Parents' experiences telling children conceived by gamete and embryo donation about their genetic origins.

To gain an in-depth understanding of parents' experiences telling children conceived by gamete and embryo donation about their genetic origins. Qualitative, descriptive. Families' homes. Gamete or embryo donation recipient parents living in the United States and who told their children, from birth to 16 years, about their genetic origins. Individual semistructured (n = 12) or dyadic (n = 2) parent interviews. Directed qualitative content analysis. Fourteen families that comprised 16 gamete or embryo donation recipient parents and represented 24 donor-conceived children between the ages of 4 months and 16 years participated in the study. Single parents (n = 3) and both parents in most two-parent families (n = 9) led the initial telling conversations. Parents recounted personal short stories using language that was both developmentally and medically appropriate. Multiple strategies, including children's books, were used by parents to aid them in their telling. The oldest donor-conceived children in each family were first informed of their genetic origins at birth (n = 10 families) or at 6 months (n = 1 family; "practice runs") or from 3.5 to 12 years (n = 3 families). The telling conversations took place during routine family activities that naturally brought parents and children in close proximity, usually in the home. Awareness of the nuances of parents' telling conversations with their children through the age of 16 years can help guide clinical counseling and the development of tools to aid parents in their telling conversations.

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