Counsellors’ practices in donor sperm treatment

Abstract

When intended parents choose to have donor sperm treatment (DST), this may entail wide-ranging and long-lasting psychosocial implications related to the social parent not having a genetic tie with the child, how to disclose donor-conception and future donor contact. Counselling by qualified professionals is recommended to help intended parents cope with these implications. The objective of this study is to present findings and insights about how counsellors execute their counselling practices. We performed a qualitative study that included 13 counsellors working in the 11 clinics offering DST in the Netherlands. We held a focus group discussion and individual face-to-face semi-structured interviews, which were fully transcribed and analysed using thematic analysis. The counsellors combined screening for eligibility and guidance within one session. They acted according to their individual knowledge and clinical experience and had different opinions on the issues they discussed with intended parents, which resulted in large practice variations. The counsellors were dependent on the admission policies of the clinics, which were mainly limited to regulating access to psychosocial counselling, which also lead to a variety of counselling practices. This means that evidence-based guidelines on counselling in DST need to be developed to provide consistent counselling with less practice variation.

Experiences of involuntary childlessness and treatment in the UK: what has changed in 20 years?

“…This is especially important given that a review of research evidence found that psychological intervention is associated with higher pregnancy rates (Frederiksen et al, 2015). However, psychological care is often insufficiently geared towards dealing with the severe and long term emotional impacts, counselling practices vary dramatically across counsellors and clinics (Visser et al, 2018) and take-up of counselling, due to barriers such as the cost of counselling, is poor (Boivin et al, 1999). The NIAC survey in the UK in 1997 (Kerr et al, 1999) found that 71% of respondents reported they would request counselling if it were offered free, but 31% had received counselling and only 12% had been provided with National Health Service (NHS) funded counselling.…”

Psychosocial counselling for intended parents who opt for donor sperm treatment: which topics do they find relevant?

“…In the Netherlands, counsellors have various backgrounds; some are psychologists, other social workers. They have no specific education or training on DST counselling and base their counselling on their clinical experience and the policy of the clinic (Visser et al, 2018). Dutch clinics follow a national protocol for infertility counselling on 'possible moral contra-indications' during the intake which also applies for intended parents who opt for DST (NVOG, 2010).…”

“…Dutch clinics follow a national protocol for infertility counselling on 'possible moral contra-indications' during the intake which also applies for intended parents who opt for DST (NVOG, 2010). This protocol states that screening intended parents is essential in view of the welfare of the future child, but does not offer any guidelines on how to counsel (Visser et al, 2018). For additional information on the practice of Dutch counsellors, see Visser et al (2018).…”

“…This protocol states that screening intended parents is essential in view of the welfare of the future child, but does not offer any guidelines on how to counsel (Visser et al, 2018). For additional information on the practice of Dutch counsellors, see Visser et al (2018).…”

“…These guidelines, however, are based on clinical consensus and not upon assessment of the relevance of topics to be addressed in psychosocial counselling (Visser, Gerrits, van der Veen, & Mochtar, 2018). In view of this, we aimed to explore which topics intended parents found relevant to discuss in counselling.…”