Secrets and lies and donor conceptions: what donor-conceived individuals feel about their disclosure/discovery...

What are the satisfaction levels, as defined by emotional comfort or contentment, of adult individuals conceived via donor-assisted reproduction concerning the method, timing, and circumstances surrounding the disclosure/discovery of their conception?

Inadvertent discovery and older age at the time of disclosure of donor-conceived status are associated with lower rates of satisfaction among donor-conceived individuals.

The proliferation of commercial DNA testing has resulted in many donor-conceived people learning inadvertently of their donor origins. As a result, donor-conceived people, healthcare professionals, and parents seek information and research about best disclosure practices and outcomes.

A survey-based cross-sectional cohort study from 2022 to 2023 was conducted involving 530 participants, of whom 422 completed the survey.

A total of 546 people ages 18 years and over opened the survey, with 530 people qualifying to complete the survey as donor-conceived persons (DCPs). Four hundred and twenty-two DCPs (79.6%) completed the survey. Descriptive statistics were applied, and data distributions were analyzed for a selection of appropriate statistical tests; parametric tests such as Student's t-test or ANOVA, and non-parametric tests such as Mann U Whitney or Kruskal-Wallis Rank Sum test were utilized as applicable, for comparing continuous data between groups. Multivariable logistic regression analyses were used to examine satisfaction levels, adjusting for potential confounders.

After accounting for age at discovery, sex, the origin of disclosure, and education, individuals with early intentional disclosure were more than three times as likely to experience disclosure satisfaction as those with late unintentional disclosure/inadvertent discovery (P-value = 0.005).

Lack of ethnic diversity among survey respondents, and limited control over reposting of the survey to other sites, potentially contributing to sampling bias.

Preliminary but substantial evidence that early, intentional disclosure to DCPs results in greater satisfaction and acceptance. This data will ultimately assist all stakeholders, including reproductive health professionals and parents in family-building counseling and decision-making.

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