Human Reproduction, Vol.24, No.3 pp.

517–523, 2009
Advanced Access publication on November 13, 2008 doi:10.1093/humrep/den386

ORIGINAL ARTICLE Psychology and counselling

Embryo donation parents’ attitudes

towards donors: comparison with
adoption
Fiona MacCallum
Department of Psychology, University of Warwick, Coventry CV4 7AL, UK

Correspondence address. Tel: þ44-2476-523182; E-mail: fi[email protected]

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background: Embryo donation produces a family structure where neither rearing parent is genetically related to the child, as in adop-
tion. It is not known how embryo donation parents view the donors compared with how adoptive parents view the birth parents.
methods: 21 couples with an embryo donation child aged 2 –5 years were compared with 28 couples with an adopted child. Parents
were administered a semi-structured interview, assessing knowledge of the donors/birth parents, frequency of thoughts and discussions
about the donors/birth parents and disclosure of the donor conception/adoption to the child. Comparisons were made between
mothers and fathers to examine gender differences.
results: Embryo donation parents generally knew only the donors’ physical characteristics, and thought about and talked about the
donors less frequently than adoptive parents thought about and talked about the birth parents. Embryo donation fathers tended to think
about the donors less often than did mothers. Disclosure of the child’s origins in embryo donation families was far less common than in
adoptive families (P , 0.001 for mothers and fathers), and was associated with the level of donor information (P , 0.05 for mothers, P
, 0.025 for fathers).
conclusions: Embryo donation parents’ views on the donors differ from adoptive parents’ views on the birth parents, with donors
having little significance in family life once treatment is successful.
Key words: IVF / adoption / embryo donation / disclosure / donor conception

with whom they share no genetic relationship, as are adopted chil-

Introduction dren. Moreover, like birth parents in adoption, the donor couple
Embryo donation is the process whereby an infertile couple receives may still be together and may have other children who are genetic
an embryo created using gametes from another man and woman, full siblings to the embryo donation offspring. However, in embryo
with the intention that the recipient couple will raise the resulting donation, unlike adoption, there is a biological link to one of the
child. First reported in 1983 (Trounson et al., 1983), embryo donation rearing parents through gestation.
is one of the less frequently used assisted reproduction techniques in Since embryo donation and adoption families are undeniably similar
the UK with an average of around 35 children per year born following in their genetic structure, the attitudes of embryo donation parents
this treatment over the last decade. In comparison, there were 800 towards the donor couple can be compared with the attitudes of
children per year born following donor insemination and 400 adoptive parents towards the birth parents. Potential adopters are
through oocyte donation [Human Fertilisation and Embryology Auth- specifically asked to consider their views on the child’s biological
ority (HFEA), personal communication]. The low usage of embryo parents during the adoption preparation process (Triseliotis et al.,
donation is partly because it is recommended only when either both 1997). Furthermore, over the last two decades, there have been
members of the couple are diagnosed as infertile, or when previous moves towards encouraging openness in adoption. In the UK, particu-
IVF/ICSI treatments using the couples’ own gametes are unsuccessful. larly if relinquishment is voluntary, meetings may be arranged between
The small numbers also result from the scarcity of available donated the birth parents and the prospective adopters prior to the child’s pla-
embryos. In the majority of cases, the embryos used had been cement. Social services can encourage adoptive parents to maintain
created by another couple in their attempts to conceive through contact with the birth family post-adoption, although this is most com-
IVF. The embryo donation child is therefore raised by two parents monly done through the exchange of letters via the adoption service

& The Author 2008. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved.
For Permissions, please email: [email protected]
518 MacCallum

