Disclosure in Assisted Reproductive Technology: Young Adults Opinions About Rights and Preferences

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Disclosure in Assisted Reproductive Technology
Young Adults Opinions About Rights and Preferences

• Jami N. Gross
• Daniel L. Clay
• Dennis C. Harper
• University of Iowa

2
Background

• Use of assisted reproductive technology (ART) is
  increasing in the U.S.
• Research on the psychological impact of ART lags
  behind medical research
• ART is often compared to adoption in the
  psychological literature
• Disclosure is a significant issue in adoption
  literature
• Most parents who use ART dont disclose
• Many aspects of a childs life may be affected by
  disclosure
• Attachment and development of the self/identity
• Family relationships and the effect of secrecy

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Purpose of Study 3 Research Questions

• Would young adults want their parents to tell
  them if they were conceived through ART?
• Would young adults believe they would have a
  right to know if they were conceived through ART?
• How do young adults believe they would be
  affected if they were told they were conceived
  through ART?

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Methods

• Participants Procedures
• 72 undergraduates at the University of Iowa
• Most were white females with a mean age of 20
  years
• Sample recruited through psychology course
• Completed packet in groups (included informed
  consent)
• 20-30 minute completion time
• Received a debriefing paragraph
• Measures
• Demographic Survey
• Survey of Opinions on Reproductive Technology
  (SORT)

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Measure Survey of Opinions about Reproductive
Technology

• 5 Scenarios were presented
• Adoption
• Use of in vitro fertilization with both parents
  gametes
• Use of donor sperm
• Use of donor egg
• Use of donor embryo
• For each scenario, the participant was asked the
  same set of questions

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Example SORT Scenario

• Situation 5
• Your parents wanted a child very much. After
  several months with no success, they decided to
  see a reproductive specialist. The doctor said
  there was a problem with your mothers eggs, but
  he could help them using donated eggs. This
  meant that he fertilized another womans egg with
  your fathers sperm and placed the fertilized egg
  into your mothers uterus. The procedure was
  successful and you were born.
• 1. To what extent do you want to know about the
  circumstances of how you joined your family?
  (circle a number)
• 1 2 3 4 5 6 7
• I definitely
  I really
• do not want
  want to know
• to know
• 2. To what extent do you believe you have a
  right to know about the circumstances of how you
  joined your family? (circle a number)
• 1 2 3 4 5 6 7
• I have no I have every
• right to know
  right to
  know
• 3. Should your parents tell you about the
  circumstances of how you joined your family?
• Yes ____ No ____
• If you answered yes, when should they
  tell you?
• At a
  specific age ____

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Results

• Disclosure Preference (DP)
• Possible responses ranged from 1-7, with a 7
  indicating that an individual would definitely
  want to know about his/her birth origins.
• Mean score 5.47 (SD 1.42, range 1.8 7)
• Score for adoption was higher than any other
  scenario
• Disclosure Right (DR)
• Possible responses ranged from 1-7, with a 7
  indicating that an individual believed he/she
  definitely had a right to know about his/her
  birth origins.
• Mean score 6.21 (SD 1.14, range 2 7)
• Score for adoption was higher than any other
  scenario
• Effect
• Possible responses ranged from 1-7, with a 1
  indicating he/she would be affected very
  positively, a 7 indicating he/she would be
  affected very negatively.
• Mean score 4.44 (SD .92, range 2 - 6.2)
• Score for adoption was lower than the three
  scenarios involving donated gametes however,
  there was no significant difference between the
  adoption and in vitro scenarios
• Disclosure Age
• Most participants believed parents should tell
  them about birth origins (91.4)
• 100 of participants believed their parents
  should tell them if they were adopted
• Mean age of disclosure 10.7 years (SD 4.03,
  range 1.5-18)
• Relationship between DP, DR, and Effect
• There was a significant positive correlation
  between DP and DR.

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Discussion

• Overall, young adults would rather know than not
  know about their birth origins.
• They believe they would have a right to know if
  conceived through ART or were adopted.
• In general, young adults do not believe they
  would be affected negatively by disclosure.
  However, they believe that finding out they were
  adopted or conceived through in vitro
  fertilization with their parents sperm and egg
  would affect them more positively than conception
  using donated gametes.
• Although most young adults believe their parents
  should disclose, they differ in regard to when
  their parents should tell them about their birth
  origins.
• Because there were significant differences in how
  young adults responded to the adoption scenario
  in comparison to the ART scenarios, adoption may
  not be an appropriate reference point for
  understanding the impact of disclosure in ART.

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Clinical Implications

• The desires of the child need to be taken into
  account when parents are deciding whether to
  disclose
• Adoption may not be an appropriate lens for
  understanding ART.
• The type of ART used may be an important factor
  in how parents and children respond to the
  disclosure process.
• The impact of secrecy on family relationships may
  need to be addressed.