Claes Gottlieb

To tell or not to tell - what parents think about telling their children that they were born following donor insemination

Pioneering legislation regarding donor insemination was introduced in Sweden in 1985. The law gives the child, upon reaching sufficient maturity, the right to obtain information about the donor and his identity. One hundred and forty-eight Swedish couples with children conceived through donor insemination after the law was introduced have answered questions about disclosure and donation in a questionnaire. This article addresses the reasoning employed by individual couples in their decision whether or not to inform the children about their origin. Parental reflections on their decision and the childrens reactions to receiving this information are also presented. Five categories of parental arguments are reported. These included ‘reasons to tell’, ‘reasons not to tell’, ‘reasons why the question about telling or not would not be answered at all’, ‘inconclusive types of reasoning, that can still influence the fundamental decision’ and ‘context-dependent reasons associated with actual circumstances’. Through this meta-dassification of arguments it was possible to identify clues to how professionals could facilitate parental decision-making and promote disclosure. Parents who had informed their children did not regret their decision. All of the parents who responded to the question of whether it had been beneficial to the child to tell answered ‘yes’.

Testosterone for male contraception during one year: attitudes, well-being and quality of sex life

Mens attitudes, well-being, and sex life were studied during 1 years use of testosterone contraception. A consecutive series of 25 men were followed by structured interviews at baseline, during the efficacy phase of oligo-azoospermia and after recovery. Open questions gave qualitative aspects on male contraception. Themes obtained were expectations about freedom and control over their reproduction (16/25) and an enhanced sex life (17/25). The method was rated to be as expected or better by the great majority. Health and most aspects of the mens sex life did not change, but the frequency of intercourse and the quality of sex life in general were higher (p = 0.001 and p = 0.006, respectively) during the efficacy phase compared to the recovery phase. The decrease during recovery phase may be explained by a pharmacological down-regulation of the androgen receptors. Eight of 22 men admitted slightly aggressive feelings during treatment. Five of 11 women reported the men as more self-assertive during the efficacy phase.

Semen providers and their three families

Background: In 1985 the Swedish government introduced legislation that required all semen providers to furnish identifying information on themselves which would then be made available to their biological/provider offspring when they are deemed to have ‘sufficient maturity’. The purpose of the legislation was to protect the childs rights and needs. The aim of this paper is to examine the degree to which semen providers have considered the implications of their decision to donate upon their three families; their birth family, the family they form with their partner, and the recipient family. Methods: Thirty semen providers from two Swedish clinics were sent self-completion questionnaires collecting both quantitative and qualitative information. The initial response rate was 100%. Questions requested demographic information; the degree to which semen providers had consulted with or advised their partners, family, existing offspring and acquaintances about their semen donation; views and attitudes of semen providers towards donor offspring, anonymity, information sharing, payments to semen providers, community acceptance of DI and semen providers, experience of donation, recruitment/screening procedures. Results: Almost all respondents had told their partners that they were providing semen, however, a much smaller proportion had told their birth families. Almost two thirds of semen providers were positive or very positive about the prospect of meeting their offspring at some time in the future, with older men expressing more enthusiasm. Conclusions: The findings suggest that semen providers have only partially considered and addressed the full implications of having semen provider offspring. The age of semen providers could be influential in determining some attitudes and views.

Oral administration of RU 486 and 9-methylene PGE2 for termination of early pregnancy

It has been shown that the antiprogestin RU 486 increases the sensitivity of the early pregnant human uterus to the stimulatory action of prostaglandin E analogues administered vaginally or intramuscularly. To examine if RU 486 also increases uterine sensitivity to a PGE analogue given orally, two investigative approaches were used in the present study: 1) direct registration of uterine contractions before and after administration of 9-methylene PGE2 in untreated and RU-486-treated early pregnant women; and 2) an efficacy trial involving treatment of pregnant women (amenorrhea of 49 days or less) with 25 mg RU 486 twice daily for three or four days followed by 2.5, 5.0 or 10 mg 9-methylene PGE2, or 600 mg RU486 followed by 10 mg 9-methylene PGE2 administered on day 3 and 4. The results showed that oral 9-methylene PGE2 had a clear stimulatory effect on uterine contractility which was further increased by pretreatment with RU 486. Following 2.5, 5.0 or 10.0 mg 9-methylene PGE2, the frequency of complete abortion was the same, or approximately 80%. The success rate is higher than that generally reported for RU 486 treatment alone. If 600 mg RU 486 was complemented with 10 mg 9-methylene PGE2 administered on both days 3 and 4, the frequency of complete abortion increased to 95%. Side effects were of a mild nature and generally occurred following administration of 9-methylene PGE2. The results of the present study indicate that a combined treatment based on oral administration of both the antiprogestin and the prostaglandin analogue can be developed into a highly effective and simple method to terminate early pregnancy.