rather than direct communication. Contact is seen by some adopters evidence of some gender differences in feelings arising from the
as an advantage in that it gives them much fuller access to the child’s experience of infertility generally. Women take infertility particularly
history and provides reassurance ‘for children, adopters and birth hard, with 48% of women in one study describing it as the worst
families in relation to each other’s well-being’ (Ryburn, 1996, experience of their lives, compared with only 15% of men (Freeman
p. 636). Indirect ‘letterbox’ contact may trigger adoptive parents to et al., 1985). When preparing for infertility treatment, women are
think about birth family members when letters arrive, and to have more likely than their male partners to express feelings of fear,
greater levels of curiosity about them generally. sadness and anxiety (Merari et al., 2002). Women are also more
In comparison, the majority of donor conception treatment pro- prone to attributing the responsibility for infertility to themselves,
grammes run by fertility clinics in the UK have involved anonymous even when the diagnosis is of a male problem (Robinson and
donors with no contact between donors and recipients. The change Stewart, 1996). In contrast, men report less overt distress in response
in UK legislation in April 2005 regarding donor anonymity, allowing to fertility problems (Daniluk, 1988), particularly when the infertility is
donor offspring access to the identity of the donors when they attributed to the woman or is unexplained (Nachtigall et al., 1992). It
reach 18, does not affect this structure since the recipient couple does not follow that infertility does not cause suffering for men, indeed
themselves will not receive identifying information on the donors. studies have found strong negative reactions to diagnoses of male
Thus, in adoption, the genetic relationships between birth families infertility (Webb and Daniluk, 1999), but men seem to demonstrate
and children are considered highly important by the practitioners their concerns less openly. This gender disparity in expressed affect
involved, whilst in embryo donation the child’s genetic links to the may arise from the use of different coping styles. In an examination

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donor couple are considered much less so. The question is whether of coping strategies of infertile couples referred for IVF treatment,
the varying significance placed on the role of the genetic parents in women used techniques involving admission of distress such as directly
embryo donation and adoption will be reflected in the mindsets of challenging the problem, seeking social support and accepting respon-
the rearing parents. sibility for the problem, relatively more frequently than men (Peterson
Linked to the emphasis on genetic relationships is the question of et al., 2006). Meanwhile, men used proportionately higher levels of
whether parents intend to disclose the information about the child’s strategies involving denial of distress, such as distancing from the
origins. The gestational link in embryo donation allows parents to problem, or keeping feelings to oneself.
keep the non-genetic relationship private if they so desire (Widdows These differences in outlook on, and coping with, infertility may
and MacCallum, 2002). The issue of disclosure in donor conception result in embryo donation parents showing gender differences in
has received a great amount of attention and debate in recent their views of the donors and the disclosure of the donation. The dis-
years, with particular concern over the adverse effect of secrecy on tancing and denial adopted by men may make them likely to wish not
the child’s psychological well-being and the nature of family relation- to think about or discuss the issue. Support for this comes from a
ships (Daniels and Taylor, 1993; Shenfield and Steele, 1997; McGee Dutch study of couples with donor insemination children which
et al., 2001; Patrizio et al., 2001). Results of this debate include the found that mothers more often disclosed the conception to others,
afore-mentioned legislation change on donor anonymity and the and in four of the 38 couples interviewed the mothers were in
current advice given by the UK regulatory body, the HFEA, that ‘It favour of telling the child whilst their partners were against this (Bre-
is certainly best to be open with your child/children about the circum- waeys et al., 1997). Furthermore, young adults who were aware of
stances of their conception’ (HFEA, 2008). Despite this, a previous their conception through donor insemination reported that their
report on the present study sample found that only 9% of embryo fathers showed more avoidance of the topic than did their mothers
donation mothers had already told their child about the donor con- (Paul and Berger, 2007). It has been suggested that men feel more
ception, with a further 24% stating an intention to do so in the threatened by the acknowledgement of their infertility than do
future (MacCallum and Golombok, 2007). In this respect, these women, due to the association between fertility and masculinity,
mothers resemble parents seen in earlier studies of donor insemina- and that it is this stigma that deters men from disclosure (Nachtigall,
tion and oocyte donation families, the majority of whom were not 1993). Indeed, men who report fewer concerns about stigma
planning to tell their child about the lack of genetic link to one related to the use of donor insemination are more likely to disclose
parent (Brewaeys, 2001; Murray and Golombok, 2003). Contrastingly, the child’s origins to others (Nachtigall et al., 1997). However,
adoptive parents generally begin the process of disclosure when the research on oocyte donation parents in the USA found a higher
child is aged 2 –4 years (Brodzinsky et al., 1998), a practice strongly percentage of women than men had told others about the donor
advocated by social workers. Comparisons between the stances of conception, even though the infertility here is a female problem
embryo donation and adoptive parents on disclosure could help (Klock and Greenfeld, 2004). This suggests that it is not only the
explore why embryo donation parents may be more private. Interest- stigma of their own infertility that determines attitudes towards
ingly, a study by Klock and Greenfeld (2004) of oocyte donation disclosure, but may be linked to men’s more general feelings
parents found an association for fathers, but not mothers, between regarding infertility and the use of donor gametes. It would thus be
information known about the donor and the decision to disclose to interesting to examine the viewpoints of embryo donation fathers,
the child. Men who knew relatively more about the donor were where both members of the couple may have infertility problems,
more likely to be inclined towards disclosure. Thus, embryo donation and to assess whether they differ from those of embryo donation
parents’ disclosure decisions may be influenced by their levels of mothers.
knowledge regarding the donors. In light of issues explored above, the primary objective of the
A further question is whether there is any discrepancy within the present study was to compare and contrast the attitudes of a
couple in their views towards the donors or birth parents. There is sample of embryo donation parents towards the donor couples with
Parents’ attitudes to embryo donors compared with adoption 519

