Donor assisted conception : the living experience and the concealment tendency in Chinese recipients

Abstract

Like many developed societies, women’s childbearing age is gradually increasing. This is accompanied by rising prevalence of fertility problems. The advancement of reproductive technology had ushered in a new era of reproductive possibilities, where couples are now privy to select their preferred assisted reproductive technology practices. The employment of donor-assisted conception (DAC) certainly provides an alternative channel through which many aspiring parents can pursuit pregnancy in case of infertility, the loss of genetic connection between the parent and child can pose cultural, social, ethical, and even legal challenges to our conventional understanding and acceptance of family. However, there is a paucity of research in understanding how these couples internalize the sense of infertility, how these perceptions shape subsequent behaviours and choices in relation to their offspring’s kinship and identity, and how the DAC recipients navigate the diametrical positions of preserving the parents’ right to privacy and the corresponding offspring’s right to know their genetic origins. The research gap is particularly evident in the Asian context, where Confucian values prevail to this date. As such, this thesis critically analyses the utilization of DAC from a cultural-, and woman-centred perspective in the context of Hong Kong. In particular, using a mixed-method approach, this thesis aims to unravel the underlying experience and processes of women come to terms with the adoption of donor-assisted conception and what the preference towards information concealment. It was found that Chinese Confucian emphases on genetic continuity and the preservation of the patrilineal line have generated a great deal of stress upon couples who experience fertility problems. The interplay between guilt and shame arising from infertility was especially evident among infertile women, which in turn distorted their sense of identity. Finding suggested that the employment of DAC provides a protecting shield for women’s social identities. Additionally, the concept of guilt and shame was found to acutely drive parents to conceal any information regarding their use of donated gametes from both society and their resulting children. The motivation for information concealment is resulted from the urge to protect self, the resulting child and other family members from possible social stigmatization. In order to examine the general acceptability toward the employment of DAC in Hong Kong society, this thesis also administered a population-based survey (n=915), and found that Chinese individuals are less supportive toward the use of DAC compared to Western samples, are more likely to reckon information disclosure damage the parent-child relationship, and display more worries over information disclosure. In light of these findings, this thesis argues that it is imperative for the government and health care professionals to design and implement counselling and supporting services that specifically cater toward Chinese. Understanding their struggles and perception toward infertility and their use of DAC constitutes the first step in doing so. This study represents the first attempt to analyse women’s living experience of DAC in the Hong Kong context.