Who requests their sperm donor's identity? The first ten years of information releases to adults with open-identity donors.

OBJECTIVE: To report findings from 10 years of requests from adults eligible to obtain their open-identity sperm donor's information. DESIGN: Analysis of archived family and donor data. Semistructured interviews at information releases. SETTING: Not applicable. PATIENT(S): A total of 85 DI adults requesting 43 donor identities; program data on 256 DI families. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): We identified [1] demographic predictors of requesting donor identities, [2] information release timing and length, and [3] request motives. RESULT(S): Just >35% of eligible DI adults requested their donor's identity. Adults ranged from 18-27 years, requesting at median age 18 years. More women than men requested. Proportionally fewer adults requested when they had heterosexual-couple parents, and proportionally more when they had one rather than two parents. In interviews, the common theme was wanting to know more about the donor, especially about shared characteristics. Most adults planned to contact their donor. More than 94% of adults had donors who were open to contact; adults expressed modest expectations about this contact. CONCLUSION(S): In 2001, the first adults became eligible to obtain their open-identity sperm donor's information. Ten years of identity requests at one program indicates that information about one's donor is important to a significant proportion of these DI adults. Most requested their donor's identity soon after becoming eligible, suggesting some urgency to wanting the information. Interview data highlighted the role of donor information in helping adults better understand themselves and their ancestry. Findings hold important implications for practice and policy.

Female-partnered women conceiving kinship: Does sharing a sperm donor mean we are family?

This qualitative study explored how 36 initially female-partnered mothers defined their own, and their children's, relationships with families who share their unknown sperm donor (i.e., "linked" families). Shared genetics among children were sometimes sufficient to describe relationships among linked families as familial, especially from the children's perspectives. Most women described their own relationships with linked families as significant but not necessarily in traditional family terms. Family terms were sometimes seen as undermining ties to siblings and genetically unrelated mothers. As shared experiences have come to define "chosen family," definitions of significant relationships must expand to include those defined by shared genetics alone.

Contact among families who share the same sperm donor.

OBJECTIVE: To examine the experience of contact among families who share the same sperm donor and the purpose served by contact. DESIGN: Study 1: retrospective survey; study 2: archival data analysis. SETTING: Donor insemination (DI) program. PATIENT(S): Study 1: 14 parents from the first cohort of matched families; study 2: Archival data about 515 families from the DI program. INTERVENTION(S): Study 1: Interview of parents via anonymous mail-back survey; study 2: none. MAIN OUTCOME MEASURE(S): Study 1: Survey questions focused on the family, contact experience, and relationship to the matched family. Study 2: Comparison of families in the matching service to DI program families on family structure, parity, and type of donor (anonymous or open-identity). RESULT(S): Study 1: Single women and lesbian couples headed most families. Parents reported positive experiences with contact. Reasons for contact focused on creating family for the child and addressing questions about the donor. Study 2: Families with open-identity donors and those headed by single women were overrepresented in the matching service; heterosexual couple-headed families were underrepresented. CONCLUSION(S): Findings indicate positive outcomes for contact among families who share the same donor. Contact appears to serve the purpose of creating extended family for the child and may also help answer questions about the donor.

How parents whose children have been conceived with donor gametes make their disclosure decision: contexts, influences, and couple dynamics.

OBJECTIVE: To describe parents' disclosure decision-making process. DESIGN: In-depth ethnographic interviews. SETTING: Participants were recruited from 11 medical infertility practices and 1 sperm bank in Northern California. PATIENT(S): One hundred forty-one married couples who had conceived a child using donor gametes (62 with donor sperm, 79 with donor oocytes). INTERVENTION(S): Husbands and wives were interviewed together and separately. MAIN OUTCOME MEASURE(S): Thematic analysis of interview transcripts. RESULT(S): Ninety-five percent of couples came to a united disclosure decision, some "intuitively," but most after discussions influenced by the couples' local sociopolitical environment, professional opinion, counseling, religious and cultural background, family relationships, and individual personal, psychological, and ethical beliefs. Couples who were not initially in agreement ultimately came to a decision after one partner deferred to the wishes or opinions of the other. Deferral could reflect the result of a prior agreement, one partner's recognition of the other's experiential or emotional expertise, or direct persuasion. In disclosing couples, men frequently deferred to their wives, whereas, in nondisclosing couples, women always deferred to their husbands. CONCLUSION(S): Although the majority of couples were in initial agreement about disclosure, for many the disclosure decision was a complex, negotiated process reflecting a wide range of influences and contexts.

Open-identity donor insemination in the United States: is it on the rise?

Information about US donor insemination programs was reviewed to determine whether an increasing number are offering open-identity donation. Results indicate that indeed, numbers are rising and that the ratio of open-identity to anonymous sperm donors in a program increases the longer that the program has offered an open-identity option.

Strategies for disclosure: how parents approach telling their children that they were conceived with donor gametes.

OBJECTIVE: To describe how parents envision, plan, and enact disclosing to their children that they were conceived with donor gametes. DESIGN: In-depth ethnographic interviews. SETTING: Participants were recruited from 11 medical infertility practices and 1 sperm bank in Northern California. PATIENT(S): A total of 141 married couples who had conceived a child using donor gametes (62 with donor sperm and 79 with donor oocytes). INTERVENTION(S): Husbands and wives were interviewed together and separately. MAIN OUTCOME MEASURE(S): Thematic analysis of interview transcripts. RESULT(S): Disclosing parents predominantly subscribed to one of two disclosure strategies: the conviction that early disclosure is of paramount importance so that the child "always knows," or the belief that later disclosure is preferable after family routines have been established and the child has the maturity to understand biologic concepts and has developed a sense of discretion. No parent regretted disclosing, and many expressed relief. CONCLUSION(S): Parents choosing early disclosure were more at ease with the disclosure process, whereas parents choosing later disclosure reported greater uncertainty about how and when to disclose. Parents wished for more peer and/or professional support and guidance to assist them with disclosure, not only initially but continuing long after their children were born.