions Detailing our early developmental processes provides transparency that can benefit the donor-conceived community as well as clinicians and researchers, especially those designing digital decision aids. Future research to evaluate the efficacy of the TELL Tool is planned.
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Affiliation(s)
- Patricia E. Hershberger
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Agatha M. Gallo
- Department of Human Development Nursing, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Kirby Adlam
- Department of Human Development Nursing, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Martha Driessnack
- School of Nursing, Oregon Health & Science University, Portland, OR, USA
| | - Harold D. Grotevant
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, USA
| | - Susan C. Klock
- Departments of Obstetrics and Gynecology and Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lauri Pasch
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Valerie Gruss
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
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Quintigliano M, Carone N, Speranza AM, Tanzilli A, Baiocco R, Barone L, Pastorelli C, Lingiardi V. Adolescent Development and the Parent-Adolescent Relationship in Diverse Family Forms Created by Assisted Reproduction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16758. [PMID: 36554637 PMCID: PMC9778924 DOI: 10.3390/ijerph192416758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/10/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
Assisted reproduction techniques (ARTs) are employed by single individuals and couples who are not otherwise able to conceive spontaneously. While the use of ARTs is increasing, research is lacking on the attempts made by adolescent offspring conceived via ARTs to integrate their ART conception into their identity and negotiate a connection with, and autonomy from, their parents. The present article reviews studies investigating adolescent development and the parent-adolescent relationship in diverse family forms created by ARTs (mainly heterosexual and lesbian parent families), and discusses the results in light of attachment, identity development, and emotional distance regulation theories. Overall, the results indicate that the psychological adjustment of adolescents conceived via ARTs is not undermined by the manner of their conception, and that they enjoy positive relationships with their parents with no difference from those enjoyed by spontaneously conceived adolescents. However, it remains unknown whether the development of a reproductive identity in adolescence is likely to influence adolescents' interest in searching for or contacting their donors, surrogates, and/or donor siblings. The results suggest the relevance of considering the parent-adolescent relationship, disclosure, and identity formation issues when planning psychological counseling and support interventions with ART parents and their adolescent offspring, and emphasize the need to further investigate these aspects in diverse ART families, including single-, gay-, bisexual-, and trans*-parent families.
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Affiliation(s)
- Maria Quintigliano
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy
| | - Nicola Carone
- Department of Brain and Behavioral Sciences, University of Pavia, Piazza Botta 11, 27100 Pavia, Italy
| | - Anna Maria Speranza
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy
| | - Annalisa Tanzilli
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy
| | - Roberto Baiocco
- Department of Developmental and Social Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy
| | - Lavinia Barone
- Department of Brain and Behavioral Sciences, University of Pavia, Piazza Botta 11, 27100 Pavia, Italy
| | - Concetta Pastorelli
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy
| | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy
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Hershberger PE. Using a Manuscript Template to Foster Dissemination of Doctoral Students' Literature Reviews. J Nurs Educ 2021; 60:111-115. [PMID: 33528584 DOI: 10.3928/01484834-20210120-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/15/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND The author was asked to teach a new PhD course, Developing Literature Reviews. The course objective is to have students prepare a structured (e.g., integrative, systematic) literature review manuscript that is suitable for publication submission. METHOD Course pedagogy and materials were created, including a novel literature review manuscript template. The template served as a guide for communicating essential section components of a rigorous and reproducible literature review manuscript and allowed for an iterative process and efficient faculty-student evaluation system to simulate the peer-review process. To measure student outcomes, standardized course evaluations were reviewed, and the number of students who were successful in disseminating manuscripts was recorded. RESULTS Students' standardized course evaluations were high. Eighteen students published integrative or systematic literature reviews as first author. Eleven students have presented peer-reviewed abstracts at scientific conferences. CONCLUSION The template successfully facilitates PhD student dissemination. The Doctor of Nursing Practice student pedagogy may also benefit from the template. [J Nurs Educ. 2021;60(2):111-115.].
