Openness And Transparency In Donor Conception
At the recent Fertility Show Africa, Dr Mandy Rodriques, resident clinical psychologist at Medfem Fertility Clinic with 25 years of experience in field of infertility, provided an insightful look at the trend towards openness and transparency when it comes to donor conception in her talk entitled “Losing my DNA”.
Donor conception – or conceiving with eggs, sperm or embryos donated by a third party – is a necessary option for increasing numbers of people. These include single parents, parents from the LGBTQ+ community and the growing numbers of couples facing infertility challenges that can only be treated with eggs, sperm or gametes from a donor.
Many people feel a deep sense of loss when they receive the news that they are unable to achieve a pregnancy with their own DNA. Couples may struggle to make the decision to use donor eggs, sperm or gametes, and very few will openly discuss the issue with friends or family. Of course, donor conception is not for everyone. However, despite the emotional struggle and secrecy, most infertile couples do decide to go the donation route, and none regret their decision later. This is because donor conception enables infertile couples to reach their true goal, which is to conceive a child.
At Medfem Fertility Clinic we have counselled thousands of couples through the process of accepting egg, sperm or gamete donation. The process involves, firstly, exploring options before you make any decision, while realising that donation may not be the right option for you. The process further involves acknowledging the enormous grief for the loss of your own DNA, knowing that the intensity of grief becomes less with time.
During the process, especially if it entails the right support, couples come to terms with the reality that they are unable to conceive with their own sperm or eggs, and begin to accept donor conception as a realistic alternative that can allow them to conceive.
To tell or not to tell
One of the most troubling aspects for many couples considering egg, sperm or gamete donations is the misconceptions and stigma around this option, and the weight of the decision whether or not to tell – not just the grandparents, family and friends, but most importantly, the child.
Disclosure of donor conception, or transparency as it is also called, remains quite a controversial topic.
Previously, like infertility itself and the many challenges it presents, the issue of donor conception was shrouded in secrecy, due to a perceived stigma around accepting donor eggs, sperm or gametes. As a result, egg, sperm and gamete donors and recipients did not come forward or seek support, and the issue was not discussed with family or friends.
Over the last 20 to 30 years, however, things have changed with a substantial shift towards disclosure – or ‘openness’ as it is referred to – in Europe, the US and countries such as Australia.
In South Africa, the move towards disclosure or ‘openness’ is also evident, although at a much slower pace. After three decades of great secrecy around donor conception, these days around 75% of the patients at Medfem Fertility Clinic are willing to disclose that they’ve used an egg or sperm donor.
This secrecy is partly driven by the legal environment in South Africa, which is geared towards nondisclosure. By law in South Africa, all egg and sperm donations are anonymous, and the donors’ privacy is protected by law. All records of egg, sperm and gamete donations are kept anonymous, with different codes and names, so that the databases are secure, and the identities of donors are absolutely protected. In addition, in South Africa, the law clearly states that the woman carrying the child is the mother, despite any donation of eggs, sperm or gametes.
This means children conceived with donor eggs, sperm or gametes in South Africa are not able to find out who the donors are at some point in the future. While many donors and recipients value the anonymity, in many parts of the world this is changing.
In many countries, donor registries are becoming more common, driven particularly by donor conceived adults. This move towards openness or disclosure is also being driven by technological advancements such as direct-to-consumer DNA testing. These days it is easy to go overseas, do a DNA swab of your saliva and find out what your DNA is. While in South Africa, we’re not seeing a lot of people doing this yet, it is quite common in Europe, the US and Australia, and it is likely to become more common in South Africa over time.
Another helpful trend in this regard is advanced by the Donor Conception Network, which has been supporting donor conception families for over 25 years. This charity network supports over 2100 mainly UK-based families with children conceived with donated sperm, eggs or embryos, as well as donor conceived people and couples thinking about or undergoing donor conception procedures.
The Donor Conception Network advocates openness versus secrecy, saying that instead of planning and possibly dreading a once-off, dramatic disclosure to a child in future, ‘openness’ can and should be approached as a ‘state of mind’ over time. Instead of keeping a child’s donor conception a big secret to be revealed at some future time, it is never a secret, but a fact that is acknowledged in the family from birth without shame or guilt. You can read more about this on the Donor Conception Network’s website at www.dcnetwork.org.
Obviously, in most families, open and honest relationships are valued. The needs of the child are paramount. Keeping a big secret or not telling a child the truth is not an ideal situation, and may become more difficult a problem later in life.
On the other hand, many parents of donor conceived children believe that not disclosing the details of their children’s conception to family, friends and colleagues is preferable, to protect their children from possible stigma and to protect their rights to decide themselves whether or not they want to reveal this information when they are of age.
What is the right decision for you?
So, what is the right decision when it comes to disclosing donor conception? Fortunately, it is not a decision a couple needs to take upfront when they are still dealing with the loss of their own DNA and accepting the idea of donor conception.
At Medfem Fertility Clinic, we recommend that parents-to-be get comfortable with the donor conception idea and process before they decide about disclosure.
During counselling sessions at Medfem Fertility Clinic, we refer to various books on the topics, discuss the issues and feelings, consider the worst-case scenarios and the likely outcomes, and recommend that couples first accept and get comfortable about their own experience of donor conception before deciding about disclosure, openness and transparency.
If you are considering donor conception, we would like to invite you to meet our team of fertility specialists at Medfem Fertility Clinic.
Our team believes in making world-class fertility treatments available for everyone. It is our joy and commitment to give you a positive outcome to your fertility journey, so you will have a fond memory of feeling empathy, caring and being part of the Medfem Fertility Clinic family.
Simply click here to book an initial consultation or contact us telephonically on +27 (11) 463 2244.
We look forward to meeting you!