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Gamete Donation: Findings on Disclosure and Anonymous Donation

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By Madeline Licker Feingold, Ph.D., AFA Mental Health Advisory Council

a familyMental health professionals often are in the position of helping people build families with the help of egg or sperm donors. At times we see people who have been trying to get pregnant on their own, sometimes for years, and are devastated that they have not been able to conceive a child. We also see same sex couples or single parents who seek gamete donation as their first choice method for family building.

When couples or individuals walk through our doors, we may encourage them to envision their future family in our consultation rooms. Therefore, one goal when meeting with intended parents is to provide them with information about donor conceived families so that they can make informed decisions about how to proceed with gamete donation.

Once the “future children” are brought into the room, questions are at the forefront of intended parents’ minds. Should they tell their children about the donor? When should they tell? What will their children want to know? Fortunately, clinical and empirical data exist about the effects of disclosure of donor origins and donor anonymity and this information may serve as a foundation for raising healthy children and building strong donor conceived families.

What Do We Know About Disclosing Donor Origins?

Infertility produces a life crisis and often leaves people feeling stressed and stigmatized. In hopes of protecting themselves and their children from stigma, couples may choose to keep their infertility, and all associated with it, a secret. Additionally, parents may decide not to inform their children about donor origins because they fear their children may view the donor as the “real” parent. Parents may believe that disclosure of donor origins has potential negative consequences and that non-disclosure is neutral. In actuality, both disclosure and non-disclosure have ramifications on families. 

Research suggests that non-disclosure is related to psychological upset. In several studies, parents reported that keeping donor insemination a secret from their offspring created psychological discomfort (Daniels et al, 2009, 2011). Other studies revealed that parents who did not disclose donor origins had higher levels of distress than their disclosing counterparts (Murray, et al, 2006; Nachtigall et al, 1997; Salter-Ling et al, 2001).

Studies also reveal that the issue of disclosure and non-disclosure seems to impact family functioning. Non-disclosure may negatively affect communication between spouses and other family members and it may also negatively affect a couple’s relationship (Hargreaves and Daniels, 2007; Lalos et al, 2007). Conversely, research indicates that disclosure is beneficial for families. In disclosing families children reported less tension in their relationship with their parents, mothers reported less frequent and less severe arguments with their children and couples reported more positive family relationships (Lycett et al, 2004, 2005). Furthermore, it is important to note that non-disclosure does not guarantee secrecy. Many parents, who have not told their children about their donor origins, have told other people. This situation leaves open the likelihood that donor offspring will discover their donor origins from people other than their parents, a highly undesirable possibility.

What Do We Know About When to Tell Children about their Origins?

Research suggests that telling children about their donor origins at an early age has benefits for both the offspring and their parents. Parents who disclosed early appeared more at ease with the disclosing process, felt relief after telling and reported that early disclosure gave them the opportunity to gradually introduce the topic. Additionally, children who were told at a young age processed the information in a factual and non-emotional way (MacDougall et al, 2007; Lycett et al, 2005; Rumball and Adair, 1999). Furthermore, when children were told early, they did not respond to disclosure negatively and did not reject their parents (Bake, et al, 2010; Scheib and Ruby, 2006).

In contrast to the benefits of early disclosure, postponing sharing information about donor origins may have negative consequences. Studies reveal that those who learned about donor insemination later in life experienced confusion regarding their identity, more negative feelings about their donor conception and feelings of deceit and mistrust (Beeson et al, 2011; Daniels and Meadow, 2006; Daniels and Thorn, 2001; Jadva et al, 2009; Turner and Coyle, 2000).

What Do We Know about Donor Anonymity versus Open Identity?

It is commonsense that disclosing donor origins to donor conceived offspring will lead them to have questions about the donor, and research supports that information about donors is important to donor offspring. Several studies indicate that donor conceived offspring want to know about their donor origins, request information about the donor and feel a sense of loss and questions about their identity when knowledge is lacking. Furthermore, there was a disparity between the small amounts of information the offspring possessed about the donor in comparison to the extensive amount of information they desired (Benward et al, 2009; Cushing, 2010; Mahlstedt et al, 2009; Turner and Coyle, 2000).

Importantly, studies also indicate that an offspring’s curiosity about the donor was independent of the parent-child relationship, meaning that children can have positive relationships with their parents and also be curious about their donor origins (Beeson et al, 2011; Mahlstedt et al, 2009; Scheib et al, 2003; Vanfraussen et al, 2003). In fact, one study demonstrated that many donor conceived offspring felt that contact with the donor would help them learn more about themselves, but that very few desired a father/child relationship (Scheib et al, 2003). From the parents’ perspective, almost no parents regretted their decision to use an open-identity donor (Scheib et al, 2003).

When first meeting people at the beginning of their fertility treatments involving donors, helping them have their future family in mind and providing information about donor conceived offspring and families is useful. People find this focused consultation helpful in easing their fears and helping them make decisions, based on their beliefs and values, which will impact their future family. Therefore, prior to commencing with medical interventions, intended parents significantly may benefit from discussing empirical and clinical data about the effects of disclosure of donor origins and donor anonymity with a mental health professional that specializes in third party reproduction so that they can make informed decisions about how to proceed with gamete donation.

Bibliography available upon request. 

Madeline Licker Feingold, Ph.D. is a psychologist in private practice in Oakland and Walnut Creek, California. She has over 25 years of experience treating adolescents, adults and couples and specializes in infertility counseling and alternative family building practices using donors and surrogates. Dr. Feingold is past chair of the Mental Health Professional Group of the American Society for Reproductive Medicine and currently serves as a member of the Mental Health Advisory Council for the American Fertility Association. She is Director of Psychological Services at the Alta Bates In Vitro Fertilization Program and is the Past President of the Alameda County Psychological Association. You can contact Dr. Feingold at (510) 540-8715 or and find information on her website, www.madelinefeingoldphd.com

 

 

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Sara Rector Apr 1, 2013 11:03am

Informative article backed up by research Thank you for another resource to use in my work with my clients considering ovum and sperm donation