RESEARCH SHOW PARENTS SHOULD TELL KIDS ABOUT DONORS

"NEW YORK (Reuters Health) - Parents of children conceived with donor eggs or sperm don't regret disclosing this fact to their child, and almost all of the parents surveyed believed it was important that the child be told, California researchers report.

But parents do wish they had more support with the process, Dr. Robert D. Nachtigall of the University of California, San Francisco and colleagues found. "If there is indeed a shift toward greater openness in parents using third-party reproduction techniques, there will be an increasing need for support services to assist parents in this process not only initially, but also continuing long after the children are born," Nachtigall and his team write in the journal Fertility and Sterility.

The researchers interviewed 141 couples, 62 of whom had conceived using donor sperm and 79 of whom had used donor eggs. Twenty percent of couples who used donor insemination had disclosed this fact to their children, 45 percent planned to disclose, 16 percent didn't plan to disclose, and 7 percent were undecided.

Among those who conceived with donor eggs, 23 percent had disclosed this to their child, 58 percent planned to do so, 10 percent didn't plan to disclose, and 9 percent had not decided.

Overall, 32 percent of parents using donor egg or sperm had disclosed to their children, while 45 percent planned to do so.

Parents who disclosed or planned to do so typically subscribed to one of two strategies for revealing this information, Nachtigall and his colleagues found: the "seed-planting strategy," in which they began talking to the child about being conceived with donor egg or sperm very early on, and the "right-time" approach, in which they waited until they felt the child would fully understand the process.

On average, "seed planters" started talking to their children about their conception when they were 3 to 4 years old. The "right time" group had planned to begin the discussion with their children when they were 10 to 12 years old, but typically told their children when they were 6 or 7.

Parents using the "seed-planting" strategy tended to be more at ease with their decision and less apprehensive, the researchers found. They believed this approach would give children the sense of "always knowing" that they were conceived with donor egg or sperm, making it "no big deal."

Parents using the "right-time" approach typically felt they could build a strong relationship with their children before having to disclose the information, when the child would be mature enough to handle and understand it.

"Most parents expressed frustration with the perceived lack of comfortable language and 'scripts' available to discuss donor conception with their children, especially as they struggled to find unambiguous terminology with which to refer to the donor," the researchers note.

Nevertheless, among parents who had disclosed to their children, none reported regret and many reported relief, the researchers found. Responses from children were, in most cases, positive or neutral.

SOURCE: Fertility and Sterility, March 2007."

SHARING IS CARING

It looked like Erin and Jenny were getting close to having their first embryo transfer. We had to decide how open to be with them. They were coming to our area and wanted to meet us and the kids. We wanted to meet them too. There is just so much secrecy about donating the raw materials to help other people have kids. Our donor is anonymous. He was willing to provide an adult photo to the sperm bank but when he got married his wife nixed that idea and made him stop donating.

In the United Kingdom and Northern Europe advocates for people conceived through donor sperm were able to get legislation passed that guaranteed adults the right to know the identity of their donor. Not to contact him or call him "Daddy", just to know who he was. No more wondering if they carried the genes of the King of Sweden or Elvis or that homeless dude they just passed on the street.

What was the result of this new openness? A flurry of news articles bemoaning the sudden sperm drought throughout Britain. In parts of Scotland there is just one guy willing to be an open donor. He is now donating for entire swaths of that country. I read on another blog that one couple almost had to cancel their cycle ON THE DAY OF THE EGG RETRIEVAL because no sperm could be found (they scrounged some up from another clinic).

Why does everyone need to be so secretive? Who knows. What I do know is I was able to pick and choose from hundreds of detailed profiles to find the best donor for us. If the price of that is not finding out who helped us have our kids so be it. Anyway, chances are we will find out, just as soon as our son decides to submit his DNA sample to one of those genealogy databases. A teenager just found his donor that way.

Did we want to maintain our family's anonymity? As Jenny and Erin planned their trip to the clinic we had a decision to make.

GETTING TO KNOW YOU

An interesting couple had contacted me about the embryos. Their positive attitude about open embryo donation intrigued me. I was really hoping for a Jewish family for these embryos, so I asked them lots of hard, personal questions right off the bat. It was only our third email exchange and already I was writing to them about their jobs and whether or not their doctor thought they could get pregnant. In a way, I was looking for an excuse to turn them down so I could keep looking for a family whose culture matched my own.

