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Self-reported mental health status of donor sperm-conceived adults

Published online by Cambridge University Press:  31 May 2021

Damian H. Adams
Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, 5042, Australia
Adam Gerace
School of Health, Medical and Applied Sciences, Central Queensland University, Wayville, South Australia, 5034, Australia
Michael J. Davies
The Robinson Institute, The University of Adelaide, Adelaide, South Australia, 5001, Australia
Sheryl de Lacey
College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, 5042, Australia
E-mail address:


While donor-conceived children have similar mental health outcomes compared to spontaneously conceived children, there is an inconsistency between studies investigating mental health outcomes of donor-conceived people in adulthood. This study is an online health survey that was completed by 272 donor sperm-conceived adults and 877 spontaneously conceived adults from around the world. Donor sperm-conceived adults had increased diagnoses of attention deficit disorder (P = 0.004), and autism (P = 0.044) in comparison to those conceived spontaneously. Donor sperm-conceived adults self-reported increased incidences of seeing a mental health professional (P < 0.001), identity formation problems (P < 0.001), learning difficulties (P < 0.001), panic attacks (P = 0.038), recurrent nightmares (sperm P = 0.038), and alcohol/drug dependency (P = 0.037). DASS-21 analysis revealed that donor sperm-conceived adults were also more stressed than those conceived spontaneously (P = 0.013). Both donor sperm and spontaneously conceived cohorts were matched for sex, age, height, alcohol consumption, smoking, exercise, own fertility, and maternal smoking. The increase in adverse mental health outcomes is consistent with some studies of donor-conceived adult mental health outcomes. These results are also consistent with the Developmental Origins of Health and Disease (DOHaD) phenomenon that has linked adverse perinatal outcomes, which have been observed in donor-conceived neonates, to increased risk of chronic disease, including mental health. Further work is required to reconcile our observations in adults to contrary observations reported in donor-conceived children.

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© The Author(s), 2021. Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease

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Ilioi, EC, Golombok, S. Psychological adjustment in adolescents conceived by assisted reproduction techniques: a systematic review. Hum Reprod Update. 2015; 21(1), 8496.CrossRefGoogle ScholarPubMed
Golombok, S, Blake, L, Casey, P, Roman, G, Jadva, V. Children born through reproductive donation: a longitudinal study of psychological adjustment. J Child Psychol Psychiatry. 2013; 54(6), 653660.CrossRefGoogle ScholarPubMed
Golombok, S, Readings, J, Blake, L, et al. Children conceived by gamete donation: psychological adjustment and mother-child relationships at age 7. J Fam Psychol. 2011; 25(2), 230239.CrossRefGoogle ScholarPubMed
Kovacs, GT, Mushin, D, Kane, H, Baker, HW. A controlled study of the psycho-social development of children conceived following insemination with donor semen. Hum Reprod. 1993; 8(5), 788790.CrossRefGoogle ScholarPubMed
Tallandini, MA, Zanchettin, L, Gronchi, G, Morsan, V. Parental disclosure of assisted reproductive technology (ART) conception to their children: a systematic and meta-analytic review. Hum Reprod. 2016; 31(6), 12751287.CrossRefGoogle ScholarPubMed
Schrijvers, A, Bos, H, van Rooij, F, Gerrits, T, van der Veen, F, Mochtar, M, et al. Being a donor-child: wishes for parental support, peer support and counseling. J Psychosom Obstet Gynaecol. 2019; 40(1), 2937.CrossRefGoogle ScholarPubMed
Harrigan, MM, Dieter, S, Leinwohl, J, Marrin, L. “It’s just who I am… I have brown hair. I have a mysterious father”: an exploration of donor-conceived offspring’s identity construction. J Fam Comm. 2015; 15(1), 7593.CrossRefGoogle Scholar
