Disclosure practices of mothers who conceived after ICSI vis-à-vis their 8- to 10-year-old child

Introduction
In families created through ICSI, the taboo concerning infertility might lead to secrecy, which in turn may influence the relationship between the parents and their ICSI conceived child. Few studies have been undertaken to assess to what extent women who have undergone ICSI tratment have told their child about its mode of conception. Mothers of 8- and 10-year-old ICSI children were questioned about this issue, as part of a Belgian two-wave long-term follow-up study into children's cognitive, psychosocial, family-relational and medical development (Leunens et al 2006;2007; Belva et al, 2007)
Materials and method
The sample consisted of mothers (n=131) of 8-year-old ICSI children in the first study wave, and mothers (n=100) of 10-year-old ICSI children in the second study wave. Outcome measure was a self-developed questionnaire on secrecy related to mode of conception. Questionnaire response rates of 87.3% were obtained for mothers in the first study wave and of 92.6% in the second study wave. Data were analyzed using Chi square with an accepted significance level of 0.05.
Results
About 33.6% of the eight year old and almost half of the ten year old (49%) ICSI children were told about their mode of conception. Main reasons for disclosing theis information according to the mothers were 'Because I do not have problems with the use of ICSI' and 'Because my child has the right to know his medical antecedents' (resp 81% and 35.7% at age 8, and 68.8% and 35.4% at age 10.). At age 10, around 40% of mothers also mentioned not wanting to have secrets to hide from their child. According to the mothers, the children reacted either interested or indifferently (resp 50% and 26.2% at age 8, and 68.8% and 22.9% at age 10).
Chi square results showed that neither the sex of the child, neither the nature of the fertility problem in the couple, or mothers' perception of heritability of the fertility problem were related to the issue of disclosing, to the reasons mothers mentioned for disclosing, or to the children's reactions to the information, as well at age 8 as at age 10.
In both study waves, 15% of mothers answered affirmatively when asked the question whether the use of ICSI had altered the parent-child relationship.
Although 88.2% (n=45) of mothers of 10-year-olds who had not informed their child were planning to do so in the future, main reasons for the remaining mothers (n=6) not to do so were 'this is irrelevant information for my child', 'my child will have difficulties accepting', and 'I don't want to make a 'special' child'.
Conclusion
At prepubertal age, one third (age 8) to about half (age 10) of the ICSI conceived children received information on their mode of conception. This is a considerably larger proportion of children than in recent studies with five-year-old ICSI and IVF children. Most mothers state that the mode of conception has had no influence on the parent-child relationship. Nor the sex of the child, the nature of the fertility problem in the couple, or mothers' perception of heritability of the fertility problem were related to the issue of disclosing, to the reasons mothers mentioned for disclosing, or to the reactions of the children to the information, as well at age 8 as age 10.
Of those mothers who have not informed their child about the mode of conception at age 10, the majority is oriented to do so in the future.

Publication year:2008

Keywords:ICSI, children, follow-up