Recent advances in assisted reproductive technologies have resulted in an increasing number of children born by gamete donation. Children conceived by egg donation lack a genetic link with their mother whereas children conceived by donor insemination lack a genetic link with their father. In families in which parents do not disclose their use of donated gametes, the child is unaware that their mother or their father in not their genetic parent. The aim of this thesis was to assess the impact of non-disclosure, and of the absence of a genetic link between parent and child, on family functioning and child adjustment. Data were obtained from a representative sample of 36 donor insemination, 32 egg donation and 54 natural conception families when the target child was 7 years old. Standardised interview, questionnaire and observational data were obtained from mothers, fathers, children and the child?s teacher. Few differences in family functioning were found between disclosing and non-disclosing gamete donation families. Likewise, few differences emerged between gamete donation families and natural conception families. The families were found to be functioning well irrespective of whether the parents had disclosed and of whether the child lacked a genetic link with a parent. However, comparisons between donor insemination and egg donation families showed that disclosure status and family type interacted in complex ways. Contrary to predictions, disclosure was not always associated with favourable outcomes. Children in disclosing donor insemination families were rated by teachers as having fewer behavioural problems. However, observational ratings showed lower levels of positive mother-child interaction in disclosing egg donation families. The process of disclosure was also explored. In all but one disclosing family, parents had started to talk to their child about their donor conception by age 4, with disclosure typically initiated and maintained by the mother. Despite mothers? concerns, children did not appear distressed by information about their donor conception. However, interviews with the children themselves suggested that most had little understanding of their donor conception at age 7.

Donor conceived (DC) teenagers are of interest as they are brought up in families where they have a genetic bond to one parent and lack a genetic bond to the other. The aim of this study was to investigate the attachment of DC teenagers to their genetic and non-genetic parent and whether the genetic link affects the attachment. We have analyzed whether the type of family form and/or donation type have an effect on the level of attachment on these teenagers. 86 teenagers participated through answering a survey which included the Inventory och Parent and Peer Attachment (IPPA), which was used to measure the attachment of donor conceived teenagers to both their parents. Wilcoxon signed rank test, Kruskal-Wallis H-test, Chi2 test and spearman correlation test were used to analyze the IPPA answers of the DC teenagers. The results showed that a secure attachment was common among the observed DC teenagers, that the attachment to genetic and non-genetic parent did not differ and that the type of donation and family form in which the teenagers were brought up did not seem to influence the attachment of DC teenagers. Consequently, our study indicates that other factors than a genetic link to their parent affect the security of attachment among DC teenagers. Clinical implications include that being conceived through donation should not be considered as a risk factor considering the attachment security to one's parents. Limitations of this study that should be considered are sample bias, the possibility that only high functioning families consented to their children’s participation in the study. / Få studier har undersökt upplevelser och uppfattningar bland barn som kommit till genom donationsbehandling. Detta är en särskilt intressant grupp att undersöka då de växer upp i familjer där de har ett genetiskt band till den ena föräldern, men inte den andra. Ambitionen med vår studie var att undersöka graden av trygg anknytning inom denna grupp och om kvalitén av anknytning till genetiska och icke-genetiska föräldrar skiljer sig åt. Vi utforskade även om det fanns några skillnader i anknytning hos tonåringar mellan olika donationsformer och familjetyper. 86 tonåringar deltog i studien genom att svara på en enkät som inkluderade the Inventory of Parent and Peer Attachment (IPPA), vilket är ett instrument som mätte anknytning till båda tonåringens föräldrar. Wilcoxon signed rank test, Kruskal-Wallis, chi2 test och Spearmans korrelationstest användes för att analysera tonåringarnas svar. Resultaten visade att en trygg anknytning är vanlig bland de observerade tonåringarna, att anknytningen till genetisk respektive icke-genetisk förälder inte skiljde sig åt samt att vilken donationsform som använts eller familjetyp som tonåringarna vuxit upp inom inte verkar påverka graden av trygg anknytning. Kliniska implikationer är att ha tillkommit genom ägg- eller spermiedonation inte bör ses som en risk för en framtida otrygg anknytning till genetisk eller icke-genetisk förälder hos tonåringar. Begränsningar med denna studie som bör beaktas är urvalsskevhet samt att endast högfungerande föräldrar gav sitt samtycke till sina barns medverkan i studien.

Donor conception (DC) is an artificial reproductive technique that refers to the use of donated gametes. Adolescence is an important period for identity formation and being donor conceived might be an important part of people’s identity, yet few studies have investigated donor conceived adolescents’ experiences. The research questions were: 1) How do adolescents integrate their donor conception into their identity? 2) Does the level of integration differ between adolescents with early and late disclosure and is there a difference when controlling for family type, current age and gender? 3) Does the level of integration differ between adolescents in families with heterosexual and lesbian parents and is there a difference when controlling for age at disclosure, current age and gender? The study had a cross-sectional design and included 86 donor conceived adolescents between 13-16 years old. They were children of heterosexual or lesbian couples that took part in the longitudinal Swedish Study on Gamete Donation. Data was collected through a questionnaire survey. The integration of DC into identity was measured with the Donor Conception Identity Questionnaire. Wilcoxon Signed Rank test and Mann-Whitney U tests were conducted to answer the research questions. Adolescents showed low curiosity and avoidance regardless of family type, indicating that the DC was not seen as a crucial part of their identity, nor something that bothered them. Adolescents with late disclosure showed more avoidance than those with early disclosure, supporting the idea that early disclosure is beneficial for the integration of DC into identity. / Donationsbehandling innebär befruktning med hjälp av donerade könsceller. Tonårstiden är viktig för identitetsformation. Att ha blivit till genom donationsbehandling kan vara en viktig del i identiteten men få studier har undersökt detta hos tonåringar. Forskningsfrågorna var: 1)Hur har tonåringar integrerat att de blivit till genom donationsbehandling i sin identitet? 2)Skiljer sig integrationen åt mellan tonåringar som fick veta tidigt och sent och finns det en skillnad när man kontrollerar för familjetyp, nuvarande ålder och kön? 3) Skiljer sig integrationen åt mellan tonåringar i familjer med heterosexuella och lesbiska föräldrar och finns det en skillnad när man kontrollerar för kön, nuvarande ålder och när de fick veta hur de blivit till? Studien var en tvärsnittsstudie med 86 stycken 13-16-åringar. De var barn till heterosexuella eller lesbiska par som deltog i den longitudinella studien Swedish Study on Gamete Donation. Data samlades in genom frågeformulär. Donor Conception Identity Questionnaire användes för att mäta hur tonåringar integrerat sitt ursprung i identiteten. Wilcoxon Signed Rank-test och Mann-Whitney U-tester genomfördes för att besvara frågeställningarna. Oavsett familjetyp visade tonåringarna låg grad av nyfikenhet och undvikande. Att de blivit till med donationsbehandling verkade alltså varken upplevas som bekymmersamt eller som en viktig del av identiteten. Tonåringar som fick veta sent visade större undvikande än de som fått veta tidigt. Det talar för att tonåringar som blivit till genom donationsbehandling kan ha enklare att integrera det i sin identitet om de tidigt får veta hur de blivit till. / Swedish Study on Gamete Donation