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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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Hershberger PE, Driessnack M, Kavanaugh K, Klock SC. Oocyte donation disclosure decisions: a longitudinal follow-up at middle childhood. HUM FERTIL 2019; 24:31-45. [PMID: 30724630 DOI: 10.1080/14647273.2019.1567945] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Few studies have captured oocyte donation (OD) parents' decision processes about intended and actual disclosure over time. Likewise, OD children's perceptions about their family composition during middle childhood are underexplored. To address these gaps, a longitudinally followed cohort of OD recipient families was invited to participate in a qualitative, follow-up study. With an 86% response rate after 12 years, families were composed of oocyte recipient mothers (n = 6) and biological fathers (n = 6) representing 12 donor-oocyte conceived children (10.33 ± 1.23 years; mean ± SD). Of the 12 children, two that were aware and two that were unaware of their conceptual origins completed conversational interviews. Only one family in the initial cohort had disclosed OD to their children by the 12-year follow-up, despite 43% of parents intending to disclose and another 43% undecided about disclosure during pregnancy. Four parental disclosure patterns emerged at 12 years: (i) wanting to disclose; (ii) conflicted about disclosure; (iii) not planning to disclose; and (iv) having disclosed. Children that were unaware of their conceptual origins displayed no knowledge of their method of conception. There is a need for family-centric interventions to assist 'wanting to disclose' parents in their disclosure process and 'conflicted about disclosure' parents in their decision-making process post-OD treatment.
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Affiliation(s)
- Patricia E Hershberger
- Department of Health Systems Science, College of Nursing, Chicago, IL, USA.,Department of Obstetrics and Gynecology, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Martha Driessnack
- School of Nursing, Oregon Health & Science University, Portland, OR, USA
| | - Karen Kavanaugh
- Department of Nursing Research, Children's Hospital of Wisconsin, Milwaukee, WI, USA
| | - Susan C Klock
- Departments of Obstetrics and Gynecology and Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Bracewell-Milnes T, Saso S, Abdalla H, Thum MY. A systematic review investigating psychosocial aspects of egg sharing in the United Kingdom and their potential effects on egg donation numbers. HUM FERTIL 2017; 21:163-173. [PMID: 28549399 DOI: 10.1080/14647273.2017.1329554] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This review aims to provide an up-to-date knowledge of the psychosocial aspects of egg donation from the perspectives of the egg share donor and their recipient. It explores the motives, experiences and attitudes of egg sharers and their views towards donor anonymity and disclosure. Conclusions are made on how these findings can guide clinical practice and improve egg sharing numbers. A systematic search of peer-reviewed journals of four computerized databases was undertaken. Eleven studies were included in the review. Psychosocial aspects towards donation were positive from the egg share donor and recipient. Concerns raised were whether participating in the egg sharing scheme would impact on their success rates, as well as frustration expressed by a minority regarding the lack of knowledge of egg sharing outside of fertility clinics. The 2005 legislative changes in the UK have not caused the anticipated dramatic decrease in egg donation; however, oocyte donation still falls short of demand. Egg sharing provides a practical option for more patients to access IVF, whilst also providing more donor oocytes. Improved information provision will result in greater awareness of egg sharing, with the potential to recruit more donors and meet the needs of recipients currently on long waiting lists.
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Affiliation(s)
- Timothy Bracewell-Milnes
- a Division of Surgery and Cancer, Institute of Developmental Reproductive & Developmental Biology , Imperial College London , London , UK
| | - Srdjan Saso
- a Division of Surgery and Cancer, Institute of Developmental Reproductive & Developmental Biology , Imperial College London , London , UK
| | - Hossam Abdalla
- b Fertility Specialist , The Lister Hospital , London , UK
| | - Meen-Yau Thum
- b Fertility Specialist , The Lister Hospital , London , UK
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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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[Psychosocial factors in reproductive medicine]. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2015; 61:309-26. [PMID: 26646911 DOI: 10.13109/zptm.2015.61.4.309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Since the development of assisted reproduction technology in the 1970s, assisted reproduction has become increasingly used by couples for various reasons. Concurrently, the diagnostic possibilities regarding the health of the unborn child have been elaborated. METHODS/RESULTS The present literature review describes and discusses the possibilities of assisted reproduction (in-vitro fertilization (IVF), intracytoplasmic sperm injection ICSI, cryopreservation, conception of children with the help of a third person) with respect to their psychosocial meaning for those affected and for the children conceived in this manner. The psychological strain pairs experience in the context of prenatal diagnostics and the resulting decisions are illustrated by a case study. CONCLUSIONS The continued progression in the possibilities and resulting conflicts and decision- making processes in reproductive medicine confronts clinicians and psychosomatic/psychotherapeutic practitioners with many new challenges. In conclusion clinical recommendations for the psychosocial counseling of couples are given.
