Confidence in the use of donor insemination: an evaluation of the impact of participating in a group preparation programme

New realities for the practice of egg donation: a family-building perspective

The practice of egg donation in the United States has been based on assumptions about secrecy, anonymity, and contact among the parties that require reexamination. This article argues for the need to acknowledge that secrecy and anonymity are no longer viable assumptions and that all parties may have a strong interest in contact and connection. A shift in the narrative for the practice of egg donation from a purely medical perspective to a broader family-building perspective is described. Significant practice changes to accommodate the new realities, rooted in a family-building perspective, are outlined in the arenas of medical record retention, informed consent, recipient and donor preparation and counseling, facilitation of contact among the parties, and outreach to other medical professionals, with the goal of promoting not only healthy pregnancy, but also long-term positive family functioning.

The interaction between donor-conceived families and their environment: parents' perceptions of societal understanding and attitudes regarding their family-building

Disclosure issues in relation to donor conception have mainly been examined in the context of relationships and interaction within donor-conceived families, whilst influences from outside the family, for example societal ones, have been little researched. This study explored the societal experiences of individuals who build their family with the help of donor conception (i.e. donor-conceived families), specifically, where and how parents and society interact and the presence and influence of cultural beliefs and values regarding the family. Belgian (n = 89) and Swedish (n = 56) donor-conceiving parents completed an online-survey focusing on their experiences with societal perceptions and attitudes and behaviour and responses from friends, healthcare professionals and teachers. Descriptive and comparative statistical analyses were conducted. Results showed that donor-conceiving parents were challenged by societal representations, responses from friends, healthcare professionals and teachers, and cultural norms and values. Parents had to cope with lack of knowledge and understanding of donor-conceived families and colliding views on the relevance of genes in kinship. They needed to be able to explain and defend themselves, correct others and handle emotions and sensitivity when managing these interactions. Through psycho-education health-care professionals can help families anticipate potential reactions and manage societal responses by strengthening parents' coping mechanisms. These findings also call for awareness of the presence of cultural norms and values even when counsellor and patient share the same culture because counsellor and donor-conceiving parents can relate differently to (collide or conform with them) the shared cultural norms, which can impact on parents' experience.

'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.

(Male) infertility: what does it mean to men? New evidence from quantitative and qualitative studies

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.

Perceived negative consequences of donor gametes from male and female members of infertile couples

OBJECTIVE

To determine the views toward donor sperm and eggs of both men and women. The use of donor sperm or ova becomes an option for some infertile couples.

DESIGN

Prospective cohort of infertile couples.

SETTING

Eight California reproductive endocrinology practices.

PATIENT(S)

Infertile couples (n=377) were recruited after an initial infertility clinic visit.

MAIN OUTCOME MEASURE(S)

From questionnaires administered at recruitment, ratings concerning the impact of the use of donor gametes were assessed. Differences between men and women in attitudes toward donor gametes were compared with analysis of variance (ANOVA). Linear regression was used to identify independent predictors of attitudes toward gametes.

RESULT(S)

Women's attitudes toward donor sperm were significantly more negative than their attitudes toward donor eggs (5.1+/-1.4 vs. 4.7+/-1.6). Similarly, male donor gamete attitude scores were higher for donor sperm compared with donor eggs (4.9+/-1.6 vs. 4.1+/-1.6). Both men and women agreed that the use of donor sperm was more likely to have negative effects on their relationship and negative societal ramifications. Female donor gamete attitude scores were predicted by marital status, race, and education, whereas men's scores were independent of all measured factors.

CONCLUSION(S)

Both men and women view the use of donor sperm with more skepticism compared with the use of donor eggs, suggesting a unique underlying perception regarding the use of male donor gametes.