those of a group of adoptive parents towards the birth parents. A the method of their conception. The extent of this disclosure was rated
second goal was to compare the responses from mothers and as: 1. plans not to tell; 2. uncertain; 3. plans to tell and 4. told.
fathers and explore whether there were any differences between Adoptive mothers were questioned about whether they had met the
genders. birth parents prior to the placement, and about the frequency and type
of contact between the adoptive parents and the birth parents since the
adoption placement. Contact was rated on a 6-point scale from 1 (meet
Materials and Methods 4 – 12 times a year) to 6 (no contact), with a regular exchange of letters
between adoptive parents and birth parents through the social services
Participants classified as ‘letterbox’ contact and rated as 5. Adoptive mothers and
fathers were questioned as to how often they each thought about the
Embryo donation couples
birth parents and how often they talked about the birth parents to each
The embryo donation couples were recruited from three fertility clinics in
other, and these variables were rated on a 4-point scale from 0 (never)
the UK. All two-parent heterosexual couples with an embryo donation
to 3 (frequently). As for embryo donation, systematic information was
child aged between 2 and 5 years inclusive were sent a letter from the
obtained from both mothers and fathers as to whether or not they had
clinic’s Medical Director, inviting them to participate. Of the 29 families
told or planned to tell the child about the adoption, and this was classified
who were known to have received the letter, 21 agreed to take part
into four categories from 1 (plans not to tell) to 4 (told).
and 8 declined, giving a response rate of 72%. Confidentiality regulations
meant that no further information was available on non-participating
families. Fifteen participating families had children born from singleton Statistical analyses

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births, and six families had twins. All couples had conceived using anon- All statistical comparisons between groups, i.e. either mothers versus
ymously donated embryos (i.e. prior to the UK legislation change in fathers, or embryo donation versus adoptive parents, were made using
April 2005). chi-square analyses. Analyses were considered to be significant at the
level P , 0.05.

Adoptive families
The adoptive families were recruited through three local authority adop- Results
tion services in the UK. The agencies contacted by letter all families
with an adopted child aged between 2 and 5 years inclusive, who had Demographic characteristics
been placed with the family at or below the age of 12 months. Forty-one
parents were approached, and 28 agreed to participate, representing a
The two family types did not differ with respect to the target child’s
response rate of 70%. All target adopted children were singletons. gender, age (M ¼ 43 months), birth order or the number of siblings
present in the household. Regarding the parents, there was no signifi-
Procedure cant group difference for marital status (one embryo donation couple
The families were visited at home by a researcher trained in the study
and no adoptive couples had divorced), or for the age of the mothers
techniques. Data were collected separately from mothers and fathers (M ¼ 41 years) and fathers (M ¼ 42 years). However, the two groups
using systematic semi-structured interviews which were tape-recorded. did differ in the length of time for which the couple had tried to start a
Overall, 100% of the mothers, and 75% of the fathers were interviewed family before succeeding, t(47) ¼ 2.70, P , 0.05, with the embryo
and there was no difference between the embryo donation and adoption donation couples trying for longer on average (M ¼ 15.5 years) than
groups in the proportion of fathers participating. The sections of the inter- the adoptive couples (M ¼ 12 years). A significant difference was
view relevant to the current report focused on areas relating to the experi- also found for social class x2(3, N ¼ 49) ¼ 10.67, P , 0.05, measured
ence of going through the embryo donation treatment or adoption. The by the highest ranking occupation of either parent on the Registrar
questions were based on those used in previous studies of assisted repro- General’s classification (Office for Population Censuses and Surveys
duction families (e.g. Golombok et al., 2004), and each variable was rated
and Employment Department Group, 1991). This reflects the rela-
according to strict standardized coding criteria. Ethical approval for the
tively high socio-economic status of those who become adopters in
study was obtained from the ethics committee at City University, where
the researcher was then based.
the UK, with a higher proportion of adoptive parents (36%) in pro-
fessional occupations compared with the embryo donation parents
Measures (5%).
Embryo donation mothers were asked what information they had been
given by the clinic about the donors. This was coded thus: 1. no infor- Knowledge about donors/birth parents
mation; 2. physical characteristics only and 3. physical characteristics and Considering the embryo donation families first, 67% (n ¼ 14) of
some demographic information. Both mothers and fathers of embryo embryo donation mothers reported that they had been given infor-
donation children were asked how often they individually thought about mation on the donors’ physical characteristics only. Only 9% (n ¼ 2)
the donors, and how often the couple talked together about the received more detailed information including some non-identifying
donors. Frequencies of thinking about, and talking about the donors
demographic details, and 24% (n ¼ 5) had no information on the
were rated on a 4-point scale from 0 (never) to 3 (frequently). The
donors at all. However, embryo donation couples did not seem to
opinion of embryo donation mothers and fathers as to the optimum
level of information available about donors was ascertained and was classi- desire further information on the donors. The majority of both
fied into one of three categories: (i) donor should remain anonymous; (ii) mothers and fathers were not in favour of donors being identifiable
some non-identifying donor information available and (iii) donors should (see Table I). For embryo donation mothers, 38% (n ¼ 8) expressed
be identifiable. In addition, both mothers and fathers were questioned a preference for completely anonymous donation, and 52% (n ¼ 11)
as to whether they had told their child, or planned to tell them, about considered the policy of providing solely non-identifying information
520 MacCallum