Mahlstedt, PP, LaBounty, K, Kennedy, WT. The views of adult offspring of sperm donation: essential feedback for the development of ethical guidelines within the practice of assisted reproductive technology in the United States. Fertil Steril. 2010; 93(7), 22362246.CrossRefGoogle ScholarPubMed
Jadva, V, Freeman, T, Kramer, W, Golombok, S. The experiences of adolescents and adults conceived by sperm donation: comparisons by age of disclosure and family type. Hum Reprod. 2009; 24(8), 19091919.CrossRefGoogle ScholarPubMed
Turner, AJ, Coyle, A. What does it mean to be a donor offspring? The identity experiences of adults conceived by donor insemination and the implications for counselling and therapy. Hum Reprod. 2000; 15(9), 20412051.CrossRefGoogle ScholarPubMed
Adams, DH, Gerace, A, Davies, MJ, De Lacey, S. Self-reported physical health status of donor sperm conceived adults. J Dev Orig Health Dis. 2020, Online ahead of print.CrossRefGoogle Scholar
Lovibond, SH, Lovibond, PF. Manual for the Depression Anxiety Stress Scales. Second edition, 1995. Psychology Foundation of Australia, Sydney, Australia.Google Scholar
Seedat, S, Scott, KM, Angermeyer, MC, et al. Cross-national associations between gender and mental disorders in the World Health Organization World Mental Health Surveys. Arch Gen Psychiatry. 2009; 66(7), 785795.CrossRefGoogle ScholarPubMed
Tuovinen, S, Raikkonen, K, Pesonen, AK, et al. Hypertensive disorders in pregnancy and risk of severe mental disorders in the offspring in adulthood: the Helsinki Birth Cohort Study. J Psychiatr Res. 2012; 46(3), 303310.CrossRefGoogle ScholarPubMed
Benjamini, Y, Hochberg, Y. Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Stat Soc Series B Stat Methodol. 1995; 57(1), 289300.Google Scholar
NHMRC. National Statement on Ethical Conduct in Human Research, 2007. National Health and Medical Research Council, Commonwealth of Australia, Australia.Google Scholar
CoA. National Health and Medical Research Council Act. Australia: Commonwealth of Australia, 1992.Google Scholar
WMA. Declaration of Helsinki - Ethical Principles for Medical Research Involving Human Subjects. France: World Medical Association, 2013.Google Scholar
Slutsky, J, Jadva, V, Freeman, T, et al. Integrating donor conception into identity development: adolescents in fatherless families. Fertil Steril. 2016; 106(1), 202208.CrossRefGoogle ScholarPubMed
Rodino, IS, Burton, PJ, Sanders, KA. Donor information considered important to donors, recipients and offspring: an Australian perspective. Reprod Biomed Online. 2011; 22(3), 303311.CrossRefGoogle ScholarPubMed
Zadeh, S, Ilioi, EC, Jadva, V, Golombok, S. The perspectives of adolescents conceived using surrogacy, egg or sperm donation. Hum Reprod. 2018; 33(6), 10991106.CrossRefGoogle ScholarPubMed
Persaud, S, Freeman, T, Jadva, V, et al. Adolescents conceived through donor insemination in mother-headed families: a qualitative study of motivations and experiences of contacting and meeting same-donor offspring. Child Soc. 2017; 31(1), 1322.CrossRefGoogle ScholarPubMed
Lozano, EB, Fraley, RC, Kramer, W. Attachment in donor-conceived adults: Curiosity, search, and contact. Pers Relatsh. 2019; 26(2), 331344.CrossRefGoogle Scholar
Nelson, MK, Hertz, R, Kramer, W. Gamete donor anonymity and limits on numbers of offspring: the views of three stakeholders. J Law Biosci. 2016; 3(1), 3967.CrossRefGoogle ScholarPubMed
WHO. Gender and women’s mental health. Gender disparities and mental health: The facts, 2014. World Health Organization. Accessed June 23, 2020. Available from: Google Scholar
Gomez, R, Summers, M, Summers, A, Wolf, A, Summers, J. Depression Anxiety Stress Scales-21: measurement and structural invariance across ratings of men and women. Assessment. 2014; 21(4), 418426.CrossRefGoogle ScholarPubMed
Lee, J, Lee, EH, Moon, SH. Systematic review of the measurement properties of the Depression Anxiety Stress Scales-21 by applying updated COSMIN methodology. Qual Life Res. 2019; 28(9), 23252339.CrossRefGoogle ScholarPubMed
Fosse, NE, Haas, SA. Validity and stability of self-reported health among adolescents in a longitudinal, nationally representative survey. Pediatrics. 2009; 123(3), e496e501.CrossRefGoogle Scholar
Schnittker, J, Bacak, V. The increasing predictive validity of self-rated health. PLoS One. 2014; 9(1), e84933.CrossRefGoogle ScholarPubMed
