Revelation of the donor in assisted procreation

Introduction

The use of donor gametes in medical treatment of infertility It has a long history, starting from the first documented case of seed donation in 1898. In the past, when it was advisable to keep the donation secret, the parents were isolated from social support and by the possibility of talking to other people on the impact of the use of the donation of gametes to create a family.

In recent years, we have witnessed a change in clinical practice with a more open approach and as regards professional recommendations in support of disclosure or revelation of the conception from donorboth as regards the removal of the donor’s anonymity in some countries.

Starting from Sweden in 1985 other countries also issued legislation that allows the conceived by donor to access the identity of the donor, including Switzerland (1992), Austria (2002), Norway (2003), New Zealand (2004), The Netherlands (2004), The United Kingdom (2005), Finland (2007) (Blyth and Frith, 2009).

Many reproduction medicine companies have recommended that disclosure is in the best interest of the conceived by donor and agree that the advice represents an essential element of the preparation of parents before the donation procedures (Blith, 2012).

In 2004 the ethical committee of the American Society of Reproduction Medicine declared the following: “Although ultimately the choice is of the aspiring parents, the revelation to the people conceived by donors is encouraged as regards the use of donor gametes in their conception” (Ethics Committee of the American Society for Reproductive Medicine, 2004).

In this changing legal, social and professional context, an increasing number of parents intends to reveal the conception from donor to their children and resorts to the help of a consultant to take this decision (Indeku, Dierickx, Schotsmans, Daniels, Rober and D’Ooghe, 2013).

Preparation of parents to disclosure

Parents choose to reveal the conception as a donor for a series of reasons, such as the prevention of an involuntary revelation, the personal beliefs about transparency and honesty and the right of children to know their genetic origin. Parents interested in disclosure are looking for information on the best age for revelation but helping parents to discuss with their own children conception as a donor requires a preparation before the real narrative.

The sharing of information represents a very emotional experience in which parents feel a series of uncertainties and concerns. The infertility consultant It can play a decisive role to help parents explore their fears, reduce their anxieties and increase their trust in disclosure.

Before discussing the “When and how” of the disclosure, the consultant must first of all explore what the revelation for the parents means; the way they see themselves as parents in light of the use of donor gametes; As they expect that others, including their son, react (Thorn, 2013). The fear that will never be a real parent can never fail to fail the bond of blood and, ultimately, there is a fear of being rejected by the son, can be created in the non -genetic parent.

The first fundamental intervention of the advice is to help parents a explore and reformulate the meaning of the family which is not only linked to genetic relationships. It is therefore important in the story about the disclosure that the person who provided the gametes is indicated as the donor and not as the other parent or true parent or even worse can we speak to the children of two mothers/dads.

Beyond the importance of language, the other key element of the history of disclosure is the definition of family as based on love relationships and not on genetics.

The second consultancy intervention is that of Educate parents on the nature of the bond. Some parents fear that the use of the donor will create a distance in their relationship with their child. Despite these fears, the research has constantly highlighted the presence of long -lasting links in families with conception by donor.

In particular, with the passage of time, parents are less worried about their relationship with their children, have more confidence in their parental roles and give less importance to genetic differences (Kirkman, 2004; Indeku, D’Ooghe, Daniels, Dierickx and Rober, 2014). In addition, parents see their choice of conception as a donor as a positive choice and children in families with conception by donor have adequate growth because there is a good parental quality (Golombok, Brewaeys, Giavazzi, Guerra, Maccallum and Rust, 2002).

The third intervention is to explore the Psychological meaning of the donor for the family. Parents often fear the child’s interest in the donor, believing that the curiosity of the latter for the donor represents a failure on their part or the refusal of the child. It is important to underline that the curiosity of the child for the donor suggests the opposite. In fact, the questions indicate attachment, security and trust in the relationship with parents and is precisely on the basis of all these feelings that can ask these questions.

When to reveal the nature of conception

Parents who intend to reveal to his son his origins have different opinions on the moment in which to do it, for example “when it is the right time”, when they believe that children can understand, or in early childhood before entry into primary school. Some consider revelation to a small child without meaning, since children do not understand, in this phase of cognitive development, as reproduction takes place. However, the emphasis on the importance of cognitive understanding, addressed as a justification to postpone the revelation, underestimates the relevance of the emotional and relational components of history for both the child and the parents.

Therefore, many parents begin to tell their story when children have 3 to 5 years and discover that early narration has several advantages (rumball and Adair, 1999). The early narrative allows parents to exercise their “narrative” skills and to overcome the first emotional obstacle, leaving them more free to engage in future conversations. Thus the history of the family with conception as a donor becomes a normal part of life, of which the children have always been aware.

Effective narratives share some characteristics including:

• the declaration of the inability to have a child alone;
• the need for help from a donor and/or a doctor;
• the uniqueness of their child;
• the joy of the parents when their child was born;
• The conclusion with “This is the way we became a family”.

In the end, listening to the story of his family, the child will first experience everything proximity of the relationship with his parents and secondly it will develop the facts based on the stage of its development. Most of the couples who arrive at the disclosure reports to be happy to have shared the information and that they have not reported any negative effect on their children or on the relationship with the child (Rumball and Adair, 1999; Blake, Casey, Readings, Jadva and Golombok, 2010).

Some research has found the most positive parent-child relationships in families who revealed the method of conception and it is highlighted that the couples who have made devosures are considered more competent than those who have not made any revelation (Lycett, Daniels, Curson and Golombok, 2005). Some parents choose to wait to speak to their children when they are between 7 and 11 years old in the belief that the story of revelation should be told when children are “big enough to understand”.

In general, disclosure during the school years means that parents deal with the topic of conception everything together and not gradually. Children’s reactions in this age group can vary a lot, but parents often report an initial response of disinterest. It is important to underline that there is no correctly to react to revelation And the same child can show variable levels of interest over time. Both research and parents’ reports suggest that children can think about conception with donation without necessarily discussing it with their parents (Blake, Casey, Jadva and Golombok, 2013). It is important that consultants recommend parents to find opportunities to deal with the topic and explore any question.

Conclusions

The revelation of donor conception is a significant problem for parents who use donors gametes to form a family. Although parents’ trust grows with the support of advice, books, educational materials and support groups, concerns regarding the discussion of conception as a donor resurface during the entire family life cycle.

Parents waiting “until they are large enough to understand” risk postponing revelation if they do not receive support and do not think about revelation as a process. There is therefore an individual/couple counseling that provides the necessary support and the reception space where you can face the fears and specific questions of parental

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