To Tell or Not to Tell: The Disclosure-to-Child Preference of Chinese Mothers with Child(ren) Born As a Result of Donor-Assisted Conception

Background: Donor-assisted conception (DAC) in terms of sperm, egg, and embryo adoption are getting more attention from infertile people who are seeking assisted reproduction. Child(ren) born as a result from DAC have different genetic origins. Whether the offspring of DAC can have full access of their genetic history largely depends on the intention of disclosure among the recipient parents. In traditional Chinese culture which put high emphasis on the genetic continuity, there is always a dilemma between the right of keeping privacy among parents and the right to know among offsprings. To understand the struggles, the current study aimed to examine the disclosure-to-child preference among Chinese mothers who have child(ren) born as a result of DAC.

Methods:Participants who have undergoing DAC at a university-affiliated hospital in HK and successfully delivered offspring between 2008-2013 were invited by the gynecologist who was the clinic-in-charge. In March 2014, four Chinese mothers agreed for two-hour in-depth semi-structured interviews, either in person or by video conference. Among four cases: two adopted sperm donation, one oocyte and one embryo donation. Based on components extracted from Theory of Planned Behavior and elements from theories on stigmatization and self-identity, the interview guideline were developed assessing three perspectives: self (attitudes, perceived control, self identity, guilt, loss of genetic link), family (parenthood, childbearing, boundaries with known donor, risk of accidental disclosure) and social (subjective norm, perceived stigmatization). The content of verbatim was transcribed and analyzed.

Results: All recipients were married (mean age: 43.8). A total of six resulted offspring (mean age: 3) were conceived through DAC. Three were conceived through known donor and one was from anonymous donor. Three of the participants revealed that they preferred upholding secrecy of identity than disclosure. Among those preferred higher level of secrecy, they reckoned that the non-disclosure is to protect the parent-child relationship and the children from possible social stigmatization. Recipients of sperm donation put further emphasis on the defense of husband’s feeling and dignity. Only one participant preferred disclosure in the future, as she acknowledged that the unconditional love of the parent can compensate the loss of genetic connection and that the child has all the right to know his/her origin. Nonetheless, when asked if disclosure to the child is unavoidable and what the optimal time be, all recipients expressed it should be when the children pass adolescence. As they are mature enough to comprehend the rationale behind these relatively complicated information. The worry over accidental disclosure was perceived as seemingly limited as those recipients preferred secrecy did not disclose either to anyone outside the recipient couple or not more than one close family member.

Conclusions and Implications: This study highlighted the greater preference on secrecy over disclosure among Chinese mother forming families through DAC. The perceived social acceptance of donor-assisted technology in Chinese society has tremendous influence on the disclosure preference. The finding of this study contributed to the understanding of Chinese culture on childbearing and how it affects the secrecy and disclosure preference among women who have adopted DAC.