Very different responses were obtained from the adoptive parents.

TableI. Embryo donation parents’ preference for All of the adoptive mothers thought about the birth parents some-
information about donors.
times, with 32% (n ¼ 9) thinking about them frequently, 46% (n ¼
Mothers Fathers 13) reporting occasional thoughts and 21% (n ¼ 6) only rarely thinking
(n 5 21) (n 5 16) about them. Adoptive mothers reported thinking about the birth
................ ................
n % n % parents significantly more frequently than embryo donation mothers
........................................................................................ reported thinking about the donors, x2 ¼ 15.61, P , 0.01 (see
Complete anonymity 8 38.1 9 56.3 Table II). With respect to adoptive fathers, 10% (n ¼ 2) reported
Non-identifying information only 11 52.4 4 25.0 that they frequently thought about the birth parents, 52% (n ¼ 11)
Identity disclosure 2 9.5 2 12.5 had occasional thoughts, 33% (n ¼ 7) rarely thought about them
Do not know/no preference 0 0.0 1 6.3 and only one adoptive father stated that he never thought about the
birth parents. As for mothers, adoptive fathers thought about the
birth parents more often than embryo donation fathers thought
about the donors, x2 ¼ 15.01, P , 0.05 (see Table II).
to be optimal. Only 10% of mothers (n ¼ 2) favoured the option of
Adoptive parents were also more likely to discuss the birth parents
having identifying information about donors available to recipients
than embryo donation parents were to discuss the donors, according
and/or donor offspring. Fathers largely preferred complete anonymity
to both mothers’ [x2(3, N ¼ 49) ¼ 27.04, P , 0.001] and fathers’
of donors with 56% (n ¼ 9) choosing this compared with 25% (n ¼ 4)

