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Counselling prospective parents

Diana Baranowski
Making babies in the 21st century
UCL
CRGH
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When a couple come to see us or an individual, and ask us about using donor eggs or donor sperm one of the key questions that will come up is do we tell the child how they’ve been conceived? And do we bring up the issue of donor eggs and donor sperm in that conception? We tend to actually get-, ask the patient questions to get them to answer their own question and just really put the seed of thought in there. So, we would ask them questions that would be along the lines of do you have secrets in your family?
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We explain about the HFEA, change in laws about children conceived through donor conception being able to pursue and find out who their donor is and why those laws were changed for the interest of the child and that it is not to the benefit of the donor or the parents. We talk about the research that went into that change in the law about how those children that had been conceived through donor conception wanted to know who their donors were. They didn’t necessarily want to contact that person but it is a human instinct to find out why am I here? Where did I come from? Why do I do the things I do?
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Is it just chance or is there a connection there? And certainly with the way the donors now can write their pen letters to the children, they can give information about themselves, and a lot of those that were conceived through donor conception actually said that was enough information. They didn’t necessarily have to go on and find out. There is then also the opportunity to find out about siblings through the donor conception. So if somebody has been an only child or a smaller family or even just curious to find out, are there people out there like me? That information is there and that opportunity is there.
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So when there wasn’t that opportunity, when donors were totally anonymous and just a number, the children conceived through that treatment really struggled emotionally, about their identity. And this is to give them that option. Patients will often ask, how do we tell? When do we tell? And we know from the, the evidence again and the research is that those children that are most well adjusted are those that reply I’ve always known. And we know that the worse case scenarios are for those children that found out by accident. Usually in their teenage years or later. And then like we say the issue of secrets, what else haven’t I been told? It could be hidden about me.
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Am I who I thought I am? And their identity becomes under question. Their family becomes under question. There is trust issues and family units can certainly break down.

What advice do prospective parents receive when using donated gametes in the UK? Diana Baranowski oversees the counselling of prospective donor recipients at a large London fertility clinic. Here, she explains the advice and support that they provide.

Diana highlights the positive change that has come about after the removal of anonymity in the UK, and the fact that children now have access to identifiable information about their donor.

Diana also makes reference to research, some of which we will cover in our learning for this week, which suggests that children who are told early about their donor-conceived status seem have the best outcomes.

However, decisions about disclosure are personal by their very nature, and many parents are worried about what it will mean for their relationship with their child.

That is why a sensitive discussion is needed at the outset, and why support in decision-making is vital to help donor-recipients to make the best choices for them.

For your discussion: What do you think are the main challenges to telling a child that they are donor-conceived? Many people say it is the right of a child to know their biological heritage. How would you argue for that principle if you were in conversation with someone opposed to it?

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Making Babies in the 21st Century

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