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- Widbom, Andreas
(author)
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Building a family with gamete donation : perspectives of parents and offspring
- 2023
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Doctoral thesis (other academic/artistic)abstract
- The aim of this thesis was to investigate the long-term psychosocial consequences for heterosexual couple families following oocyte donation (OD) and sperm donation (SD), in the context of the Swedish legislation. An additional aim was to explore how heterosexual couple families following SD experience the process of obtaining identifying information about the donor. Methods: As part of a prospective longitudinal study, two cross-sectional studies assessed aspects of psychosocial well-being among OD and SD families with seven-yearold children (Study I) and 13 to 17-year-old adolescents (Study II). Two qualitative interview studies explored the experiences of obtaining identifying information about the donor from the perspective of 29 adult children (Study III) and 23 parents (Study IV). Results: Study I showed that donor conception families’ psychosocial well-being is within normal levels and is not related to whether or not the parents have disclosed the use of donor conception to their seven-yearold child. Study II revealed that donor conception families’ psychosocial wellbeing is within normal levels and similar to a reference group of parents using IVF with own gametes, but that SD mothers to a significantly higher extent reported symptoms of anxiety indicating clinically relevant levels (31%) compared to OD mothers (7%) (p=.018). Study III described that searching for donor information could fill varying needs for the adult donor conceived person and that the process of obtaining donor information meant having to balance interests of different stakeholders. Study IV showed that parents’ experiences were influenced by how they perceived parenthood in the context of nature and nurture, which was related to how the parents managed the presence of the donor. Conclusions: Donor conception does not appear to be detrimental to the psychosocial well-being of families. However, both parents and their adult children face several challenges in the process of obtaining identifying information about the donor.
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| 2. |
- Widbom, Andreas, et al.
(author)
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Positioning the donor in a new landscape-mothers' and fathers' experiences as their adult children obtained information about the identity-release sperm donor
- 2021
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In: Human Reproduction. - : Oxford University Press. - 0268-1161 .- 1460-2350. ; 36:8, s. 2181-2188
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Journal article (peer-reviewed)abstract
- STUDY QUESTION: How do heterosexual parents experience identity-release donation when adult children have obtained information about their sperm donor?SUMMARY ANSWER: Adult offspring's receipt of identifying information about the sperm donor challenged the fathers' role as a parent, which was reflected in how parents positioned the donor in relation to the family.WHAT IS KNOWN ALREADY: An increasing number of countries provide access to treatment with identity-release or 'open-identity' donors. However, there is limited knowledge about how parents experience and manage the situation when adult offspring obtain identifying information about the donor and may even establish contact with him.STUDY DESIGN, SIZE, DURATION: This qualitative interview study included 23 parents whose offspring had obtained information about their sperm donor. Interviews were conducted from October 2018 to January 2019.PARTICIPANTS/MATERIALS, SETTING, METHODS: A purposive sample of parents (15 mothers and 8 fathers) was recruited via adult offspring, who had requested identifying donor information at five Swedish University hospitals. All participating parents were part of a heterosexual couple who had conceived with sperm from an identity-release donor. Individual semi-structured interviews were conducted face-to face or via telephone, and transcribed audio recordings were analyzed using reflexive thematic analysis.MAIN RESULTS AND THE ROLE OF CHANCE: The parents expressed diverse experiences related to their parenthood and the presence of the donor after offspring had obtained information about him; these were described in two themes. The theme 'Navigating (in)visible markers of parenthood' describes parenthood as embedded with dichotomous meanings of nature and nurture that parents navigated in relation to social approval. The theme 'Positioning the donor in a new landscape' describes how parents managed the presence of the donor by positioning him at a distance or acknowledging him as a person or even as part of the family, while some struggled to position him, giving rise to ambivalent feelings. The absence of genetic connectedness challenged the father's role as parent, which was reflected in parents' positioning of the donor.LIMITATIONS, REASONS FOR CAUTION: The study was performed within the context of the Swedish legislation on identity-release donation and is based on experiences of heterosexual couples who had used sperm donation and had informed their offspring about their donor conception. This, together with the fact that parents' accounts were predominantly represented by mothers, must be taken into consideration regarding transferability to other populations.WIDER IMPLICATIONS OF THE FINDINGS: Negotiations of social and genetic parenthood are still present among parents many years after treatment and may resurface when adult offspring obtain the donor's identity. Access of the adult offspring to identifying information about the donor may have unexpected consequences for family relations, including expanding the family to include the donor. Challenges related to male infertility and family dynamics indicate that parents should have access to counseling and support to manage family life with varying genetic linkage within and outside the family unit.
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| 3. |
- Widbom, Andreas, et al.