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Hadizadeh-Talasaz F, Latifnejad Roudsari R, Simbar M. Decision for disclosure: The experiences of Iranian infertile couples undergoing assisted reproductive donation procedures. HUM FERTIL 2015; 18:265-75. [DOI: 10.3109/14647273.2015.1076579] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Mandatory counseling for gamete donation recipients: ethical dilemmas. Fertil Steril 2015; 104:507-12. [DOI: 10.1016/j.fertnstert.2015.07.1154] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 07/20/2015] [Accepted: 07/21/2015] [Indexed: 11/22/2022]
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Stuart-Smith SJ, Smith JA, Scott EJ. To know or not to know? Dilemmas for women receiving unknown oocyte donation. Hum Reprod 2012; 27:2067-75. [DOI: 10.1093/humrep/des116] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Stuart-smith SJ, Smith JA, Scott EJ. Treatment decision making in anonymous donor eggin-vitrofertilisation: A qualitative study of childless women and women with genetically related children. HUM FERTIL 2011; 14:97-105. [DOI: 10.3109/14647273.2011.571747] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Laruelle C, Place I, Demeestere I, Englert Y, Delbaere A. Anonymity and secrecy options of recipient couples and donors, and ethnic origin influence in three types of oocyte donation. Hum Reprod 2010; 26:382-90. [PMID: 21149319 DOI: 10.1093/humrep/deq346] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND This study compares recipient couples' and donors' motivations towards the type of donation and attitudes concerning secrecy or disclosure of the mode of conception in three oocyte donation groups: couples and their donor for a known donation, couples and their donor for a permuted anonymous donation (known-anonymous) and couples without a donor, on a waiting list for a donation (anonymous). METHODS Data collected by two psychologists through semi-structured interviews of 135 recipient couples and 90 donors before oocyte donation were analysed retrospectively. RESULTS In known donation (42 couples), donors were preferentially family members with a blood tie (54.7%). Choosing their donor seemed mainly for the couple's reassurance rather than to access the child's origins as 50% wanted secrecy. On the other hand, in known-anonymous donation (48 couples), donors were more frequently chosen among friends (41.6%; P = 0.038). These couples were either open to disclosure (45.8%; P = 0.002) or remained hesitant (39.6%). In anonymous donation (45 couples), 49% chose not to seek a donor mostly in order to maintain secrecy towards the child (77.3%). Among the 51% who sought but could not find a donor, only 30.4% wanted secrecy. Recipients from North Africa and from Europe preferred anonymous or known-anonymous donation (83.3 and 75.6%), whereas sub-Saharan Africans opted more often for known donation (63%; P < 0.001). Among Europeans (90 couples), 50% were in favour of disclosure compared with only 8.9% of recipients from North or sub-Saharan Africa (45 couples; P < 0.001). CONCLUSIONS A diversity of attitudes and cultural differences exist among recipient couples and donors regarding oocyte donation; this pleads for maintaining access to different types of oocyte donation as well as for psychological counselling prior to treatment.
