Monday, July 15, 2024

Long-Term Psychological Outcomes of Donor-Conceived Individuals: A Systematic Review

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In the UK, more than 70,000 donor-conceived (DC) individuals have been born since 1991, yet their long-term psychological outcomes remain relatively unexplored. This systematic review aims to fill that gap, providing insights into their experiences from childhood through adulthood. The comprehensive analysis, registered under Prospero: CRD42021257863, incorporated 50 studies encompassing 4,666 DC participants, primarily from high-income anglophone countries. Key findings highlight a spectrum of psychological outcomes, revealing both positive and negative aspects associated with being donor-conceived.

Extensive Literature Search and Selection Criteria

The review involved a thorough search of databases including CINHAL, Embase, MEDLINE®, and PsycINFO, conducted on January 4, 2024. Studies were included based on strict criteria: a minimum of five participants, peer-reviewed status, and assessments of any DC psychological outcomes. No restrictions were placed on date, language, or country, ensuring a diverse and comprehensive dataset. The double screening, data extraction, and quality assessment were meticulously performed using the Joanna Briggs Institute (JBI) scoring system.

Main Findings and Psychological Outcomes

Out of the 50 studies reviewed, 19 were comparative. Among these, 14 studies reported no significant differences between DC and non-DC individuals, while 10 indicated better outcomes for DC individuals in terms of health, well-being, self-esteem, and emotional warmth. Conversely, six studies highlighted worse outcomes, identifying increased rates of autism spectrum disorder, attention deficit hyperactivity disorder, addiction issues, mental illness, disruptive behavior, and identity problems among DC individuals. Qualitative data pointed to recurring themes of identity formation, mistrust, and concerns regarding genetic heritage.

Implications for Market Access

The findings of this review have significant implications for market access, particularly in the field of reproductive technology and psychological services. Understanding the nuanced outcomes for DC individuals can inform healthcare providers, policymakers, and support organizations, ensuring that appropriate resources and services are accessible to meet the unique needs of this population. Early disclosure of DC status appears to be beneficial, suggesting the need for guidelines and support systems to facilitate this process.

Key Insights for Stakeholders

– Early disclosure of DC status is linked to better psychological outcomes.
– Healthcare providers should be aware of the potential for increased mental health issues in DC individuals.
– Support systems should address identity formation and genetic heritage concerns.
– Policymakers need to consider the diverse outcomes when formulating guidelines for DC individuals.

The research on DC individuals presents a nuanced picture, with most studies suggesting comparable or improved outcomes in terms of well-being and relationships, but with a notable minority indicating higher rates of mental health and identity struggles. Qualitative findings underscore common negative experiences, whereas the early disclosure of DC status appears beneficial for psychological well-being.

Original Article: BJOG. 2024 Jun 27. doi: 10.1111/1471-0528.17892. Online ahead of print.

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