Donor Conception Network - Articles
Counselling around donor conception: Jenny Dunlop “Changing Times”..
Two experienced counsellors Jenny Dunlop and Paul Crowther gave talks to the DC Network meeting in September. This is an edited version of Jenny’s talk.
I have been asked to look at the issues arising from the change in the law making donors identifiable. I will also talk about questions brought to counsellors by people who conceived using donor insemination prior to the the Human Fertilisation and Embryology Act in 1990.
I will look at what effects the change in the law has had and also what hasn’t changed. To begin with it might be useful to look at change in general. I think a useful quote is “The only certainty in life is change” and “we are all responsible for the way we respond to change.” To my mind these phrases are particularly applicable to the change to the Human Fertilisation and Embryology Act and are relevant to both to the Clinics and the people they treat. The word ‘we’ is very important, as I believe we should all have taken responsibility for the effects of the change on how it would affect people requiring donor treatment and also on the recruitment of potential donors.
On 1st April 2005 the practice of using anonymous donors was ended (with the exception of using banked sperm already stored). From 1st April 2006 clinics were only allowed to use donors who were prepared to be identified. There will be non-identifiable information for young people reaching the age of 18 years from 2008 (those conceived between August 1991 and March 31st 2005) and identifiable information from 2023 (for those conceived after April 1st 2005).
The drivers for the change in the law included adults who had discovered they were donor conceived, parents of donor conceived children and social workers and counsellors who had witnessed the trauma of people unable to access half of their genetic identity. There also seemed to be a new lead from the HFEA with emphasis on transparency which perhaps reflected a societal shift to more openness and honesty.
What has been the impact of the change to the law? I can only speak from my own perspective as an NHS and private clinic Counsellor. It was apparent that many senior people within the fertility field did not welcome this change. There was some shock, some denial ‘this isn’t really happening’ and some anger projected towards the Department of Health and the HFEA. This initial response was followed by a grudging and guarded acceptance. On the ground, some Clinics gave up donor insemination and closed their sperm banks; most clinics acknowledged that they were finding it extremely difficult, if not impossible to recruit donors. At the present time I gather there is a slight turn around with clinics being prepared to start or restart sperm banking, and looking at different methods of recruiting different type of donors (i.e. more mature men).
After this upheaval what has not changed? Many key emotional issues around infertility are untouched by the change in the law. The psychological burden of infertility, which brings with it the grief and loss reactions of shock, denial, sadness, anger, and regret. “Why me or us?” is a common response to this loss. People still talk about feeling marginalized and consequently they sometimes isolate themselves to avoid further pain. There is still this feeling that there is a ‘club’ that people belong to if they have children, and you can’t become a member if you are childless. For some there is still a need to protect the partner who has the fertility problem, which means that it can be kept a ‘secret’, which can lead to withdrawal from family and family events. This is relevant for people needing both donor sperm and eggs. There is also the constant worry underlying all treatment about whether it will work or not, and consequently the concern for those who finance their own treatment about the mounting costs. For others there can be a desire to use a partner’s genes with the consequent rise in the use of ICSI, rather than using donated sperm. And lastly there is nearly always the worry about how to tell the donor conceived offspring about their conception and the effects that this will have on the child. There is concern about the parents’ relationship with the donor conceived child, and the fear that the parent with the ‘problem’ will be rejected by that child if s/he knows the truth.
As a counsellor these are some of the issues that have not changed, and I would like to put on record how valuable I have found the DC Network material as an aid in helping couples make their choices about what to do and how to tackle some of these issues.
But the new law has brought about some changes. I feel that there has been a positive acceptance from many people that it will benefit donor conceived children/young adults to be brought up with the knowledge that at 18 they can have the choice whether they identify their donor or not. This change has been crystallised in the new law, but has been growing generally as infertility issues and treatment became more talked about and therefore more open. In an email survey of infertility counsellors concerning whether prospective parents intentions had changed due to the removal of donor anonymity (Crawshaw 2007) preliminary findings found that 75% of counsellors said that there had been a change towards telling and openness and not to non-disclosure. It is becoming apparent that the change in legislation has led to some clarification for intending parents that it is in the interest of the child/children as much as it is in the interest of the parent/parents to know their identity.
On the not so positive side is that fact that the change has brought about an initial decline in sperm donors coming forward. (There has always been and still is a shortage of egg donors.) However this seems to have been remedied by a few clinics increasing their advertising and being more imaginative in recruiting donors. From the survey of infertility counsellors also came the concern from a few counsellors that because of some intending-parents age, the worry about waiting was too great so they specifically decided to get treatment abroad. For other people who have strong feelings about the loss of anonymous donors in the UK this has also meant that they have decided to go abroad as they do not want to disclose that they have used donors.
For many counsellors people going abroad for treatment are a source of concern as little or no information is available about foreign donors. Counsellors know that some intending parents are fearful that when donor conceived children identify their donors the donor parents maybe rejected. Parents need to be assured that such rejection is very unlikely to happen.
That said, all parents however they make their family, have to be prepared for a ‘natural amount of rejection’ in adolescence!
All counsellors have some clients who have no intention of disclosing the fact that their child is donor conceived. We are aware that there may be cultural and religious issues that cause immense problems for some intending parents.
Another issue that may arise from the change in the law is that couples that had previously donated embryos to other couples may now reject this option because of the possible link to ‘full siblings’ in their own family.
Finally there is the dilemma for people who have used donor sperm before the law changed and would like another child. If there is no sperm left from the original donor, these parents face the prospect of one child who could identify their donor and one who could not.
Lastly there are issues specific to parents who used donor sperm before the Human Fertility and Embryology Act 1990. Quite often people seek counselling if the child/young person has not been told about how they were conceived. Such a ‘secret’ within the family becomes a time bomb, often creating enormous stress on relationships.
Major life events such as adolescence, relationship breakdown and illness can intensify the pressure to rethink whether to tell the child/young person
As a counsellor I have to remember that prior to 1990 people were often advised by medical staff that they didn’t need to tell the child about how they were conceived, advice which compounded the problems for the parents. I also will acknowledge the high level of loving and caring parenting which is provided despite the ‘secret’ that may be dominating the parents’ lives.
Finally I would recommend Donor Link (an organisation that is trying to help people conceived before the 1990 Act to trace their donors and half siblings).
References
Crawshaw M (2007) Unpublished paper /Prospective parents' intentions regarding disclosure following the removal of donor anonymity
