O-211 Families created through identity-release egg donation: parents’ understanding of, and feelings about, donor identification in early childhood
Authors: Lysons J , Imrie S , Jadva V , Golombok S 
Published: June 2022

Abstract

Study question
How well do parents understand identity-release donation, and how do they feel about potential donor-child contact?

Summary answer
Almost one-third of mothers (28%) and fathers (31%) did not understand the identifiable nature of their egg donation. Mothers expressed considerable ambivalence about donor-child contact.

What is known already
Egg donation is an increasingly common method of conception for women who are unable to use their own eggs. Identity-release egg donation has been the only treatment option available to patients wishing to pursue this route to parenthood in the UK since 2005. Despite this, little is known about how well parents understand this legislation, and how they feel about potential donor-child contact. At 18 years, donor-conceived offspring can request identifying information about their donor. The first UK cohort of identity-release offspring will turn 18 in 2023; understanding parents’ comprehension of, and feelings about, identity-release is therefore particularly timely.

Study design, size, duration
Data are reported from phase two of a longitudinal study of families created using open-identity egg donation, when children were aged five. At phase one, 85 families were recruited through 12 UK fertility clinics. An 85% response rate was subsequently achieved at phase two. A sub-sample of sixty-one mothers and 51 fathers were included in the present analyses. This qualitative investigation explored parents’ level of understanding of, and egg donation mothers’ feelings about, identity-release donation.

Participants/materials, setting, methods
In-depth, semi-structured interviews were conducted with mothers and fathers. The interviews contained a section on what parents understood about the identifiable nature of the donor. These data were analysed using qualitative content analysis. Mothers who understood the identifiable nature of their egg donation (n = 44) were then asked about their thoughts and feelings regarding the prospect of future donor-child contact. Mothers’ narratives were analysed using thematic analysis.

Main results and the role of chance
Almost one third of parents (27.9% of mothers, n = 17; 31.4% of fathers, n = 16) did not understand the identifiable nature of their egg donation. Qualitative content analysis revealed two main types of misunderstanding: i) parents whose understanding of identity-release was incorrect or incomplete (n = 26, 10 mothers, 13 fathers) and ii) parents who believed their donor was anonymous (n = 10, 7 mothers, 3 fathers). Thematic analysis revealed that egg donation mothers’ feelings about identity-release donation could be understood in relation to three main themes: 1) Identity-release as a threat, 2) Acceptance: it is what it is, and 3) Embracing identity-release. Mothers had complex and sometimes contradictory feelings about the prospect of future donor-child contact, and used a number of strategies to manage those feelings in day-to-day life. Donor-child contact was commonly perceived as a threat to the mother-child relationship, to the child, and to the donor. Conversely, the possibility of future donor-child contact was viewed by some mothers as an opportunity to be embraced; access to the donor’s identifying information was seen as essential to the child’s identity, and as a gateway to a broader family network.

Limitations, reasons for caution
Participants were predominantly from White, middle-class backgrounds. Further research with a more diverse sample is needed to improve generalisability. However, no other research has yet examined egg donation parents’ understanding of, and feelings about, identity-release donation in the UK. This research is therefore an important addition to the limited literature.

Wider implications of the findings
These findings indicate that parents would benefit from more comprehensive provision of information, both at time of treatment and following conception, to ensure they have fully understood the nature of the donation. Parents may also benefit from follow-up care to help manage any complex or difficult feelings about donor-child contact.

Trial registration number
N/A