Experiences and attitudes of Danish men who were sperm donors more than 10 years ago; a qualitative interview study

Stina Lou; Stina Bollerup; Morten Deleuran Terkildsen; Stine Willum Adrian; Allan Pacey; Guido Pennings; Ida Vogel; Anne-Bine Skytte

doi:10.1371/journal.pone.0281022

Peer Review History

Original SubmissionAugust 22, 2022
14 Nov 2022 Decision Letter - Sónia Brito-Costa, Editor PONE-D-22-21878Experiences and attitudes of Danish men who were sperm donors more than 10 years ago; a qualitative interview studyPLOS ONE Dear Dr. Lou, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. ============================== Dear Stina Lou About your paper entitled “Experiences and attitudes of Danish men who were sperm donors more than 10 years ago; a qualitative interview study” We have considered that the paper is interesting and could potentially be published in a new versión (the decisión is Major Revision) that takes into account the observations made by the referees. I am attaching the referee's comments, which will help to explain the reasons for our decision. As you can see, the reviewer finds the paper to be of interest, but raises a number of significant concerns. I hope the reports may be useful if you are considering revising the paper for re-submission to Plos One. Yours sincerely, Sónia Brito-Costa ============================== Please submit your revised manuscript by Dec 29 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). 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Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Sónia Brito-Costa, Ph.D. Academic Editor PLOS ONE Journal Requirements: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. Thank you for stating the following in the Acknowledgments Section of your manuscript: “This study was funded by Cryos International and the Novo Nordisk Foundation (Grant No. NNF16OC18722).” We note that you have provided additional information within the Acknowledgements Section that is not currently declared in your Funding Statement. Please note that funding information should not appear in the Acknowledgments section or other areas of your manuscript. We will only publish funding information present in the Funding Statement section of the online submission form. Please remove any funding-related text from the manuscript and let us know how you would like to update your Funding Statement. Currently, your Funding Statement reads as follows: “This study was funded by Cryos International, https://www.cryosinternational.com/da-dk/dk-shop/professionel/forskning/vores-videnskabelige-forskning/ (to SL) ,and the Novo Nordisk Foundation, https://novonordiskfonden.dk/en/ (Grant No. NNF16OC18722 to IV). Cryos International assisted with recruitment of participants, but otherwise the funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.” Please include your amended statements within your cover letter; we will change the online submission form on your behalf. 3. Thank you for stating the following in the Competing Interests section: “SL, SB, MDT and IV declare no conflict of interest. AP, GP and SWA are members of the Cryos External Scientific Advisory Committee. GP has received honorarium for this. ABS is an employee of Cryos International.” Please confirm that this does not alter your adherence to all PLOS ONE policies on sharing data and materials, by including the following statement: "This does not alter our adherence to PLOS ONE policies on sharing data and materials.” (as detailed online in our guide for authors http://journals.plos.org/plosone/s/competing-interests). If there are restrictions on sharing of data and/or materials, please state these. Please note that we cannot proceed with consideration of your article until this information has been declared. Please include your updated Competing Interests statement in your cover letter; we will change the online submission form on your behalf. 4. We note that you have stated that you will provide repository information for your data at acceptance. Should your manuscript be accepted for publication, we will hold it until you provide the relevant accession numbers or DOIs necessary to access your data. If you wish to make changes to your Data Availability statement, please describe these changes in your cover letter and we will update your Data Availability statement to reflect the information you provide. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: N/A ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Very interesting and important longterm follow up of sperm donors. The manuscript is well written and I have only a few concerns. My first concern is about how the donors who were possible to interview were selected (39 donors)? Please develop that part ie how many in total were available >10 years, if not all there is a need for mor information regarding the criteria for being recruited. My second concern is about the semi structured questions. How were they used? Were all these questions asked to all of the participants? It would improve the understanding if you describe a little more (few examples) how your process of doing reflexive thematic analysis was performed/developed regarding from the main text from the interviews? The analysis was based on interviews 9-47 minutes (mean 24). 