Zajacova, A, Dowd, JB. Reliability of self-rated health in US adults. Am J Epidemiol. 2011; 174(8), 977983.CrossRefGoogle ScholarPubMed
Singh-Manoux, A, Martikainen, P, Ferrie, J, Zins, M, Marmot, M, Goldberg, M. What does self-rated health measure? Results from the British Whitehall II and French Gazel cohort studies. J Epidemiol Community Health. 2006; 60(4), 364372.CrossRefGoogle ScholarPubMed
Allan, S. Report of the review of the Assisted Reproductive Treatment Act 1988. Australia: Sonia Allan for the South Australian Minister for Health, 2017.Google Scholar
VLRC. Inquiry into access by donor conceived people to information about the donors. Australia: Victoria Law Reform Committee, Victorian Government Printer, 2012.Google Scholar
Allan, S. The Review of the Western Australian Human Reproductive Technology Act 1991 and the Surrogacy Act 2008 Australia: Sonia Allan for the Western Australian Minister for Health, 2019.Google Scholar
Ohrnberger, J, Fichera, E, Sutton, M. The relationship between physical and mental health: A mediation analysis. Soc Sci Med. 2017; 195, 4249.CrossRefGoogle ScholarPubMed
Adams, DH. Conceptualising a child-centric paradigm: do we have freedom of choice in donor conception reproduction? J Bioeth Inq. 2013; 10(3), 369381.CrossRefGoogle ScholarPubMed
Steel, Z, Marnane, C, Iranpour, C, et al. The global prevalence of common mental disorders: a systematic review and meta-analysis 1980-2013. Int J Epidemiol. 2014; 43(2), 476493.CrossRefGoogle ScholarPubMed
Tuovinen, S, Aalto-Viljakainen, T, Eriksson, JG, et al. Maternal hypertensive disorders during pregnancy: adaptive functioning and psychiatric and psychological problems of the older offspring. BJOG. 2014; 121(12), 14821491.CrossRefGoogle ScholarPubMed
Koh, AS, Bos, HMW, Gartrell, NK. Predictors of mental health in emerging adult offspring of lesbian-parent families. J Lesbian Stud. 2019; 23(2), 257278.CrossRefGoogle ScholarPubMed
Ilioi, E, Blake, L, Jadva, V, Roman, G, Golombok, S. The role of age of disclosure of biological origins in the psychological wellbeing of adolescents conceived by reproductive donation: a longitudinal study from age 1 to age 14. J Child Psychol Psychiatry. 2017; 58(3), 315324.CrossRefGoogle Scholar
Leeton, J, Backwell, J. A preliminary psychosocial follow-up of parents and their children conceived by artificial insemination by donor (AID). Clin Reprod Fertil. 1982; 1(4), 307310.Google Scholar
Milsom, I, Bergman, P. A study of parental attitudes after donor insemination (AID). Acta Obstet Gynecol Scand. 1982; 61(2), 125128.CrossRefGoogle Scholar
Klock, SC, Jacob, MC, Maier, D. A prospective study of donor insemination recipients: secrecy, privacy, and disclosure. Fertil Steril. 1994; 62(3), 477484.CrossRefGoogle ScholarPubMed
Durna, EM, Bebe, J, Steigrad, SJ, Leader, LR, Garrett, DG. Donor insemination: attitudes of parents towards disclosure. Med J Aust. 1997; 167(5), 256259.CrossRefGoogle ScholarPubMed
Godman, KM, Sanders, K, Rosenberg, M, Burton, P. Potential sperm donors', recipients’ and their partners’ opinions towards the release of identifying information in Western Australia. Hum Reprod. 2006; 21(11), 30223026.CrossRefGoogle ScholarPubMed
Mac Dougall, K, Becker, G, Scheib, JE, Nachtigall, RD. Strategies for disclosure: how parents approach telling their children that they were conceived with donor gametes. Fertil Steril. 2007; 87(3), 524533.CrossRefGoogle ScholarPubMed
Shehab, D, Duff, J, Pasch, LA, Mac Dougall, K, Scheib, JE, Nachtigall, RD. How parents whose children have been conceived with donor gametes make their disclosure decision: contexts, influences, and couple dynamics. Fertil Steril. 2008; 89(1), 179187.CrossRefGoogle ScholarPubMed
Isaksson, S, Sydsjö, G, Skoog Svanberg, A, Lampic, C. Disclosure behaviour and intentions among 111 couples following treatment with oocytes or sperm from identity-release donors: follow-up at offspring age 1-4 years. Hum Reprod. 2012; 27(10), 29983007.CrossRefGoogle ScholarPubMed
Crawshaw, M. Lessons from a recent adoption study to identify some of the service needs of, and issues for, donor offspring wanting to know about their donors. Hum Fertil (Camb). 2002; 5(1), 612.CrossRefGoogle ScholarPubMed
