fertilityby Jana M. Rupnow, LPC (2010)

According to the CDC’s report on ART success rates, just over 1% of all infants born in the United States every year are conceived using assisted reproductive technology, ART.  A portion of that 1% is conceived via third-party reproduction which involves using another person’s sperm, ovum (egg), or uterus (surrogacy) to conceive a child.  For various medical reasons, some infertile couples cannot use their own sperm or egg to conceive.   An emerging option for these couples is using embryo donation.  Couples with unused frozen embryos (cryopreservation) are choosing to donate them to infertile couples rather than destroy them.  The donated embryo is implanted in a woman who is genetically unrelated to the embryo.  As third-party reproduction methods advance, and the number of families with partially biological or non-biological children will increase. Families facing these choices have legitimate questions about the social and psychological impact on their future child.

The ethical controversy of embryo donation surfaced in Canada in April 2010, when The Globe and Mail printed a front page article announcing the opening of the first embryo donation service company in the country.  This was not good news for everyone.  Members of the International Donor Offspring Alliance (IDOA) offer their less-then-favorable opinion of the announcement in a UCalgary Medicine blog.   These adults conceived through donation technology  point out that we may not be fully considering the unborn child’s well-being.  Their mission statement asserts that individuals have the right to know about their genetic history and that the state has “a duty not collude in deceiving or depriving individuals of such information.”  While reproductive social policy lags far behind medical advances, some groups are taking the initiative to promote awareness on the issue.   Adoption agencies experienced with the legal, ethical, social and psychological needs of a non-genetic family are at the forefront of the cause.  Although, adoption law has been in place for over 100 years it is not currently applied to embryo or gamete donation.   For example, adoption policy requires that biological or genetic parent information be preserved in state records for the child to access at a later date.  This is not the case with gamete donation. Few state laws for embryo donation have been established.   In addition to lacking policy, there are limited psychological resources for  parents considering donation reproduction methods.  For example, take the issue of disclosure; whether parents should tell their offspring about his genetic origins.  Even though the child is not “given up” at birth, he is “given up” at conception and carried in-utero by a woman with no genetic relation.  This makes it tempting to avoid disclosure to the child.   Will this lead to the same problems created 50 years ago with closed, secret adoptions?  Even if parents do disclose, children are likely to face some of the same social challenges that adopted children face.  Which lead to the question, why are genetic links important in our society?

Psychological genetic connections are linked to the basic instinct of survival. Infants need adults to survive and parents have strong protective instincts of their offspring.  Part of our parenting programming is to care for our young because they are “part” of our DNA and therefore an extension of ourselves; our molecular immortality.  We no longer require such strong allies to survive but genetic bonds are deeply weaved into our instincts and therefore our society scripts.  We can manipulate the reproductive process but we can’t change our psychological genetic coding…yet.   Imagine if during the IVF process, we could insert a DNA strand that overrides the “need” for a genetic connection. But seriously, its our society scripts by way of story-telling that cause the most challenges for families. Pay attention to conversations that revolve around genetics, like, “Your son has your eyes, or she dances like her mom.” We are a genetically obsessed culture so modern families are having to pave the way to create new scripts.

What happens when the offspring we parent are not genetically related to us? For answers, you can turn to the adoption community.  The answer you will probably get is simple: Love.  Love happens in spite of DNA differences This is not to disregard the challenges families may encounter.  Many couples considering donation are concerned about the social impact it will have on their family.  Disclosure is the most common concern.  Should they tell their relatives and friends?   How and when should they tell their child about his origins?  How might their child feel about their choice?   Questions go beyond disclosure and parents should be informed of how to address psycho-social issues that may arise.  Attachment and identity formation are hot topics in the adoption world.  Do genetic differences impact the attachment process between a parent and child or the identity formation of the child?  In some cases, it could. Most professionals in the field of psychology know the impact of poor attachment on the human psyche.  Our job as fertility mental professionals is to educate families about the psychological and social aspects of raising a child that is not genetically related to us.  If genetic differences and social issues are handled correctly, I believe the importance of a DNA connection can become a non-issue in most families.  What makes these modern families work is love and awareness.  Let’s call it educated love.

Jana is a professional fertility counselor, ASRM member and adoption expert in Dallas. Janarupnow.com for more.

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