In our last blog we discussed the three types of egg donation arrangements available to donors and recipients: Unknown (Anonymous), Semi-Known, and Known (Open). These contracts all contain very similar provisions and use consistent language regarding the legal effect of the contract on parental rights, roles, and responsibilities of each party, but each varies dramatically on how and when information is shared between the parties. This week we are going to dive a little deeper into Known Arrangements, and why, in my opinion, they are better for everyone.
Donor Conceived Child’s Perspective
These donation arrangements, if successful, eventually lead us to the ultimate goal of creating a child. But, that donor conceived child is not a party to the donation contract. And often times, what is “best” for the donor conceived child in the future might appear to be inconsistent or contrary to what is desired by the recipients at the present moment. While I appreciate that it is the recipients who get to decide if, or how, they want to become a parent, it would probably do us some good to actually consider what is best for these future donor conceived children at the beginning of all of this, meaning before the contracts are signed and before their conception.
Most people would agree that it is important for any person, whether a child or an adult, to know about their genetic origins. Not only does that help ground a person in the world they live in, but it is vitally important for medical treatments as well. Vast amounts of amazing medical technology exist today that can help diagnose and cure certain ailments that continue to plague humanity. But, if you do not know your genetic origins or medical history, then you and your doctor will be at a significant disadvantage. This is why many European countries have made it a requirement that all genetic donation arrangements be known, and have declared it a human right for donor conceived children to learn their donor’s identity in the future, if they desire. While it is unlikely that we will see similar legislation passed in the United States any time soon, we can help achieve these same goals by moving away from anonymous donation contracts and developing a consensus preference for known arrangements.
In recent surveys of donor conceived individuals, the vast majority of them indicated they would like to have some connection with their genetic donor. This could be both a social/emotional ongoing relationship or just a casual connection whereby they know their genetic origins and have access to their medical history. 76% of those surveyed in 2020 were against using anonymous donations; There is an abundance of insightful information about the lives of these donor conceived children available at We Are Donor Conceived. This data and the conclusions drawn from it should help inform us as we consider what benefits exist, and what harms are mitigated, through known donation arrangements.
Recipients’ Perspective
The reasons for needing an egg donor can be as unique as the recipients themselves. For some people, say a single male or same-sex male couple, an egg donor is an obvious requirement for their family planning objectives. For others, it might be a realization they came to after years of trying to conceive on their own. But whatever the reasons are, there shouldn’t be any shame or disappointment in coming to the conclusion that an egg donor is necessary to build their family. Egg donation provides opportunities for individuals and couples of all types to achieve their goals of having a family of their own. It is much more common today (and much more accepted) to use egg donors to build a family than it was when egg donation was in its infancy.
One of the main reasons recipients pursue “anonymous” arrangements is because of privacy. This is much more common with opposite-sex couples where the woman intends to carry the child herself. Perhaps they don’t want their families or friends to know that they were unable to conceive on their own. They may feel ashamed, or less than, if they share the facts around their child’s conception with anyone, let alone the future child. In order to safeguard their privacy, they might even go to great lengths searching donor profiles for someone that looks a lot like the mother who plans to carry the pregnancy, hoping no one, not even their future child, will suspect they used an egg donor.
For these mothers in particular, there is a very real and palpable fear of the impostor syndrome. This is where the legal mother, the one who raises (and sometime carries) the child, feels like an impostor because her baby is not her genetic child. This can be very difficult for some women to accept and move beyond, just as many elements of infertility (both female and male) can be. For women in that position, please know that there are numerous mental health professionals in our industry out there ready to talk through these challenges and work with you to overcome them.
What we have found from recent surveys of donor conceived individuals is that the vast majority of them do not view their genetic donor as their “real” parent. Instead, the surveys suggest that the vast majority of donor conceived children respect and acknowledge their legal parents as their real parents, but at the same time they have an innate desire to know about who they are and where they came from; that curiosity does not go away with time. That reality will be true if the child finds out they are donor conceived at 5, at 15, or at 50.
When recipients are in a known arrangement, they have the opportunity to get more information about their donor and to develop a personal relationship with them; something much more valuable than could ever be learned or discovered in a 2-page donor profile. In the future, they also have the opportunity to access to information directly from their donor, something that is restricted in anonymous arrangements.
