Re: Full-sibling embryos created by anonymous gamete donation in unrelated recipients

9 11 2011

To the Editor:

The otherwise informative paper “Full-sibling embryos created by anonymous gamete donation in unrelated recipients” by Dicken et al. (1) was marred by use of limited evidence to support the claim that “most parents conceiving with the assistance of donor gametes do not disclose the nature of their conception to their resulting offspring.” A more thorough review of available literature than the two cited sources (2,3) reveals a more nuanced picture, as indicated by several European studies.

A Swedish study published in 2000 (4) reported that 11% of parents of donor insemination (DI)-conceived children had told their child about the nature of her or his conception, while 40% of parents intended to tell their child “later.” When re-interviewed some years later (5), 61% of these parents had already told their child about her or his conception, and a further 22% were still intending to do so.

In a Finnish study reported in 1998 (6), 38% of parents of children aged up to four years conceived following oocyte donation intended to disclose to their child the nature of her or his conception. When re-interviewed when their children were 13–14 years old, 27.8% of parents had already disclosed and 16.6% still intended to do so (7). In the same study, 83.3% of parents of children aged under three years indicated their intention to tell their child.

Two separate United Kingdom studies of oocyte donation draw broadly similar conclusions. In the first study, when the children were aged up to eight years old, one set of parents only had already told their child about the nature of her or his conception, 38% had decided not to tell their child, and the intentions of the remaining 53% are unspecified (8). These parents were re-interviewed when their child was 12 years old (9); 35% had either disclosed to their child already or stated their intention to do so. A separate cohort of parents of children conceived following oocyte donation aged under one year was recruited for a second study (10). No parent had told their child of the circumstances of her or his conception, 56% stated their intention to disclose, 22% were uncertain and 22% planned not to disclose. When these parents were re-interviewed when their child was aged seven years (11), 40.6% had already told their child, 31.3% were planning to disclose, 12.5% were unsure whether or not to disclose, and 15.6% had decided not to tell.

It is essential to be aware that parental intentions to tell may not result in actual disclosure. Nevertheless, the evidence currently available means that unqualified assertions that “most parents conceiving with the assistance of donor gametes do not disclose the nature of their conception to their resulting offspring” are no longer sustainable.

Eric Blyth, C.Q.S.W., B.A., M.A., Ph.D.
Professor of Social Work
School of Human and Health Sciences
University of Huddersfield
Queensgate
Huddersfield, United Kingdom

References
1. Dicken C L, Zapantis A, Illions E, Pollack S, Lieman HJ, Bevilacqua K, et al. Full-sibling embryos created by anonymous gamete donation in unrelated recipients Fertil Steril 2011; 96:641–2.

2. Golombok S, Readings J, Blake L, Casey P, Mellish L, Marks A, et al. Children conceived by gamete donation: Psychological adjustment and mother-child relationships at age 7. J Fam Psychol 2011;25: 230–9.

3. Readings J, Blake L, Casey P, Jadva V, Golombok S. Secrecy, disclosure and everything in-between: decisions of parents of children conceived by donor insemination, egg donation and surrogacy. Reprod Biomed Online 2011;22:485–95.

4. Gottlieb C, Lalos O, Lindblad F. Disclosure of donor insemination to the child: the impact of Swedish legislation on couples’ attitudes. Hum Reprod 2000; 15: 2052-2056.

5. Lalos A, Gottlieb C, Lalos O. Legislated right for donor-insemination children to know their genetic origin: a study of parental thinking. Hum Reprod 2007; 22(6): 1759–1768.

6. Söderström-Anttila, V., Sajaniemi N, Tiitinen A, Hovatta O. Health and development of children born after oocyte donation compared with that in those born after in vitro fertilization, and the parents’ attitudes regarding secrecy. Hum Reprod 1998; 13: 2009-2015.

7. Söderström-Anttila, V., Sälevaara, M. and Suikkari, A. M. Increasing openness in oocyte donation families regarding disclosure over 15 years. Hum. Reprod 2010; 25: 2535-2542.

8. Golombok S, Murray C, Brinsden P, Abdalla H. Social versus biological parenting: family functioning and the socioemotional development of children conceived by egg or sperm donation. J Child Psychol Psychiat 1999;40:519 –27.

9. Murray C, MacCallum F, Golombok S. Egg donation parents and their children: follow-up at age 12. Fertil Steril 2006;85:610-618.

10. Golombok, S., Lycett, E., MacCallum, F., Jadva, V., Murray, C., Rust, J., Abdalla, H., Jenkins, J., Margara, R. Parenting infants conceived by gamete donation. J. Fam. Psychol. 2004; 18: 443-452.

11. Readings J, Blake L, Casey P, Jadva V and Golombok S. Secrecy, disclosure and everything in-between: decisions of parents of children conceived by donor insemination, egg donation and surrogacy. Reprod. Biomed. Online 2011; 22:485-495.

Published online in Fertility and Sterility doi:10.1016/j.fertnstert.2011.11.006

The authors declined to reply to this letter.

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