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[x2(2, N ¼ 37) ¼ 20.70, P , 0.001] reports. Eleven per cent (n ¼
who opted for non-identifying information only. Similarly to mothers,
3) of adoptive mothers stated that they frequently discussed the
just 13% (n ¼ 2) of fathers would have liked the donors to be ident-
birth parents with their partner, 57% (n ¼ 16) of mothers occasionally
ifiable, and one father expressed no particular preference. The differ-
talked about them and the remaining 32% (n ¼ 9) talked about the
ence between mothers and fathers in the level of information seen as
birth parents only rarely. Adoptive fathers’ data found that 48%
optimal was not significant, x2(2, N ¼ 37)¼2.39, P ¼ 0.30.
(n ¼ 10) felt they talked occasionally with their partner about the
Adopted parents had far more direct knowledge about the birth
birth parents, and 52% (n ¼ 11) talked about them rarely. Compari-
parents than embryo donation parents did about the donors. Over
sons of adoptive mothers with adoptive fathers showed no significant
half of the adoptive mothers (57%, n ¼ 16) had met the birth
differences between them for either thinking about [x2(3, N ¼ 49) ¼
parents prior to the placement. In terms of current contact, only
4.80, P ¼ 0.19] or talking about [x2(3, N ¼ 49) ¼ 3.66, P ¼ 0.16] the
7% of the adoptive mothers (n ¼ 2) had no contact at all with the
birth parents.
birth mother. The large majority of adoptive parents (86%, n ¼ 24)
were involved in ‘letterbox’ contact schemes. Seven per cent (n ¼
2) of adoptive mothers had been in direct contact with the birth Disclosure of the donor conception/adoption
mother, either meeting her or speaking to her on the telephone to the child
once or twice a year. No adopted child themselves currently had
Only 2 (9%) of the 21 embryo donation mothers had already told the
direct contact with his/her birth parents.
child about the method of conception. A further five mothers (24%)
reported that they were planning to tell in the future. Forty-three
per cent of embryo donation mothers (n ¼ 9) had definitely decided
Thinking and talking about donors/birth they would never tell the child, and the remaining 24% (n ¼ 5) were
parents uncertain. Of the participating embryo donation fathers, the majority
In the main, embryo donation mothers reported thinking about the (56%, n ¼ 9) were not planning to tell the child, with 19% (n ¼ 3)
donors only rarely (43%, n ¼ 9, Table II), with the remaining uncertain, a further 19% (n ¼ 3) intending to tell the child at a later
mothers equally divided between never thinking about them (28.5%, date and one father (6%) who had already told his child. There was
n ¼ 6) and thinking about them occasionally (28.5%, n ¼ 6).With no significant difference in the proportion of mothers and fathers
respect to embryo donation fathers, two-thirds of them (67%, n ¼ choosing each disclosure option, x2(3, N ¼ 37) ¼ 0.67, P ¼ 0.88.
10) stated that they never thought about the donors. Twenty per Where both parents participated in the study, the disclosure decision
cent of fathers (n ¼ 3) thought about the donors occasionally, and of each individual was compared with that of their partner. The
13% (n ¼ 2) only rarely. In addition, couples talked about the mother and father disagreed on this issue in three of the couples
donors infrequently. According to mothers, 57% (n ¼ 12) never (19%).
talked to their partner about the donors, 19% (n ¼ 4) rarely talked To examine the relationship between information known about the
and 24% (n ¼ 5) occasionally discussed the topic. Fathers’ data fol- donors and parents’ disclosure to the child, mothers and fathers were
lowed a similar model; 69% (n ¼ 11) never talked about the separately divided into two groups. The first groups comprised those
donors, 13% (n ¼ 2) rarely talked and 19% (n ¼ 3) occasionally who were inclined towards non-disclosure and included parents who
talked about them. There was no significant difference between had definitely decided against telling or were undecided (14 mothers,
embryo donation mothers and fathers for the reports of talking 12 fathers). The second groups comprised those who were in favour
about donors, x2(2, N ¼ 37) ¼ 1.72, P ¼ 0.42. However, the com- of disclosure and included parents who had already told the child or
parison for thoughts about donors did show a significant trend, were planning to tell them in the future (7 mothers, 4 fathers). Com-
x2(2, N ¼ 37) ¼ 5.28, P ¼ 0.07, with fathers thinking about donors parisons of these two groups on their levels of knowledge about
less often than mothers. donors found that, for both mothers and fathers, the higher levels
Parents’ attitudes to embryo donors compared with adoption 521

TableII. Comparison of thoughts and discussions about donors/birth parents by family type.

Embryo donation Adoptive (n 5 28 x2 P-value

(n 5 21 mothers;16 mothers; 21 fathers)
fathers)
.............................. ..............................
n % n %
.............................................................................................................................................................................................
Mother’s thoughts about donors/birth parents 15.61 ,0.01
Never 6 28.5 0 0.0
Rarely 9 43.0 6 21.4
Occasionally 6 28.5 13 46.4
Frequently 0 0.0 9 32.1
Father’s thoughts about donors/birth parents 15.01 ,0.05
Never 10 66.7 1 4.8
Rarely 2 13.3 7 33.3
Occasionally 3 20.0 11 52.4

