Two new studies appearing in the medical journal Human Reproduction provide an insight into the increasing trend in society to be more open about the use of sperm donors. They indicate however, that not all parents are comfortable with the new openness. Last June, the Netherlands made it compulsory for all sperm donors to be identified. The Fertility Center at Leiden University Hospital has run a double-track system since 1994 allowing couples to choose either an anonymous or an identifiable donor whose details would be available to children when they are 16. This has enabled researchers led by Dr Anne Brewaeys of the university's medical center to compare the reasons for the different choices and provide some insight into the potential impact of the new legislation.
The Dutch study involved couples seeking a sperm donor for their first child. Around 60 percent were heterosexuals and 39 percent were lesbian couples. All received counselling before treatment and data were collected on reasons for their choice. Sixty-three per cent of heterosexual couples and all but one of the lesbian couples chose identifiable donors. "Motives for choosing an identifiable donor were the same for heterosexual and lesbian couples," said Brewaeys. "The majority pointed to the right of the child to know its genetic origins. Although most parents did not want to be involved with the donor they decided it was not for them to block the child's access to donor information. Access to the donor's medical records was an important factor and some couples were also influenced by the fact that the majority of donor insemination children in the future would have access to information because of the forthcoming legislation."
Among heterosexual couples, those opting for anonymous donors had a different profile from those wanting an identifiable donor. They were more likely to have a low socioeconomic status, difficulties coping with male infertility and an attitude of secrecy to the child. Only 12% had considered adoption. By contrast, among those opting for identifiable donors, the majority were better educated and better off financially and the men dealt better with their fertility problems. "The associations between donor choices, education level and infertility distress were intriguing," said Brewaeys. "We believe these are strongly influenced by the sociocultural environment, with those choosing anonymity living more often in a context where other family values prevail. Male infertility and non genetic parenthood remains more of a taboo whereas childlessness is less accepted. Such values may have influenced the high levels of distress about infertility seen in most of the men and the wish not to tell the children about their genetic origins. However, the design of our study does not allow for firm conclusions: we need more sophisticated measures to disentangle the complex relationships that play a part."
Brewaeys concluded that lesbian couples and more privileged heterosexual parents should fare well under the new laws, but couples wanting anonymous donation appeared more vulnerable. "It's essential that we make available pre-treatment counselling focused on individual motives and attitudes and that we continue the counselling after the birth. We also need to develop education campaigns to prevent further stigmatisation of male infertility."
In addition to the Dutch law, from April this year, all children conceived in the UK via donors will be entitled to identifying information when they are 18. In the second study, led by Dr Emma Lycett of London's City University, researchers compared the emotions and experiences of UK parents who favoured openness with their children with those who were not keen on disclosure.
The researchers interviewed families from a London clinic who had a 4-8 year old child conceived through donor sperm. They found that 39 percent were inclined to openness and 61 percent were not. Thirteen per cent had already told their child, 26 percent intended to in the future, 43 percent had decided against telling their child and 17 percent were still uncertain.
The two most important reasons the disclosers gave for telling their child were that they favoured openness to avoid accidental discovery and because they wanted to be honest. Almost half also said they believed the child had a right to know their genetic origins. The reaction of the children who had already been told was generally one either of curiosity or disinterest. The two main reasons for the non-disclosers not to tell their child were that the parents felt there was no reason to tell, or to protect one or more family members, including the feelings of the child itself. Nearly 30 percent also felt that openness might affect the relationship between the father and child. Some feared the child might reject them with some fathers being concerned they would be rejected in favour of the biological father.
Dr Lycett said that although the sample of parents could not be considered representative of donor insemination parents as a whole, the findings suggested a marked proportion of parents recognised the importance of sharing donor insemination information with their child. "It will be interesting to know what proportion of those parents who intend to tell the child actually follow through," said Lycett. "An earlier European study of parents in this age group found that fewer than 10 percent had told their child by the time they reached early adolescence, which shows that intention is not necessarily followed by practice. However, in our most recent study of donor insemination children born since the new millennium 46 percent of parents said that they intended to disclose the donor conception to the child, suggesting a change in attitudes to openness in recent years. The new legislation could mean a greater proportion of parents will be encouraged to be open, as has been the case in Sweden since anonymity was barred, but it remains to be seen how the new laws will affect parental attitudes towards disclosure in the future."
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