Disclosure of genetic origins : parental experiences and attitudes in the UK and Brazil

Embryo donation (ED) and double donation (DD) are fertility treatments whereby resulting children are raised by parents to whom they are genetically unrelated. The main similarity between ED/DD and adoption is the lack of genetic parent-­child relationships, and the main difference is the presence of the gestational link in ED/DD families, which provides an option of concealing genetic origins. This thesis consists of one large study followed by three subsidiary studies, with the overall aim of exploring the disclosure of genetic origins in the UK and Brazil, and the support available to assist parents with this process. In Study I, 36 ED/DD parents, and 27 adoptive parents were interviewed to determine if and how they disclosed to their children, and identify the support that they received to manage this process. In Study II, 30 UK-­based infertility counsellors completed an online survey to ascertain how they engage in disclosure-­related issues with patients seeking embryo donation/double donation treatment. In Study III, 19 Brazilian parents, who conceived a child using donated sperm or eggs, completed an online survey to explore if and how they disclosed to their children, and whether they felt supported with this process. In Study IV, 24 Brazilian fertility professionals completed an online survey to determine how they engage with parents seeking treatment with donated gametes. Overall, adopters were more confident in the process of adoption revelation, and received more support in order to achieve this, compared to ED/DD parents. Findings highlight the complex nature of disclosing donor conception, and identified that Brazilian parents experience similar challenges compared to those in the UK. Disparities were found in the disclosure-­related support provided both across and within these two country contexts. From these results, recommendations for how parents could be better supported with disclosure-­related issues are given.