9 minutes are very short to get substance for an analysis. You base your results on 21 anonymous and separate 2 non-anonymous donors answers. Why did you include only 2 non-anonymous, or why did you include these two at all? The main message may be more clear if focus and discussion only were about anonymous donors. As you write (and participants answers show) the non-anonymous donors think differently. Interesting discussion that add insight about donors longterm perspectives. Reviewer #2: This article is relevant to a better understanding and characterization of gamete donors. Most studies focus on donation motivations and are carried out before or shortly after donation, not allowing this long-term analysis. Regarding the submitted article, there are 3 fundamental points that I want to emphasize: 1. The abstract should be improved, as it is not particularly appealing to the potential reader. I also emphasize the need to correct the second sentence of its "methods" section and improve the conclusions; 2. Although in Denmark this type of study does not require the statement of an Ethics Committee, this statement is required by PLOS One "if the study involved human participants", so the authors, if they intended to submit their study to this journal, should have read the submission rules and prepare theirr project accordingly. The decision of whether or not to accept the publication without fulfilling this requirement will, of course, be at the discretion of the Editor; 3. Despite being a qualitative study, I believe that the designation in the results, repeatedly, of terms such as "many", "for the majority", "a few", "several" and "most" should be replaced by the number of participants that we are actually mentioning in each case. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0281022.r001
Revision 1
4 Jan 2023 Author Response Response to decision letter Dear Sónia Brito-Costa, Academic Editor, PLOS One First, we wish to thank the reviewers for insightful and very constructive comments on our manuscript. We have revised the paper in accordance with the reviewers' suggestions and believe it has improved the manuscript. Below we address the comments and explain how we have aimed to accommodate them in the revision of the manuscript. All reference to line numbers are in the track changes version of the revised manuscript. We hope that the revision meets your expectations and look forward to hearing from you. On behalf of the authors, Best regards, Stina Lou Journal requirements 1. Please ensure that your manuscript meets PLOS ONE's style requirements. - We have revised the manuscript in accordance with PLOS ONE's formatting requirements, including title page, tables and manuscript headings (PLOSOne_formatting_sample_main_body.pdf (storage.googleapis.com) 2. Please remove any funding-related text from the manuscript and let us know how you would like to update your Funding Statement. Please include your amended statements within your cover letter; we will change the online submission form on your behalf. - Updated Funding Statement: This study was funded by Cryos International (personal grant to SL, no grant number assigned) and the Novo Nordisk Foundation (Grant No. NNF16OC18722 to IV). Staff at Cryos International assisted in recruitment of participants for the study, but the funders had no role in the data collection, analysis and interpretation of results. 3. Thank you for stating the following in the Competing Interests section: “SL, SB, MDT and IV declare no conflict of interest. AP, GP and SWA are members of the Cryos External Scientific Advisory Committee. GP has received honorarium for this. ABS is an employee of Cryos International.” Please confirm that this does not alter your adherence to all PLOS ONE policies on sharing data and materials, by including the following statement: "This does not alter our adherence to PLOS ONE policies on sharing data and materials.” (as detailed online in our guide for authors http://journals.plos.org/plosone/s/competing-interests). If there are restrictions on sharing of data and/or materials, please state these. Please note that we cannot proceed with consideration of your article until this information has been declared. Please include your updated Competing Interests statement in your cover letter; we will change the online submission form on your behalf. - Updated Competing Interests statement: SL, SB, MDT and IV declare no conflict of interest. AP, GP and SWA are members of the Cryos External Scientific Advisory Committee. GP has received honorarium for this. ABS is an employee of Cryos International. This does not alter our adherence to PLOS ONE policies on sharing data and materials. Due to anonymity issues, data material can only be made available upon reasonable request to the first author. 4. We note that you have stated that you will provide repository information for your data at acceptance. Should your manuscript be accepted for publication, we will hold it until you provide the relevant accession numbers or DOIs necessary to access your data. If you wish to make changes to your Data Availability statement, please describe these changes in your cover letter and we will update your Data Availability statement to reflect the information you provide. - Updated Data Availability Statement: For this study, participants only consented to external data sharing in anonymized form. Since full transcripts cannot be fully anonymized due to the highly individual context, the transcripts can only be made available upon reasonable request and special conditions may apply. Any requests concerning data access can be directed to stina.lou@rm.dk Reviewer #1 1. Very interesting and important longterm follow up of sperm donors. The manuscript is well written and I have only a few concerns. - Thank you for this positive feedback! 