(author)
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Psychological adjustment in disclosing and non-disclosing heterosexual-couple families following conception with oocytes or spermatozoa from identity-release donors
- 2022
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In: Reproductive BioMedicine Online. - : Elsevier. - 1472-6483 .- 1472-6491. ; 45:5, s. 1046-1053
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Journal article (peer-reviewed)abstract
- Research question: Is there a relationship between disclosure and psychological adjustment in heterosexual-couple families following oocyte donation and sperm donation when the child is 7 years old?Design: This was a cross-sectional study of heterosexual couples with 7- to 8-year-old children conceived with identity-release oocyte donation (n = 83, response rate 56%) or sperm donation (n = 113, response rate 65%). Participants individually completed instruments for the assessment of parents’ emotional distress (HADS), parenting stress (SPSQ) and relationship quality (ENRICH), and their child's psychological adjustment (SDQ-Swe) and reported whether they had talked with their child about their donor conception.Results: About half of parents had talked with their child about their donor conception (oocyte donation 61%, sperm donation 58%). Separate analyses for mothers and fathers showed no main effects of disclosure or type of donation on the outcomes, nor were there any interaction effects. Overall, mothers and fathers in oocyte donation and sperm donation families were found to be well adjusted, reporting within-normal range levels of anxiety, depression and parental stress, and a high relationship quality. The children were well adjusted, with low levels of emotional and behavioural problems.Conclusions: Overall, the present results confirm previous research indicating that early disclosure of the donor conception to children is not associated with negative outcomes for parents or children. Heterosexual couples using oocyte or sperm donation should be informed that disclosure when the child is 7–8 years old is not detrimental to the psychological adjustment of families.
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| 4. |
- Widbom, Andreas, et al.
(author)
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The motives and experiences of donor-conceived persons requesting the identity of their sperm donors
- 2024
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In: Reproductive BioMedicine Online. - : Elsevier. - 1472-6483 .- 1472-6491. ; 48:1
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Journal article (peer-reviewed)abstract
- Research question: What are the motives and experiences of donor-conceived persons (DCP) who search for and receive information about their identity-release sperm donor?Design: A qualitative interview study with 29 individuals (21 women, seven men, one non-binary) who were consecutively recruited after having requested information about their sperm donor at five Swedish University hospitals. All participants were conceived after donor insemination to heterosexual couples within an identity-release donation programme. Individual semi-structured interviews were conducted face-to-face or via telephone between September 2016 and November 2019, and transcribed audio recordings were analysed using reflexive thematic analysis.Results: The motives and experiences of DCP were described in two themes. The theme ‘donor information can fill different needs’ describes that varying motives, thoughts and feelings are related to searching for and obtaining donor information. Motives ranged from curiosity and a desire for agency over one's conception to hopes of finding a new father. The theme ‘navigating donor information in a relational context’ describes the process of obtaining donor information as interpersonal, highlighting that the DCP needs to balance the interests of different stakeholders, and that obtaining donor information can challenge the relationship quality with the father.Conclusions: Obtaining the donor's identity has the potential to affect the understanding of DCP of themselves, and to influence relationships within their family in unexpected and challenging ways. Therefore, adequate resources should be allocated to support the growing number of families after identity-release donation.
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| 5. |
- Widbom, Lovisa, 1994-
(author)
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Lifestyle, biomarkers and the risk of developing inflammatory bowel disease
- 2023
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Doctoral thesis (other academic/artistic)abstract
- Introduction: Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), is a chronic disease causing inflammation in the gut mucosa. The pathogenesis involves alteration in gut microbiota and in the intestinal barrier due to genetic factors, environmental exposure and dysregulation of the immune response. Several environmental risk factors and risk genes have been identified, but still, the pathogenesis is not fully understood. Methods: Included papers are all case-control studies based on previously collected data stored with the biobank in Umeå, Sweden. Cases are individuals that participated in the Northern Sweden Health and Disease Study (NSHDS) at least one year before developing IBD. Information was available for all cases regarding age, time and place for inclusion in NSHDS, height and weight, sex and tobacco use. Part of the cases also had available data from a detailed food-frequency questionnaire. For each available case, controls matched for age, sex and time and place were selected. Analysed factors included tobacco use, with smoking and snuff use analysed separately), cotinine (a metabolite of nicotine), iron status (including ferritin, iron, transferrin and transferrin saturation), B-vitamins and tryptophan metabolites. Results: Smoking was associated with an increased risk of developing IBD both based on questionnaire data and using cotinine as a marker for exposure. Snuff use was not associated with risk for developing IBD. A lower ferritin was associated with an increased risk of developing IBD, whereas no association was seen for other iron status analytes. When analysing iron deficiency based on ferritin and CRP, it was shown that iron deficiency was more common among men before onset of IBD, whereas no difference was seen for women. Active vitamin B6 was lower among cases compared to controls, as well as an index indicating functional B6 deficiency. Kynurenic acid and xanthurenic acid, both tryptophan metabolites with immunomodulatory properties, were lower among cases than controls. For CD only, picolinic acid was lower among cases later developing IBD.Discussion: Smoking increases the risk of developing both UC and CD. Snuff use did not increase the risk for IBD, indicating that tobacco exposure is not the reason for increased IBD risk. Low ferritin indicates an early pathological process affecting iron storage unrelated to inflammation. Changes in vitamin B6 and tryptophan metabolites might indicate early pathological processes possibly related to gut microbiota changes. To conclude, this dissertation shows that multiple differences between individuals later developing IBD and controls can be seen years before IBD diagnosis. Some of which give insight to early pathophysiology in IBD.
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