Feast, J. Using and not losing the messages from the adoption experience for donor-assisted conception. Hum Fertil (Camb). 2003; 6(1), 4145.CrossRefGoogle ScholarPubMed
Triseliotis, J. Donor insemination and the child. Politics Life Sci. 1993; 12(2), 195197.CrossRefGoogle ScholarPubMed
Tieman, W, van der Ende, J, Verhulst, FC. Psychiatric disorders in young adult intercountry adoptees: an epidemiological study. Am J Psychiatry. 2005; 162(3), 592598.CrossRefGoogle Scholar
Cubito, DS, Brandon, KO. Psychological adjustment in adult adoptees: assessment of distress, depression, and anger. Am J Orthopsychiatry. 2000; 70(3), 408413.CrossRefGoogle ScholarPubMed
Wierzbicki, M. Psychological adjustment of adoptees: a meta-analysis. J Clin Child Psychol. 1993; 22(4), 447454.CrossRefGoogle Scholar
Bohman, M, von Knorring, AL. Psychiatric illness among adults adopted as infants. Acta Psychiatr Scand. 1979; 60(1), 106112.CrossRefGoogle ScholarPubMed
Moreno-Sepulveda, J, Checa, MA. Risk of adverse perinatal outcomes after oocyte donation: a systematic review and meta-analysis. J Assist Reprod Genet. 2019; 36(10), 20172037.CrossRefGoogle ScholarPubMed
Adams, DH, Clark, RA, Davies, MJ, de Lacey, S. Update on: a meta-analysis of sperm donation offspring health outcomes - 2018 update. J Dev Orig Health Dis. 2018; 9(5), 561562.CrossRefGoogle ScholarPubMed
Mascarenhas, M, Sunkara, SK, Antonisamy, B, Kamath, MS. Higher risk of preterm birth and low birth weight following oocyte donation: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2017; 218, 6067.CrossRefGoogle ScholarPubMed
O’Donnell, KJ, Meaney, MJ. Fetal origins of mental health: the developmental origins of health and disease hypothesis. Am J Psychiatry. 2017; 174(4), 319328.CrossRefGoogle ScholarPubMed
Ward, AM, Moore, VM, Steptoe, A, Cockington, RA, Robinson, JS, Phillips, DI. Size at birth and cardiovascular responses to psychological stressors: evidence for prenatal programming in women. J Hypertens. 2004; 22(12), 22952301.CrossRefGoogle ScholarPubMed
Sucksdorff, M, Lehtonen, L, Chudal, R, Suominen, A, Joelsson, P, Gissler, M, et al. Preterm Birth and Poor Fetal Growth as Risk Factors of Attention-Deficit/Hyperactivity Disorder. Pediatrics. 2015; 136(3), e599e608.CrossRefGoogle ScholarPubMed
Banerjee, TD, Middleton, F, Faraone, SV. Environmental risk factors for attention-deficit hyperactivity disorder. Acta Paediatr. 2007; 96(9), 12691274.CrossRefGoogle ScholarPubMed
Smith, GN, Walker, M, Tessier, JL, Millar, KG. Increased incidence of preeclampsia in women conceiving by intrauterine insemination with donor versus partner sperm for treatment of primary infertility. Am J Obstet Gynecol. 1997; 177(2), 455458.CrossRefGoogle ScholarPubMed
Gonzalez-Comadran, M, Urresta Avila, J, Saavedra Tascon, A, et al. The impact of donor insemination on the risk of preeclampsia: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2014; 182, 160166.CrossRefGoogle ScholarPubMed
Kyrou, D, Kolibianakis, EM, Devroey, P, Fatemi, HM. Is the use of donor sperm associated with a higher incidence of preeclampsia in women who achieve pregnancy after intrauterine insemination? Fertil Steril. 2010; 93(4), 11241127.CrossRefGoogle ScholarPubMed
Dachew, BA, Scott, JG, Mamun, A, Alati, R. Hypertensive disorders of pregnancy and the risk of anxiety disorders in adolescence: findings from the Avon Longitudinal Study of Parents and Children. J Psychiatr Res. 2019; 110, 159165.CrossRefGoogle ScholarPubMed
Lahti-Pulkkinen, M, Girchenko, P, Tuovinen, S, et al. Maternal hypertensive pregnancy disorders and mental disorders in children. Hypertension. 2020; 75(6), 14291438.CrossRefGoogle ScholarPubMed
Tuovinen, S, Räikkönen, K, Kajantie, E, et al. Depressive symptoms in adulthood and intrauterine exposure to pre-eclampsia: the Helsinki Birth Cohort Study. BJOG. 2010; 117(10), 12361242.CrossRefGoogle ScholarPubMed
Sun, BZ, Moster, D, Harmon, QE, Wilcox, AJ. Association of preeclampsia in term births with neurodevelopmental disorders in offspring. JAMA Psychiatry. 2020; 77(8), 823829.CrossRefGoogle ScholarPubMed
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