Gamete and Embryo Donation: Deciding Whether to Tell

Gamete donation is giving sperm, eggs, or embryos (fertilized eggs) to another person/couple so that they may have a child. This offers people the opportunity to have child(ren) when their own sperm, eggs, or both are not healthy enough to lead to successful pregnancy. When only sperm or eggs are donated, it allows recipients to have children that will have a genetic link to themselves or a partner. It can also permit recipients to experience the pregnancy and birthing event.

One of the most difficult challenges parents face is whether or not to tell their children about the donation. Conventional wisdom about whether to tell children they were adopted has changed over recent years. Early on, intended parents were advised never to 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 harmful to a child’s well-being to know about their genetic makeup. In fact, most mental health professionals agree that it is better for the child(ren) when parents are open about his/ her/their particular family-building story.

The decision of whether or not to disclose gamete donation to child(ren) 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. It is important to understand the consequences of both telling and not telling, now and in the future. It is also important to understand how the disclosure process may vary depending on whether a person chooses to have a known or anonymous donor. Cultural and religious values may also be considered when deciding what to do and how best to do it.

Key Questions/Points To Consider

• Who does the information about the use of gamete donation belong to: the parents, the child(ren), or both?
• When is the “right” time to tell the child(ren)?
• Laws about reproductive rights are constantly changing; it is possible that files regarding gamete donors may be opened at any time.
• Secrets are difficult to keep and information can be shared by accident.
• Your personal feelings about donation must be addressed before sharing this information with your child(ren).
• Working with a mental health professional who is well-versed in third-party reproduction can make a world of difference in how you handle and share the information.
• The readily availability of DNA testing (i.e., 23 and me) may lead to the discovery of gamete donation. This plays a role in understanding how unintentional discovery may occur

Disclosure Is Good Because It

• Builds trust among family members.
• Allows families to live in truth rather than secrecy.
• Fosters honesty between parents and children.
• Avoids unhealthy alliances between those who know and those who do not.
• Eliminates the threat of betrayal and deception.
• Is the right of the child to know about his/her genetics.
• Allows parents and child to be forthcoming about medical history with health-care practitioners.
• Encourages children to question and gain understanding.
• Avoids worry about the child finding out by accident from those who know, the internet, or DNA tests.
• Gives parents the opportunity to control the “telling story.”
• Avoids the need for emergency disclosure due to a medical emergency.

Reasons parents may decide not to tell can be centered on avoiding negative behaviors by others. Parents may be concerned that their child(ren) will be socially stigmatized, ostracized, or teased. Parents may also be concerned about the child’s reaction to this information and choose not to disclose to avoid anticipated confusion or rejection by the child(ren). Some see nondisclosure as a way to avoid confusion and frustration about identity. Lastly, parents may choose not to disclose because they value their own privacy or “normalcy” within the family. Parents may carry mixed feelings, shame, or sadness about donation and feel that donation is a lesser form of family building. If parents choose not to tell, they should be prepared to discuss the reasons for nondisclosure and what may result should the child(ren) discover his/her/their genetic origins.

When And How To Tell

There is a wealth of information available on how and when to tell children about their beginnings, including children’s books to help tell your story. Telling is not a one-time event but an ongoing discussion that will evolve and change with the needs and interests of the children. 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.
• Tell the truth in a loving context.
• Use age-appropriate language.
• Allow the child(ren) to have his or her own feelings on the matter.
• Leave room for further questions as they come up throughout the child’s life.
• Do not ask them to keep the information secret; the implication of a secret means something is wrong and can create shame.
• Children need information to understand their genetic identity.
• Bonds can develop through relationships and not just genetics.
• Late telling can break the bonds of trust between parent and child(ren).

Whether parents ultimately decide to tell or not should be based on sound reasoning and a thorough understanding and exploration of all the relevant issues and concerns. It is important to make this decision after careful thought on what is in the best interest of your child(ren) rather than imagined fears and threats.

Whichever path is chosen, it is important to respond to any unforeseen outcome of your decision with dignity, determination, and integrity. This will be the greatest legacy to children born through gamete donation. Furthermore, ASRM strongly encourages a consultation with a mental health professional whose expertise is in reproductive medicine.