BACKGROUND: A major concern in relation to donor insemination (DI) is whether children should be told about their genetic origins. This study compared the thoughts, feelings and experiences of DI parents who were inclined towards openness with those who were inclined towards non-disclosure. METHODS: Forty-six families with a 4-to 8-year-old DI-conceived child were interviewed about their decision, their reasons and subsequent concerns regarding disclosure. RESULTS: Thirty-nine percent of parents were inclined towards disclosure whilst the remaining 61% were not. The two main reasons for favouring disclosure were to avoid accidental discovery and a desire for openness. Non-disclosing parents felt that there was no reason to tell and wished to protect family members. The children who had been told reacted with either curiosity or disinterest. CONCLUSIONS: In spite of donor anonymity, parents who were intending to tell their child in the future had optimistic expectations of their child's reaction. Parents who had already told their child generally described the telling experience as a positive one.

This article explores the issues surrounding the notions of secrecy and openness in donor insemination (DI). Secrecy in DI is first placed in historical context, with an outline of some of the main reasons that secrecy has been advocated. The concept of openness is then introduced, and some of the arguments for a more open approach to DI are presented. On this basis, the responses of various governments to calls for more openness are outlined, and the social policy implications of these are discussed. It is concluded that more openness in DI would be advantageous to all of those involved. Couples, professionals, and policymakers are therefore urged to reexamine their views about the need for maintaining secrecy in the area.

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This study investigates the motivations, views and experiences of semen donors willing to have contact with their offspring. An online questionnaire for semen donors was posted by the US-based Donor Sibling Registry in 2009. A total of 164 respondents who had previously been donors completed the questionnaire, which consisted of 45 open and closed questions covering motivations for donating, health and medical information, experiences of donating, contact with offspring and implications of donating and contact for their families. The donors' primary motivation was to help other families, although payment was also a factor. Almost all donors were open to contact with their offspring and, where donors were partnered, three-quarters of the partners also supported possible contact. Almost one-third, however, had reservations about contact or were opposed. Two-thirds of donors' own children were interested in meeting the offspring. Contact between a donor and his offspring is often seen as a coming together of these two people only. The results of this study suggest that there are important ramifications for both of the families who become linked. Understanding gamete donation in this broader family context is crucial to the contribution that health professionals can make in this area.

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.

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background: Studies of parental decision making regarding information sharing with offspring conceived as a result of donor insemination are almost all based on a 'one point in time' design. This study reports on parental decision making at two points in time, Time 1 and Time 2, 14 years apart.methods: Forty-four of 57 families (77%) who had agreed to take part in a follow-up study were interviewed. An in-depth semistructured interview format was used. In addition, two questionnaires seeking mainly quantitative data were administered.results: Fifteen families (35%) had told their offspring of the donor insemination conception at Time 2 (2004). An additional seven families said they had always wanted or intended to tell the children and asked for assistance on how to do this. Where partners were in agreement on information sharing at Time 1 (1990)-either to tell or not to tell-this position was maintained. Where there was disagreement, or uncertainty, two-thirds had not told and one-third had.conclusions: Despite the professional and socio-political culture at the time of treatment, almost half of the families in this study ended up sharing the donor insemination conception with their offspring. The results support the need for appropriate preparation for donor insemination family building.

This study was funded by an AUT University Faculty of Health Environmental Sciences research grant.