Family building using embryo adoption: relationships and contact arrangements between provider and recipient families — a mixed-methods study

STUDY QUESTION
What contact arrangements are established between providers and recipients of embryos using Snowflakes® Embryo Adoption Program?

SUMMARY ANSWER
Contact arrangements varied considerably and were generally positively described, although some challenges were acknowledged.

WHAT IS KNOWN ALREADY
Reproductive technologies create new and diverse family forms, and the ways in which families created by embryo adoption are negotiated in practice have not been extensively investigated.

STUDY DESIGN, SIZE, DURATION
This exploratory, mixed-methods study had two phases: (i) an online survey (open May-September 2013) and (ii) qualitative semi-structured interviews by email (conducted between 2014 and 2015), exploring participants’ experiences of contact with their embryo provider or recipient.

PARTICIPANTS/MATERIALS, SETTING, METHODS
Phase I included 17 providers (14 women and 3 men) and 28 recipients (27 women and 1 man). Phase II included 8 providers (5 women and 3 men) and 12 recipients (10 women and 2 men). All participants, except one, were located in the US.

MAIN RESULTS AND THE ROLE OF CHANCE
This study illustrates how embryo adoption in the US, as a form of conditional donation, can operate and how the participants define and negotiate these emerging relationships. All families were open with their children about how they were conceived and early contact between recipients and providers (frequently before birth) was valued. On the whole, participants were happy with the amount and type of contact they had, and where the current contact did not involve the children, it was seen as a way of keeping the channels open for future contact when the children were older. Participants often portrayed the opportunities for contact as being in the best interests of the child.

LIMITATIONS, REASONS FOR CAUTION
The study participants are a particular group who had chosen to either receive or give their embryos via a conditional embryo adoption agency in the US and had established contact. Therefore, this is not a representative sample of those who provide or receive embryos for family building.

WIDER IMPLICATIONS OF THE FINDINGS
This embryo adoption model clearly fulfils a need; some people want to use a conditional embryo donation programme such as Snowflakes®. Some form of ‘ongoing support mechanism’ such as counselling could be useful for those negotiating the complex sets of new kinship patterns and balancing these relationships with their children's welfare.

STUDY FUNDING/COMPETING INTEREST(S)
The authors have no conflict of interest to declare. Snowflakes is a commercial adoption agency and the authors have no relation to the organization, other than requesting that they participate in this research project.

TRIAL REGISTRATION NUMBER
N/A.