Parents have a generally optimistic view about being open with their children who were conceived using sperm donation, according to a pair of new studies.^1,2 But the research also found that some parents are still uncomfortable about discussing their children's origins with them.

The research follows a study published last November that found that children conceived from sperm donation in most cases want to learn about their origins—specifically, the identity of the donor.³

These two latest research projects were published in the journal Human Reproduction, a publication of the European Society for Human Reproduction and Embryology.

Varying Modes of Communication
One study was done in the Netherlands,¹ where a new law was passed last summer requiring all sperm donors to be identified. Since 1994, the Fertility Center at Leiden University Hospital gave parents using sperm donation the option of keeping the donor's identity anonymous, or making the donor's identity available to children once they reach age 16. This rule allowed a research team to study the reasons why some parents choose anonymity and others did not. Their study also provided some insight into the potential impact of the new legislation.

"Undoubtedly, parental attitudes about the role of the donor within their family will influence their children's donor concept and their future need for donor information," wrote Anne Brewaeys, PhD, a psychologist in the department of Gynecology and Reproductive Medicine at Leiden University Medical Center, and her colleagues.

"The aim of the present study was to gain insight into parents' own donor choices and motives within a system where they had the freedom to choose," the researchers wrote.

Brewaeys and her team collected information on 105 couples who had sought a sperm donor for their first child. Sixty-one percent of the couples were heterosexuals, and the rest were lesbian couples. All had received counseling before treatment. While the counseling sessions did not include advice about the choice of a donor, they did include information about the consequences of both secrecy and disclosing information to the child later, consequences of choosing either an anonymous or known donor, and issues to be considered when raising a child conceived using donor insemination.

Information had been collected on the reasons for their choice. Brewaeys and her team found that nearly two-thirds of the heterosexual couples and all but one of the lesbian couples had chosen identifiable donors.

Reasons for Choosing Openness
"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."

While most parents said they didn't want to be directly involved with the donor, they felt it was not their right to block their children's access to that information, if they wanted it. "Although the majority of future parents expressed the wish not to become involved with the donor, they decided that it was not for them to block the child's access to donor information," Brewaeys' group wrote.

Some couples were also influenced by the Netherlands legislation that would grant full access to sperm donor identification anyway, Brewaeys and her colleagues noted. Lesbian couples' attitudes were similar; they felt the absence of a male infertile partner spared them the stigma of infertility and they planned to inform their children as early as possible about their origins.

Motives Behind Anonymity
Heterosexual couples who opted for anonymous donors had a different perspective. The researchers found that these couples were more likely to have a low socioeconomic status, difficulties coping with male infertility, and an attitude of secrecy to the child. By contrast, those choosing identifiable donors tended to be more educated, had higher incomes, and men coped better with their infertility diagnosis, the researchers found. Secrecy to their children was not an option for these couples.

"The associations between donor choices, education level and infertility distress were intriguing," Brewaeys said.

Among couples choosing donor anonymity, "male infertility and non genetic parenthood remains more of a taboo, whereas childlessness is less accepted," she explained. "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."

Brewaeys and her colleagues point out that the new donor identity law in the Netherlands will make couples preferring donor anonymity more "vulnerable." As such, more pre-treatment psychological counseling is necessary, as are education campaigns aimed at easing the stigma of male infertility, Brewaeys said.

Similar Study in the UK
In the second study, doctors at City University in London interviewed nearly 50 families from an area clinic who had children ranging from 4 to 8 years of age, and who had been conceived using donor sperm.

Emma Lycett, PhD, a child psychologist at City University's Family and Child Psychology Research Centre, and her colleagues wrote that donor insemination was shrouded in secrecy in the past, and that these children at one time were considered illegitimate in the UK, requiring parents to apply for adoption.

"In more recent years, however, many countries have witnessed a change in their legal and policy approach to donor insemination and donor anonymity, in part to encourage the disclosure of donor conception to children," Lycett's group wrote.

Most Still Prefer Being Tight-Lipped
The study found that nearly 40 percent of these families were comfortable with open communication about their children's genetic origins, but 61 percent preferred keeping this topic secret. Additionally, 13 percent of the families reported they had already told their children, more than quarter said they intended to in the future, 43 percent decided against communicating with their children, and nearly a fifth were uncertain about it.

"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."

Still, in a previous study by Lycett and her team, nearly half of the couples said they intended to tell their children about their origins,4 suggesting an increase in openness in the past few years among couples using donor insemination, Lycett said.

For their latest research, Lycett's group divided the parents into two categories:

• Disclosers—those who had told their children or intended to tell them.
• Non-disclosers—those who were definitely not telling their children or were uncertain about it.

Why Parents Chose Openness or Secrecy
The most important reasons that the disclosers gave for informing their child about his or her origins were that they favored openness to avoid accidental discovery, and because they wanted to be honest. Almost half also reported that they believed their children had the right to know this information. Among six couples who had already told their children (aged between 3 and 5), the reaction was either one of curiosity or disinterest.

The main reasons that those in the non-disclosers group gave for keeping the information a secret was that they felt there was no reason to tell or to protect certain family members, including the feelings of the child. Nearly a third also felt that being open might affect the relationship between the child and his or her father. Some fathers even feared that their children, on learning this information, might reject them in favor of the biological father.

Though the findings don't represent donor insemination couples as a whole, Lycett stressed, they do suggest that a significant proportion of parents using this form of assisted reproduction are inclined to be open about it with their children later. She said the study might provide practical information for fertility clinics in terms of counseling patients before treatment, particularly for parents who are unsure about advising their children later.

Similar to the law in the Netherlands, the UK has also announced a change in its law about donor insemination identity. It states that children born after April 2005 will be entitled to identifying information about their donor when they reach age 18, Lycett and her colleagues wrote.

"The new legislation could mean a greater proportion of parents will be encouraged to be open … but it remains to be seen how the new laws will affect parental attitudes towards disclosure in the future," Lycett said.

1. Brewaeys A, Bruyn JK, Louwe LA, Helmerhorst FM. Anonymous or identity-registered sperm donors? A study of Dutch recipients' choices. Hum Reprod 2005 Jan 27;[Epub ahead of print].
2. Lycett E, Daniels K, Curson R, Golmobok S. School-aged children of donor insemination: a study of parents' disclosure patterns. Hum Reprod 2005 Jan 27;[Epub ahead of print].
3. Scheib JE. Riordan M, Rubin S. Adolescents with open-identity sperm donors: Reports from 12-17 year olds. Hum Reprod 2004 Nov 11 [Epub ahead of print].
4. Golombok S, Lycett E, MacCallum F et al. Parenting infants conceived by gamete donation. J Fam Psychol in press.

John Martin is a long-time health journalist and an editor for Priority Healthcare. His credits include coverage of health news for the website of Fox Television's The Health Network, and articles for the New York Post and other consumer and trade publications.