'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 1.5­2 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.

How couples' experiences prior to the start of infertility treatment with donor gametes influence the disclosure decision.

AIMS: To explore couples' experiences in the preconception phase of infertility treatment with donor gametes and how this may influence the disclosure process to the offspring and/or others. METHODS: In-depth interviews with 10 recipient couples were analyzed using a grounded theory approach. RESULTS: In the context of their infertility and a culture in which definitions of gender and family are fundamentally biologically based, participants reconsidered the significance and meaning of genetics, and social connectedness in family-building and parenthood. When couples emphasized the similarities with the biologically based definitions of parenthood and family, the question of disclosing the donor conception to the offspring seemed less relevant. When couples adapted their view on families and parenthood to an alternative family formation, long-term consequences became more relevant, including the disclosure question. Support from others was needed to manage the challenges of this stage, but this could be in conflict with their decision of non-disclosing the donor conception to the potential offspring. CONCLUSIONS: This study highlights the importance of couples' experiences in the preconception phase for their disclosure process. The treatment of infertility and a future-oriented, family-building approach should be addressed in a fertility program with donor gametes and valued as complementary.

Factors contributing to parental decision-making in disclosing donor conception: a systematic review.

BACKGROUND In recent years, changes in attitudes towards (non-)disclosure of donor conception to offspring and/or others have been observed. Studies have started to identify possible factors that contribute to these changes that are relevant for clinics, counsellors and policy-makers in their approach to the disclosure process. The aim of this systematic review was to integrate the existing knowledge on factors that influence the disclosure decision-making process of donor conception to offspring and/or others in heterosexual couples, and to discuss future trends and concerns. METHODS A bibliographic search of English, French, German and Dutch language publications of five computerized databases was undertaken from January 1980 to March 2012. A Cochrane Database systematic review approach was applied. RESULTS A total of 43 studies met the inclusion criteria, and these represented 36 study populations. The review shows that the parents' disclosure decision-making process is influenced by a myriad of intrapersonal, interpersonal, social and family life cycle features. These influences were not necessarily independent but rather were interwoven and overlapping. Theoretical frameworks have not yet been used to explain how the different factors influenced disclosure. Methodological limitations of the original publications (lack of information, several factors included in one study, descriptive character of studies) and this review (multiple factors that may interact) which hindered integration of the findings are outlined. CONCLUSIONS Intrapersonal, interpersonal, social and family life cycle factors influence the parents' disclosure decision-making process. The review has demonstrated the need for the development of a theoretical model to enable integration of the identified influencing factors. Further research is needed on the role of stigma, confrontation efficacy, extended family, donor siblings' characteristics, cross-border treatment, culture, gender and socio-educational factors.

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

BACKGROUND: As pregnancy and childbirth have long been considered women's issues and male infertility has long been surrounded by taboo, limited research has focused on the experience of infertile men. The purpose of this study was to compare male motives for parenthood, male well-being and disclosure patterns concerning the method of conception among men from couples starting treatment with IUI using their own sperm (autologous sperm recipient, ASR) or donor sperm (donor sperm recipient, DSR). METHODS: This prospective study included 46 DSR- and 151 ASR-couples. Self-report questionnaires assessing parenthood motives, well-being and disclosure patterns concerning the method of conception were administered to both men and women prior to treatment. Unpaired T-tests and Fisher's exact tests were used to test for significant differences. RESULTS: When compared with ASR-men, DSR-men expect more positive effects from parenthood on relationships and feelings of fulfilment, and report less negative effects of infertility on sexuality, but a lower self-image and more guilt. DSR-men plan to disclose the method of conception less frequently and have so far disclosed to a lesser degree than ASR-men. CONCLUSIONS: DSR-men feel differently about parenthood and infertility compared with ASR-men, and their higher expectations combined with lower self-esteem need (more) attention during counselling.