More counselling is needed for couples opting for donor insemination
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《英国医生杂志》
Parents of children conceived through sperm donation will need support to adapt to their children抯 new legal rights to know their donor抯 identity. This is the view of authors of two studies in the journal of the European Society of Human Reproduction and Embryology showing that until now many couples opposed disclosure.
From April the United Kingdom follows an international trend set by Holland, Sweden, New Zealand, and Australia in allowing children conceived through sperm donation to know the identity of the donor once they reach adulthood. Fearing that this may deter donors, the Department of Health in England has launched a campaign to encourage sperm and egg donation. However, the research indicates that recipients need encouragement too.
A UK study found that nearly two thirds of parents had not been inclined to tell their child that he or she was conceived from donated sperm. And Dutch researchers identified couples from lower socioeconomic groups as "vulnerable," because stronger social taboos inclined them to secrecy.
Emma Lycett of London抯 City University and colleagues compared parents in favour of openness with their children about their genetic origins with parents less keen on disclosure (Human Reproduction 2005;20:3). Of the 46 families studied 18 said that they either had already or intended to tell their children. Those rejecting openness said it was to protect one or more family members. They feared it might lead to the child rejecting their father for their biological one. Many felt it was a "personal matter" and wished to protect their child from "negative social pressures."
Anne Brewaeys and colleagues from Leiden University Medical Centre had, before identification of donors becoming compulsory in the Netherlands last June, compared couples who chose an anonymous donor with those who chose an identifiable donor (published online ahead of print publication on 27 January in Human Reproduction at http://humrep.oupjournals.org/, doi:10.1093/humrep/deh708). The study showed that of 64 heterosexual couples 24 chose anonymous donors, of whom 20 did not intend to inform their child that they were conceived by donor insemination.
Couples choosing anonymous donors tended to come from lower socioeconomic groups. Of the 24 couples who chose anonymous donors four had further education, compared with more than half (21) of the 40 couples who chose an identifiable donor. Also, many more male partners in the couples who chose anonymous donation reported "major distress" about their infertility.
Dr Brewaeys argues that the link between choice of donor type, education, and infertility distress shows a strong sociocultural influence. Couples choosing anonymous donors lived more often in a context where male infertility and non-genetic parenthood remained taboo topics.
She urges education campaigns to prevent stigmatisation of male infertility. She also stresses the importance of counselling before and after treatment. "Donor insemination is seen strictly as a medical intervention, but you need far more. You need people available who can offer expert care through counselling."
Dr Lycett believes attitudes are changing in Britain in line with the new law but agreed that it was "important for couples to be supported so they fully understand the consequences under the law once their child reaches adulthood." She is concerned that many UK clinics did not promote counselling after the child抯 birth.(Utrecht Tony Sheldon)
From April the United Kingdom follows an international trend set by Holland, Sweden, New Zealand, and Australia in allowing children conceived through sperm donation to know the identity of the donor once they reach adulthood. Fearing that this may deter donors, the Department of Health in England has launched a campaign to encourage sperm and egg donation. However, the research indicates that recipients need encouragement too.
A UK study found that nearly two thirds of parents had not been inclined to tell their child that he or she was conceived from donated sperm. And Dutch researchers identified couples from lower socioeconomic groups as "vulnerable," because stronger social taboos inclined them to secrecy.
Emma Lycett of London抯 City University and colleagues compared parents in favour of openness with their children about their genetic origins with parents less keen on disclosure (Human Reproduction 2005;20:3). Of the 46 families studied 18 said that they either had already or intended to tell their children. Those rejecting openness said it was to protect one or more family members. They feared it might lead to the child rejecting their father for their biological one. Many felt it was a "personal matter" and wished to protect their child from "negative social pressures."
Anne Brewaeys and colleagues from Leiden University Medical Centre had, before identification of donors becoming compulsory in the Netherlands last June, compared couples who chose an anonymous donor with those who chose an identifiable donor (published online ahead of print publication on 27 January in Human Reproduction at http://humrep.oupjournals.org/, doi:10.1093/humrep/deh708). The study showed that of 64 heterosexual couples 24 chose anonymous donors, of whom 20 did not intend to inform their child that they were conceived by donor insemination.
Couples choosing anonymous donors tended to come from lower socioeconomic groups. Of the 24 couples who chose anonymous donors four had further education, compared with more than half (21) of the 40 couples who chose an identifiable donor. Also, many more male partners in the couples who chose anonymous donation reported "major distress" about their infertility.
Dr Brewaeys argues that the link between choice of donor type, education, and infertility distress shows a strong sociocultural influence. Couples choosing anonymous donors lived more often in a context where male infertility and non-genetic parenthood remained taboo topics.
She urges education campaigns to prevent stigmatisation of male infertility. She also stresses the importance of counselling before and after treatment. "Donor insemination is seen strictly as a medical intervention, but you need far more. You need people available who can offer expert care through counselling."
Dr Lycett believes attitudes are changing in Britain in line with the new law but agreed that it was "important for couples to be supported so they fully understand the consequences under the law once their child reaches adulthood." She is concerned that many UK clinics did not promote counselling after the child抯 birth.(Utrecht Tony Sheldon)