As requested, they sent me pictures of themselves. What I saw was a well-matched, happy young couple. The dark-haired woman looked like me around the eyes and in her general facial structure. She could easily be taken for one of my relatives. Her partner did not resemble me or my children at all.

From their body language they appeared to be very much in love. They looked right for each other and they seemed to be sweet, decent people.

Here is what they said:

The doctor explained that if we were a heterosexual couple it would be possible for Erin to get pregnant, it just might take years. Since we do not have the luxury of free sperm, it would be very time consuming and financially draining. She is a perfect candidate for embryo donation.

For myself: with PCOS, it could be possible for me to get pregnant but miscarriage is highly possible and this process could also take a lot of time and money.

Financially, it was going to be 24,000$ minimum for us to use my
eggs and with PCOS we were not even sure it was going to be possible. With embryo donation it will cost around 6-8000$ and we would like to have more than one child. We just decided that financially, time wise (we have both missed a lot of work for appointments etc ) and emotionally this was our best option. This child will not have a biological link to either of us, but we will raise it TOGETHER and it will be ours...When we were going through all our options, that’s exactly what I said, “I don’t have to have to have [our own] biological child, what is important to me is that we have a healthy baby and we raise it together”.

That’s when our decision was made. Our doctor told us here the embryo donation is anonymous and we would more than likely get singletons. We would implant two different embryos from two different donors. We would be put on a list and there was not a timetable given. Our preference would be to have biological siblings or have the ability for our children to make contact with biological family.

With regard to the sperm donor being an anonymous donor, we would love to have some information regarding medical and personal information that the sperm bank typically provides. The important aspect for us is that the child(ren) have the opportunity to contact other members of their biological family. We think it is important for them to understand where they came from, and although we are not Jewish, we are happy to discuss and share their heritage with them.

Drat! They didn't mind the anonymous sperm donor. He may never agree to meet children he helped create but he does have a lengthy family health history and a great essay to share with children conceived with his DNA. I was growing more interested in these women and they were not being very considerate about giving me a better reason to reject them than their lack of Jewish blood.

In fact, the email these women had sent really moved me. They were disappointed by the fact that their family would not be created the way they originally thought. Still, it was obviously more important to them to have a baby to love than to chase that dream of a bio-kid into financial and emotional bankruptcy. They sounded practical, loving and well-grounded.

I was concerned that their jobs might be too type-A to ensure they had enough time for their children, or too type-B to provide properly for the three kids they want. Previously, a potential recipient had opened an email asking for my embryos by lauding her "wonderful nanny" who was raising her first child while she persued a professional career. My first thought was "perhaps the nanny should be writing to me instead" since she was the one who would be raising a child from my embryos.

But these new candidates even had the perfect jobs. Jenny was a Physical Therapist in the schools. She worked in a helping profession because she cared about kids. It also meant she was pre-screened by the state licensing board as safe to be around children with no legal convictions against her, etc. Her job was, co-incidentally, very similar to mine. Erin was an interior designer, working professionally in a field my wife loves to dabble in for fun.

I was starting to think of these women as viable candidates for the embryos. But they still were not Jewish. They were willing to tell kids from these embryos about their genetic heritage, but how can someone raise a child to know a culture s/he is not familiar with?

How serious were these women about having a kid, and from these embryos in particular? The first time I was asked for the embryos I said yes because I didn't know how to properly screen candidates. That couple used an awful fertility clinic that hated lesbians and single heterosexuals so much their doctor was only allowed to use their labs as a guest. Yet they refused to use the clinic where my embryos are stored, even though it welcomes all women and has the best frozen embryo transfer rates in the US. My clinic is so good at what they do, and so inexpensive due to efficiencies of scale, that most of their patients are from out of town.

My ideal recipients would happily agree to use the clinic where the embryos are stored. Serious candidates would want to maximize their chances of having a baby by using the best possible clinic and avoiding shipping the delicate embryos.

In the case of the women I was now considering, their clinic would charge them $6000 to $8000 per embryo transfer. My clinic, with far better success rates, charges $2500. Jenny and Erin could transfer the embryos in three separate cycles at my clinic for the cost of one less successful attempt at their local clinic. Would they agree to do their transfers at my clinic? It meant flying one round trip and staying in a hotel at least two nights. Their answer would tell me how commited they were to a positive outcome.