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Frequently 0 0.0 2 9.5
Mothers’ discussion about donors/birth parents 27.04 ,0.001
Never 12 57.1 0 0.0
Rarely 4 19.0 9 32.1
Occasionally 5 23.9 16 57.1
Frequently 0 0.0 3 10.7
Fathers’ discussion about donors/birth parents 20.70 ,0.001
Never 11 68.8 0 0.0
Rarely 2 12.5 11 52.4
Occasionally 3 18.7 10 47.6
Frequently 0 0.0 0 0.0

of information they had, the more likely they were to be inclined particular, would have been happy with complete anonymity. In
towards disclosure (mothers: x2(2, N ¼ 21) ¼ 6.54, P , 0.05; line with their levels of knowledge, embryo donation parents
fathers: x2(2, N ¼ 16) ¼ 7.47, P , 0.025). All mothers and fathers reported significantly less thinking about and talking about the
who had no information about the donors were inclined towards non- donors than adoptive parents did about the birth parents. Embryo
disclosure, whereas in the two couples who had the most detailed donation parents were grateful to the donors for allowing them
information about the donors, mothers and fathers were in favour the chance to have a child but their feelings did not go any
of disclosure. further. In comparison, adoptive parents often talked about the
The inclination of the majority of embryo donation parents against birth parents, and mentioned especially thinking about the birth
disclosure contrasts sharply with the adoptive parents. Both adoptive mother when it came time for their regular letter or telephone
mothers [x2(3, N ¼ 49) ¼ 30.38, P , 0.001] and adoptive fathers call, suggesting that contact prompts consideration of the role of
[x2(3, N ¼ 37) ¼ 24.64, P , 0.001] were significantly more inclined the birth parents. It is important to note that this acknowledgement
to be open about the method of family creation than were their of the relevance of the birth parents did not seem to undermine the
counterparts in the embryo donation families. All of the adoptive quality of parenting provided by the adoptive parents, which a pre-
parents had either told the child about the adoption already or vious report found not to be inferior to that of the embryo donation
were planning to tell them in the near future (mothers: 79% (n ¼ parents (MacCallum et al., 2007).
22) told, 21% (n ¼ 6) planning to tell; fathers: 67% (n ¼ 14) told, Since embryo donation parents seem to view the donors as rela-
33% (n ¼ 7) planning to tell). tively unimportant to their family life, it is perhaps not surprising
that only 33% of participating mothers and 25% of participating
fathers reported having told or planning to tell the child about the
Discussion donor conception; a distinctly different pattern from the full disclosure
As expected, the embryo donation parents had far less information by adoptive parents. Non-disclosure in adoption can be virtually
about the donors than did the adoptive parents about the birth impossible when the child is of a different ethnic origin to the adoptive
parents. This can be explained by the procedures regarding infor- parents. However, in the current sample this was the case in only one
mation release followed by the fertility clinics at the time of treat- family, where the child had been adopted from China by Caucasian
ment. Interestingly, the large majority of embryo donation parents parents. In all other families, the child’s ethnic background matched
did not want to know any more about the donors. Fathers, in that of at least one of the adoptive parents. Therefore, obvious
522 MacCallum

physical dissimilarity of the child does not seem to be a key factor in donation is recognized as an essential component of treatment but
openness about adoption. is seen as unimportant to the rest of the child’s life. Therefore, the
There is evidence of a relationship between information about gestational link has an impact on parents’ perception of the processes
donors and disclosure, with higher levels of donor information associ- of family creation; embryo donation parents are to some extent able
ated with inclination towards disclosure. This supports the findings by to forget that they even used donor conception, whereas adoptive
Klock and Greenfeld (2004), and Scheib et al.’s (2003) proposition parents include the adoption as part of the family history.
that donor information is one factor taken into account in the disclos- Considering discrepancies of attitudes within the couple, few
ure decision. The implication for practice is that providing as much gender differences were found in the embryo donation parents.
information as possible, even if non-identifying, to recipients during Embryo donation fathers did tend to think about the donors less
the treatment process could promote later disclosure to offspring. often than did embryo donation mothers. This adds some support
However, it is not known whether parents always take up the full to the proposal that men are more likely to cope with infertility by dis-
extent of donor information offered to them by clinics. Those tancing themselves from the problem or denying it exists (Peterson
parents who are generally in favour of disclosure may be more likely et al., 2006). Although in most cases, both embryo donation
to ask for further information than those who are inclined towards mothers and fathers were infertile, the fathers seem more reluctant
privacy. to acknowledge their infertility by considering the role of the
To some extent, these attitudes towards birth parents and donors donors, in line with previous findings (e.g. Nachtigall et al., 1992).
are reflected by, and may stem from, the perspective taken by the However, fathers were not significantly more reluctant than mothers

