Judith Kottick, LCSW
Montclair, New Jersey
For many couples and individuals yearning for a child, it is unwelcome news to hear that the time has come to transition from the dream of parenting a child of your genes to an alternative family building method. While accepting the concept of non-genetic parenting may be a challenge, it can also represent new hope and greatly improved odds for success. The question is, when confronted with the choice to continue medical treatment through gamete donation or move to adoption, what are the issues to consider? Making an informed decision and having realistic expectations will only enhance the process and in the end, even improve the parent-child bonding experience. The following are questions and issues to consider.
Can my body endure more medical treatment?
For some women, this is the clincher. You no longer feel comfortable in your own skin because of the effects of the hormones and you’re fed up with the pressure of waiting for your body to do something you can’t control. Your sex life has suffered and the thought of more invasive medical procedures fills you with dread rather than hope and optimism. Whether the infertility issue is due to female or male factors, the bulk of the treatment procedures fall on the female partner. At this crossroads it can be a huge relief to step off the fertility treatment bandwagon and embrace the adoption option that no longer requires your body for success.
Can I deal with odds that are still not 100%?
Although gamete donation, either egg or sperm, will undoubtedly increase your odds significantly, the end result, ultimately, still lies in the hands of Mother Nature, albeit with the help of competent professionals. On the other hand, under the guidance of knowledgeable experts, adoption can be counted on to guarantee success almost all the time, as long as you’re willing to take the risk of experiencing some disappointments and false starts along the way. Some parents-to-be balk at the idea of “gambling” away more money in fertility treatment and find the finances of adoption less of a risk.
How important is the pregnancy?
For some women, yearning for the pregnancy and delivery experience equals the wish to parent. While letting go of the genetic connection is sad, the idea of giving up the pregnancy feels intolerable. Likewise, there are plenty of partner/parents-to-be who relish the idea of sharing in the pregnancy with their partner and witnessing the miracle of birth. In these cases, egg and sperm donation, if successful, can lessen the blow of infertility and provide donor recipients with the opportunity to control the prenatal environment. Many parents of donor children express a great sense of fulfillment in having the opportunity to nurture their child in utero, experience the delivery, care for a newborn and breast feed.
I want as much control as possible over the genes of my child.
Every parent, genetic or not, sooner or later has to come to terms with the fact that each child is an individual and does not perfectly embody all the traits, whether physical, emotional, intellectual, or personality-wise that we hoped or imagined we would see in our offspring. The degree to which nature vs. nurture is expressed in any given child remains a mystery and may differ in every person. Naturally, any control we think we have over the genetic expressions in our children is an illusion. That said, however, we can’t take away the power of the genetic influence, and some people find it reassuring to know that fifty percent of their child’s genetic contribution will be a known quantity. This is the reason some people give for embracing the donor option.
Art there differences in the disclosure issues between adoption and gamete donation?
There is no longer any controversy about whether or not to tell adopted children their birth story. It is accepted practice to be open and there is a body of research, books and journal articles and plenty of material for children to back up the recommendation. Gamete donation, on the other hand, has been less studied and there is not a great deal of empirical knowledge about the effects of disclosing versus not disclosing. While it is generally the belief of family therapists to avoid harboring secrets in families, and an open policy has recently been endorsed by the American Society for Reproductive Medicine, the disclosure issue is much less clear here. Historically, there has been a sense of secrecy surrounding sperm donation, and only recently, with the advent of egg donation, has the subject been debated and a recommendation formulated.
Some people prefer the clear cut template of adoption, where friends, family and the child are all told the same information without concern for hidden secrets leaking out. Other couples and individuals take comfort in the ability to be private with their family building efforts and appreciate a greater sense of choice regarding whether and when to tell their child. With these choices, however, come more questions. For instance, if you want the option of not telling your child, or telling him/her at a later age, you must stop and think before talking to friends and family members about the donor issue. Once the information is “out there,” you run the risk of your child finding out inadvertently. In addition, with the degree of genetic information being discovered and disseminated these days, there is the very real possibility that our individual genetic coding will be known to us in the future, making it impossible to keep this information from your child. Decisions about whether or not to inform obstetricians and pediatricians are also important, as well as thinking about how to handle your child’s medical history, as being different from your own. In short, parents tend to consider the disclosure issue with gamete donation to be more complicated and difficult for the child to understand in the short term, but less complicated than adoption in the long term.
What about the potential imbalance between the genetic and non-genetic parent in gamete donation?
This potential inequality in parenting is a frequent reason people give for choosing adoption over gamete donation. Some non-genetic parents-to-be fear they will have less “parental clout” than their partner, the genetic parent. You may worry your child will be less attached to you and that you will harbor feelings of being “left out.” The weight of these concerns depends on a variety of factors such as family of origin issues, dynamics of the partners’ relationship, sense of confidence as a potential parent, previous experiences with children and one’s own attachment issues. If these concerns sound familiar, it is important to acknowledge your feelings and let them guide you to making a choice that feels most comfortable.
To summarize, some people seem to know instinctively which family building path to take and they are able to mobilize their resources quickly and move on. For many others, however, it is a difficult choice that requires more self reflection and research. Although most parents-to-be, by this time, are in a hurry and are sick to death of waiting, it is always worthwhile to give yourself the space to make an informed and thoughtful choice. As one adoptive parent recently told me about the process, “once you have that baby in your arms, everything that came before fades away.”