Another benefit we often see with open arrangements is that recipients who use known donors are much more likely to stay in contact with their donor after the donation cycle. This, in turn, leads to the recipients being more open to the idea of sharing the facts of conception with their donor conceived child. Furthermore, the recipients can develop and maintain a friendly relationship with their donor beyond the clinical aspect of needing an egg. This shared experience can facilitate overcoming the fears and anxiety some recipients feel when they have a donor conceived child. Rather than the donor being this unknown maternal competitor lurking out there somewhere, she has the opportunity to be a close family-friend, and someone the recipients know has no desire to become a parental figure to their child.
Donor’s Perspective
This is post is mainly directed towards donors, so I will end with why I think Known Donation arrangement are best for YOU. Being a genetic donor (egg/sperm/embryos) is not like any other donation arrangement we often think of when we hear DONATION. My first thought goes to donating blood, maybe being an organ donor, or perhaps something more tangible like donating old clothes or used furniture to Goodwill. All those donations are good and valuable to society and to the individuals and families they help. However, donating your eggs is not like dropping something off at the Goodwill down the street. Your donation has the ability to create the most precious of precious things, a human life. That gift of life is different in kind from every other type of donation. And your role as a donor should not end with the drop-off (egg retrieval), because your donation lives on in the growth and maturation of a human being.
The donation contract, whether anonymous or known, is going to obligate you to the same kinds of responsibilities. You will be required to keep someone informed of changes in your medical history and to update them with any changes to your contact information. The recipients are going to notify someone about changes to their contact information, if there is a live birth resulting from the donation, and if there are any medical issues that present in the child. It will just be someone else (maybe an agency, an egg bank, or a clinic) that you are updating. Most of the contract provisions are going to be exactly the same regardless of whether it is a known or anonymous arrangement.
Legally, the contract will say and affirm multiple times that the child conceived from your donation is not yours. You have no legal connection to the child, and you are not financially responsible for the child. For all intents and purposes, the only connection you have is a biological one. But just because you have no legal relationship to the child doesn’t mean that you don’t have a moral or ethical role to play in their life. Eighty (80%) of donor conceived individuals in a 2020 survey indicated they attempted to contact their genetic donor (assuming the donor was still alive). Most of those who did try to connect with their genetic donor indicated they just wanted to meet them and hopefully find out more about them, and thereby learn more about themselves.
Technology to locate individuals with genetic connections is only going to increase as social media access and genetic testing becomes more and more commonplace. The reality is that truly anonymous donations don’t exist anymore, and not only is that OK, it is probably better for everyone. We need to take the blinders off and accept that reality at the beginning of the journey before we let ourselves erroneously believe that your donation contract will protect your anonymity just because we call it an anonymous contract.
With a known donation arrangement, we don’t have to pretend that your donation is something that takes place during discrete period of time and then ends. Your donation today will feel very different 20 years from now when a living, breathing, and curious young adult tries to friend request you on Facebook or follow you on Instagram. At the same time, don’t lose sight of the fact that a known arrangement DOES NOT mean you MUST have an involved relationship with the recipients or their future child(ren). Most donors in known arrangement are casual acquaintances of the recipients. They might exchange holiday cards or birthday photos, but it doesn’t sign you up to be a co-parent. In fact, the contract expressly prohibits that. Additionally, a known arrangement does allow you, consistent with a level of connection you are comfortable with, to witness and experience the life-changing joy of helping a family have a child, and to do so on a personal level.
Conclusion
Ultimately, as the donor, you get the decide what kind of arrangement you want to sign up for. It may turn out that an anonymous arrangement is what you want, but just remember that it is not your only option. You don’t have to donate anonymously to an egg bank and feel pressured to instantaneously divorce yourself from all connections that might result from your donation. You don’t have to pretend like your donation is a Goodwill drop that you won’t ever think about after you leave the clinic. You can get all the same good feelings and joy of knowing you are helping a family have a child that you would get from an anonymous donation, but with all the added benefits of knowing who the recipients are and who their child turns out to be. Remember, you are valuable at every stage of that child’s life, not just at the very start.