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agencies involving in arranging adoptions and assisted reproduction to disclose the donor conception to the child. This may be because
treatments. The British Association of Adoption and Fostering disclosure rates overall were low, because embryo donation
(BAAF) states unequivocally in its information for those interested in mothers are particularly private, or because mothers were going
adoption that ‘Children should be raised knowing they were along with their husbands’ wishes. In addition, the size of the
adopted. Adopted parents should give appropriate information from sample led to small cell magnitudes for comparisons between men
the time the child is little and as they grow up’ (BAAF, 2008). Regard- and women, reducing the statistical power and possibly resulting in
ing the birth parents, BAAF makes clear in its information that contact some gender differences not being detected. Nevertheless, only
of some kind with the birth family is common and can be expected. As three couples disagreed about disclosure intentions; a similar pro-
mentioned earlier, preparation training for adoptive parents includes portion to the 18% of couples found to be inconsistent on this issue
consideration of contact arrangements and how these might be in Klock and Greenfeld’s (2004) study of oocyte donation parents.
handled. Bearing in mind that the current sample of embryo donation Thus, these findings suggest that the disclosure decision is no more
parents received treatment before the 2005 legislation change, they contentious for the couple when neither is genetically related to the
were not expecting access to any identifying information about the child than when one partner alone lacks a genetic link.
donors or for their offspring to be able to do so in the future. With The degree to which findings from this study can be generalized to a
respect to disclosure, advice given by the HFEA and by individual fer- wider population is limited by the small size of the embryo donation
tility clinics is much less absolute than that of BAAF on adoption. sample. This was caused in part by the relative infrequency of use
Statements to parents such as ‘it is certainly best to be open’ of embryo donation treatment in the UK. In light of this, it is encoura-
(HFEA, 2008) or ‘you will be encouraged to consider telling your ging that response rates were moderate to high, but no conclusions
child about his or her origin’ (London Women’s Clinic, 2006) make can be drawn as to how the attitudes of parents who refused to par-
it clear that the disclosure is preferred but still leaves the final decision ticipate may diverge from those reported here. Replication with a
to the parents’ discretion. larger sample would be useful, as would an examination of parents
The differing perspectives may also be related to the gestational link who conceived with treatment after the new legislation was intro-
present in embryo donation and absent in adoption (Widdows and duced in 2005. It may be that knowing their offspring will be able to
MacCallum, 2002). Firstly, this means that the embryo donation trace their donors will have an impact on embryo donation parents’
parents are registered as the child’s legal parents at birth, and the attitudes towards these donors, and increase the relevance of the
donors have no rights or responsibilities, whereas in adoption, legal donors to their view of the child’s life story. A survey of the extent
parentage must be transferred from the birth parents to the adoptive of donor information supplied by clinics to embryo recipients could
parents; a process which is not finalized until the child has lived with help establish whether some clinics routinely offer more information
the adopters for a minimum period (usually 3 months). Thus, from than others, and what influence this has on parents’ future thoughts
the outset, birth families have a role in the child’s life, whereas and feelings about the donors and their plans for disclosure.
donors do not. Psychologically, the experience of pregnancy and Although the genetic family structures of embryo donation and adop-
birth allows embryo donation parents to feel that the child is ‘theirs’ tion are similar, the processes differ in many aspects, including social,
from the outset. This can affect the disclosure decision, with many legal and psychological factors. These differences may mean that con-
parents feeling that since the mother has carried the child, and both sideration of the child’s genetic background is simply more necessary
parents have reared the child since birth, there is no need to disclose in adoption than in embryo donation. Since there were no problems
the donor conception since they are the ‘real’ parents to all intent and in the embryo donation families regarding child adjustment or
purposes. Interesting, the attitudes of embryo donation parents are in parent–child relationships (MacCallum et al., 2007), the lack of com-
line with the attitudes found in some studies of couples who have munication regarding donors does not seem to be adversely affecting
donated embryos and who viewed the donation on a par with family functioning. Nevertheless, problems could arise if the child
blood or organ donation (Soderstrom-Antilla et al., 2001). The later becomes aware of the facts of the donor conception and deems
Parents’ attitudes to embryo donors compared with adoption 523

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