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Affiliation(s)
- C Laruelle
- Department of Obstetrics and Gynaecology, Fertility Clinic, Erasme Hospital, 808 Route de Lennik, 1070 Brussels, Belgium
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16
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Hershberger PE. Pregnant, donor oocyte recipient women describe their lived experience of establishing the "family lexicon". J Obstet Gynecol Neonatal Nurs 2007; 36:161-7. [PMID: 17371517 DOI: 10.1111/j.1552-6909.2007.00128.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To describe the lived experience of pregnant women who used donor oocytes for conception. DESIGN Qualitative, using a descriptive phenomenologic approach. SETTING Interviews were completed at a location and setting selected by the participant. Of the 16 interviews, 13 were conducted at the participant's home, 1 was conducted at a private office, and 2 were conducted by telephone. PARTICIPANTS Eight women, between the ages of 33 and 46 years, were recruited at a large urban infertility center. The women were between 9 and 23 gestational weeks pregnant at the time of data collection. Each of the women participated in two open-ended, in-depth, audiotaped interviews and answered a demographic questionnaire. RESULTS Four themes emerged from the women's description of their experience, which were (a) acknowledging the desire for motherhood, (b) accepting and coming to terms with donor oocytes as a way to achieve motherhood, (c) navigating an intense period of decision making, and (d) living with the lasting legacy of achieving motherhood through oocyte donation. CONCLUSION Clinical practice can be improved by incorporating recognition, support, and communication of the experience to women contemplating or undergoing donor oocyte treatment.
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17
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Hershberger P, Klock SC, Barnes RB. Disclosure decisions among pregnant women who received donor oocytes: a phenomenological study. Fertil Steril 2006; 87:288-96. [PMID: 17094982 PMCID: PMC1864942 DOI: 10.1016/j.fertnstert.2006.06.036] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2006] [Revised: 06/19/2006] [Accepted: 06/19/2006] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To investigate the controversy surrounding disclosure among donor oocyte recipients. This controversy is escalating worldwide, yet little research has sought to understand the disclosure experience of pregnant, donor oocyte recipient women. This study aims to provide an in-depth description of the disclosure experience, and identify factors that were significant to recipient women which influenced their reasoning as they formulated disclosure decisions. DESIGN Qualitative, naturalistic design, using a phenomenological approach. SETTING The home or private office of the recipient woman. PATIENT(S) Donor oocyte recipient women between 9-23 weeks of gestation. RESULT(S) Disclosure decisions were influenced by multiple factors emerging from the women's values and beliefs and their social and cultural environment. Values and beliefs consisted of the right to know and the duty to protect. Social and cultural factors included social support, culture of the family, evolution of the social process, and personal testimonials. Women's age and selection of donor type were interrelated with disclosure decisions. CONCLUSION(S) Disclosing women voiced the right of the child to know, and perceived social and cultural factors as conducive to disclosure. Nondisclosing and undecided women emphasized protecting normative relationships, perceived a social stigma, and were unable to identify a benefit to disclosing. Women's age and choice of oocyte donor should be considered when counseling recipient women.
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Affiliation(s)
- Patricia Hershberger
- Center for Enhancement and Restoration of Cognitive Function, School of Nursing, University of Michigan, Ann Arbor, Michigan 48109, USA.
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18
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van den Akker O. A review of family donor constructs: current research and future directions. Hum Reprod Update 2005; 12:91-101. [PMID: 16172110 DOI: 10.1093/humupd/dmi038] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This review addresses research on gamete donors, recipients, and offspring and demonstrates that the foci on all three within the triad are largely directed at disclosure or anonymity; and each in turn centers on the perceived importance of the genetic link. The importance attached to genetics has led some countries to review the ethics of anonymous gamete donation (e.g. New Zealand's 'open system' of information sharing) and has led other countries (Sweden, Austria, Victoria, Australia; the Netherlands, the UK) to change their laws allowing donor gamete offspring the right to obtain identifying information about their genetic parent. This review demonstrates that genealogical inconsistencies between and within members of the triad are common regardless of legislation. A discussion of future trends and concerns, relating to the use of gamete donation and the effects legislation is likely to have on the donor triads in the UK following 2005, is provided. The review also addresses the importance of testing theoretical models within future research, and argues this would lead to a better understanding of the underlying problems encountered at a psychosocial level, such as continued preference for anonymity in donors and denial in large numbers of users of the involvement of a donor in conception. Lack of disclosure effectively prevents true implementation of legislation; if a child is not informed, it is the result of donated gametes, it cannot take up the legally available option of finding out identifiable information about their genetic parent(s).
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Affiliation(s)
- Olga van den Akker
- School of Life and Health Sciences, Aston University, Aston Triangle, Birmingham, UK.
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