Disclosure decisions among pregnant women who received donor oocytes: a phenomenological study

Abstract

Capsule-Controversy surrounding disclosure among donor oocyte recipients is escalating worldwide. This in-depth analysis captures the voice of pregnant women who received donor oocytes and the factors that influence their decision to disclosure.OBJECTIVE-Controversy surrounding disclosure among donor oocyte recipients is escalating worldwide, yet little research has sought to understand the disclosure experience of pregnant, donor oocyte recipient women. The purpose of this study was to provide an in-depth description of the disclosure experience, and identify factors that were significant to recipient women which influenced their reasoning as they formulated disclosure decisions. DESIGN-Qualitative, naturalistic design using a phenomenological approach. SETTING-The home or private office of the recipient woman. PARTICIPANTS-Donor oocyte recipient women between 9 and 23 weeks gestation.RESULTS-Disclosure decisions were influenced by multiple factors emerging from the women's values and beliefs and their social and cultural environment. Values and beliefs consisted of the right to know and the duty to protect. Social and cultural factors included social support, culture of the family, evolution of the social process, and personal testimonials. Women's age and selection of donor type are interrelated with disclosure decisions.CONCLUSIONS-Disclosing women voiced the right of the child to know and perceived social and cultural factors as conducive to disclosure. Non-disclosing and undecided women emphasized protecting normative relationships, perceived social stigma, and were unable to identify a benefit to disclosing. Women's age and choice of oocyte donor should be considered when counseling recipient women.

How Couples' Experiences prior to the Start of Infertility Treatment with Donor Gametes Influence the Disclosure Decision

“…This uncertainty has been observed to last into pregnancy [7]. Recognition and support by others (partner, family, friends) was felt important to cope with these challenges.…”

“…It is important that the acceptance and the treating of infertility as well as the family-building approach are recognized and valued as complementary components in a TPR program [8,14]. Such fertility counselling encourages couples to combine their focus on the planned TPR treatment with a more future-oriented view that incorporates the long-term implication of a family formation with donor gametes [6,7,8,40]. Such an approach will lead to a consideration and gradual integration of the disclosure decision-making process.…”

“…As at this stage a future pregnancy is by no means guaranteed, it seems difficult for couples to reflect on future family functioning and the disclosure issue [7,8,9,10]. Moreover, it has been suggested that infertility patients may avoid difficult subjects about their future family life in a defensive, superstitious attempt ‘not to jinx' their pregnancy chances [11].…”

The impact of disclosure on donor gamete participants: donors, intended parents and offspring

“…In another qualitative study, Hershberger et al [13] interviewed women, pregnant as a result of oocyte donation, about their disclosure decisions on two occasions. The in-depth interviews explored subjects' values and beliefs as well as their social and cultural environment.…”

Selective Disclosure in a First Conversation About a Family Death in James Agee's NovelA Death in the Family

“…There is no longer an exclusive promotion of openness, but rather an appreciation of the importance of the dialectic of openness= closeness and on developing concepts that allow us to grasp something of the complexity of disclosing sensitive information in families. The dialectic of openness=closeness is also captured in the concept of selective disclosure, which has been used in the literature on HIV diagnoses (Leask, Elford, Bor, Miller, & Johnson, 1997) and donor insemination (Hershberger, Klock, & Barnes, 2007). This concept refers to the differential openness of family members toward each other and emphasizes the processes of selecting who to tell about a sensitive issue (e.g., seropositive status, infertility), how much to tell, and so on.…”