Gamete Donation: Deciding Whether to Tell or Not

Gamete donation offers patients the opportunity to have a child when one partner is unable to provide their genetic material for conception, whether it be sperm or an egg. It allows patients to use donated sperm or eggs from a donor and have children while preserving the genetic link to one of the partners. It also permits the patients to experience the pregnancy and birthing event.

One of the most difficult challenges parents face is whether to tell their children about the donation or not. The discussion regarding disclosure has its roots in the adoption world whereby the conventional wisdom has changed over time. Early advice given to want to be parents was to never disclose the child's reproductive origins. Over time this philosophical perspective has drastically shifted from a never tell stance to a must tell one.  It is no longer considered detrimental to a child's well-being to know about their genetic make-up. In fact, the conventional wisdom now purports that it is of benefit to be open with your children about their particular family building story.

The American Society for Reproductive Medicine (2013) states, “while ultimately the choice of the recipient parent, disclosure to donor conceived persons of the use of donor gametes or embryos in their conception is strongly encouraged".

The decision to disclose or not should be thoughtfully considered by all intended parents so that a ‘right’ decision can be made that will be in the child's best interest despite the often touted fears and concerns that often surface regarding this very sensitive issue. It is important to understand the ramifications of both telling and not telling now and into the future. Cultural and religious values must also be brought into the equation in deciding what to do and how to best do it.

KEY CONSIDERATIONS:

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1. • Who does the information about the use of gamete donation belong to… the parents
   

    or the child?                                     

• When is the ‘right’ time to disclose about one's genetic origins?

1. •Laws regarding reproductive rights are in constant flux and files regarding gamete donors
   

    may be opened at any time.  

• Secrets are difficult to keep and information can be inadvertently shared.

1. •Making peace with your personal feelings about donation must be addressed before
   

    sharing this information with your child.

1. •Working with a professional who is well versed in reproductive medicine can make a world
   

    of difference in how you handle and share the information.

BENEFITS OF DISCLOSURE:

•Builds trust among family members.

•Allow families to live in truth.

•Fosters honesty between parents and children.

•Avoids unhealthy alliances between those in the know and those not.

•Eliminates the threat of betrayal and deception.

•It is the right of the child to know about their genetics.

•Encourages children to question and gain understanding.

•Avoids worry concerning an inadvertent revelation.

•Give parents the opportunity to control the “telling story”.

•No need for emergency disclosure due to a medical emergent issue.

PERCEIVED BENEFITS FOR NON-DISCLOSURE:

•Protection from assumed shame.

•Avoids children being ostracized.

•Respects parental rights to privacy.

•Avoids perceived social stigma.

•Gives the appearance of normalcy.

•Minimizes anticipated confusion and rejection.

•Preserves the concept of normalcy among family members.

•Supports belief that donation is a lesser form of family building.

•Supposedly avoids confusion and frustration regarding identity.

WHEN AND HOW TO TELL:

There is information available on how and when to tell children about their unique beginnings, as well as many children's books written for children on the subject. Telling is not a one time event but is an ongoing discussion that will evolve and change as the needs and interests of the children surface. A child's emotional and psychological development will determine what to tell and when to tell at various stages of development.

TIPS FOR TELLING:

•The earlier the better.

•The truth in a loving context.

•Allow the child to have his or her own feelings on the matter.

•Leave room for further questions as they emerge.

•Do not ask them to keep the information secret.

•The implication of a secret means something is wrong.

•Children need information in understanding their genetic identity.

•Bonds develop through relationships not genetics.

•Late telling breaks the bonds of trust between parent and child.

Whether parents decide to ultimately tell or not should be based on sound reasoning and a thorough understanding and exploration of all the relevant issues and concerns. It remains important to make a decision after careful thought on what is in the best interest of your child and not on imagined fears and threats. It is crucial to understand that every parent struggling to build a family has their own feelings and concerns about pursuing gamete donation. This needs to be addressed before disclosure. Assess your ability to tackle any unforeseen outcome of your decision whether to disclose or not with dignity, determination, and integrity. This will be your greatest legacy to your children born through gamete donation.