donor insemination in smcg mck between 1977 and 2003 leiden clinic n.
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Donor-insemination in SMCG/MCK between 1977 and 2003 (Leiden Clinic). DI in the Netherlands: it is time to produce data!. How did our population of women asking for DI change in the 1977 – 2003 time-frame; What data do we have about the mothers and the children born in this period;

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di in the netherlands it is time to produce data
DI in the Netherlands: it is time to produce data!
  • How did our population of women asking for DI change in the 1977 – 2003 time-frame;
  • What data do we have about the mothers and the children born in this period;
  • The donors during this time frame, did they react on the discussions in society about anonymity?

Medisch Centrum Kinderwens

acceptance of d i in the mid seventies
Acceptance of D.I in the mid- seventies
  • First reports on DI in 1948 (Levie)
  • DI for non-married women is to be rejected (Resolution KNMG, 1962)
  • DI for women in an infertile relationship could be tolerated under strict conditions
  • ‘In 1960 in the NL, 90% of all gynaecologists opposed DI as treatment for infertility, in 1970 40% of them still did so’ (Hoogerzeil, 1985).

Medisch Centrum Kinderwens

conditional acceptance
Conditional acceptance
  • Non-disclosure about the way of conception from the parents to the child was the prevailing norm. Anonymity until infinity of the donor is the logical consequence.
  • In his 1975 publication for dutch practitioners, Levie elaborated on contra indications for DI. He wrote: … ‘we think that knowledge by any person outside the directly involved medical team about the intention to have DI is a contra-indication to start DI treatment.’

Medisch Centrum Kinderwens

di in nl the seventies and early eighties
DI in NL : the ‘seventies’ and early ‘eighties’
  • In 1985 Hoogerzeil writes:’… in the DI program of the AZUA the question of confidentiality was always left for the couple to decide’.
  • At the start of the DI clinic in Leiden Single women and Lesbian couples were welcome from the start in 1977 : confidentiallity has a different perspective in such treatments…

Medisch Centrum Kinderwens

children born after treatment between 1977 2003
Children born after treatment between 1977 - 2003
  • Women : 1105 pregnanciesleading to a firstbirth of at leastonechild;
  • 273 women had twosuccessivebirths, 26 had threebirths, in 1 case was even a fourthbirth
  • In total 1365 singletons, 47 twins and 2 triplets, adding up to 1465 children.
  • From these 1465 we could record the sex of 1431 children (98%). This is the groupunderstudy in thispresentation.
di from 1977 and 2003 3 periods
DI from 1977 and 2003 : 3 periods
  • 1977 - 1984, anonymity and secrecy, insemination partly with fresh sperm and several inseminations per cycle
  • 1985 - 1993, discussions on anonymity and secrecy are opened; insemination mainly with cryopreserved sperm, introduction of IVF.
  • 1994 – 2003, introduction of ICSI (!), trend to voluntary non-anonymous donors, TV-publicity and discussions on secrecy, bill on regulated artificial fertilization passed in june 2002 and became the Law.
3 groups of mothers
3 groups of mothers
  • Mothers in a heterosexual relationship;

indication: infertility problem, other;

 Mothers in a lesbian relationship;

  • Single mothers
requests for non identifying donor information
Requests for non identifying donor information
  • Requests of mothers for non-ID info (‘donor pasport’), after birth; Requests of children;
  • Mother and child come with a request
  • Only the child comes with a request
  • Only the mother comes with a request
comparison of 2 groups of mothers
Comparison of 2 groups of mothers

Medisch Centrum Kinderwens

sex of the children who ask
Sex of the children who ask
  • 72 children who requested donor information
  • 30 were male, 42 were female
  • Are girls more inclined to search for this information?
conclusions about disclosure
Conclusions about disclosure ?

- In the oldest group of children with a social father (29 - 36 yrs) only 4% of the children make a request themselves;

  • In the youngest group (10 – 19 yrs) many more mothers (20% vs 7%) make a request for a ‘donor pasport’ than in the oldest group;
  • In general mothers are much more active in this respect than children;
  • In the group without a social father 20 – 30% of the children request for donor info..
general conclusions on di between 1977 and 2003
General conclusions on DI between 1977 and 2003
  • DI became an accepted treatment mode for infertility and unvolontary childlessness in the Netherlands;
  • Also lesbian relationships and single women as candidates for DI became widely accepted;
  • The landscape in relation to the DI candidates changed drastically :

- the ‘classical’ infertility cases now logically prefer IVF or ICSI, if needed in combination with PESA or TESE.

- a limited group of severe azoospermia still remains indicated.

- single women and lesbian couples are a large group in DI programs

Symposium MCK 2013

special thanks
Special Thanks
  • Erica de Reus
  • Anne Brewaeys

Medisch Centrum Kinderwens

thanks to many colleagues and staff members from leiden clinic
Thanks to many colleagues and staff members from Leiden Clinic
  • Willem Beekhuizen
  • Kees van Schie
  • Hanna Bonink
  • Renske v.d. Baan
  • E. Tellegen
  • J. van de Noort
  • Carla van Gerwen
  • Mirjam Denteneer
  • Maria Noboa
  • Elly van der Kwaak
  • Ingrid Heijnsbroek
  • Lies ter Haar
  • Gerda van Niekerk
  • Jacqueline Heemskerk
  • Maureen Roos
  • Present secretarial staff MCK
  • Present medical staff MCK
  • Present laboratory staff MCK