2. My first concern is about how the donors who were possible to interview were selected (39 donors)? Please develop that part ie how many in total were available >10 years, if not all there is a need for mor information regarding the criteria for being recruited. - Good point. We have added more information on the recruitment process, L121-28 3. My second concern is about the semi structured questions. How were they used? Were all these questions asked to all of the participants? - The same guide was used for all interviews, but the extent of probing to different topics varied between respondents. We have added this information to the manuscript, L140-41 4. It would improve the understanding if you describe a little more (few examples) how your process of doing reflexive thematic analysis was performed/developed regarding from the main text from the interviews? - Yes, transparency is important! We have now revised the section and added more examples to our process of doing reflective thematic analysis, L154-67 The analysis was based on interviews 9-47 minutes (mean 24). 9 minutes are very short to get substance for an analysis. We completely agree. And that was also an argument for continuing recruitment until we had a relatively large sample to ensure sufficient substance in the analysis. For some of these men, having been a donor was completely unproblematic and not something they were used to articulating (which is an interesting finding in itself). Therefore, with a few men, the interviews were short, because they mainly provided one-syllable answers and/or did not respond to/recognize some of the topics and potential problems, that we asked about. Luckily most interviews were longer and with more substance. 5. You base your results on 21 anonymous and separate 2 non-anonymous donors answers. Why did you include only 2 non-anonymous, or why did you include these two at all? The main message may be more clear if focus and discussion only were about anonymous donors. As you write (and participants answers show) the non-anonymous donors think differently. - Reviewer 1 touches an important point that we have also discussed in the research team several times. However, we decided to 'keep' the non-anonymous donors, because they provide an interesting juxtaposition to our main findings. 5. Interesting discussion that add insight about donors long-term perspectives. - Thank you! Reviewer #2 1. The abstract should be improved, as it is not particularly appealing to the potential reader. I also emphasize the need to correct the second sentence of its "methods" section and improve the conclusions; - Sorry about that second sentence! We have thoroughly revised the abstract to make it more appealing, L34-71. 2. Although in Denmark this type of study does not require the statement of an Ethics Committee, this statement is required by PLOS One "if the study involved human participants", so the authors, if they intended to submit their study to this journal, should have read the submission rules and prepare theirr project accordingly. The decision of whether or not to accept the publication without fulfilling this requirement will, of course, be at the discretion of the Editor; - We have uploaded an ethics statement with the submission. Also, we have revised the ethics statement to clarify that the project has been presented to the ethics committee, L173-75 3. Despite being a qualitative study, I believe that the designation in the results, repeatedly, of terms such as "many", "for the majority", "a few", "several" and "most" should be replaced by the number of participants that we are actually mentioning in each case. - There are very divergent attitudes towards the use of numbers in qualitative research. We believe that numerical values can be misleading in qualitative research, particularly if they are read as 'evidence' for a particular finding. A qualitative analysis should describe a pattern or an overall theme. Within this analysis, data points that appear less frequently may also have great value, for example to shed light on varied points of view. We hope that reviewer #2 can accept this explanation for why we have chosen not to add specific numbers to the manuscript https://doi.org/10.1371/journal.pone.0281022.r002
13 Jan 2023 Decision Letter - Sónia Brito-Costa, Editor Experiences and attitudes of Danish men who were sperm donors more than 10 years ago; a qualitative interview study PONE-D-22-21878R1 Dear Dr. Lou, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Sónia Brito-Costa, Ph.D. Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0281022.r003
Formally Accepted
19 Jan 2023 Acceptance Letter - Sónia Brito-Costa, Editor PONE-D-22-21878R1 Experiences and attitudes of Danish men who were sperm donors more than 10 years ago; a qualitative interview study Dear Dr. Lou: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Sónia Brito-Costa Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0281022.r004

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