emotional burdens which we carry as part of an inherited compromise. (Whipp 2004)
Many donor-conceived adults will freely admit that their sense of identity has been damaged and would concur with Cicero that: “To be ignorant of what occurred before you were born is to remain always a child. For what is the worth of human life, unless it is woven into the life of our ancestors by the records of history?” (Cicero, Orator, 46 bc).
Whipp goes on to talk about the anxiety some donor offspring feel about missing medical information and adds:
Our dissatisfaction has also been tempered with the knowledge that adoptees in the UK were given the right to access their birth records as long ago as the mid-1970s, yet no official records concerning donor conceptions have been maintained at all until the setting up of the HFEA in 1991. (Whipp 2004)
Unfortunately, many countries, including the United States, have been slow to react to these concerns. Barbara Sumner Burstyn summarizes these sentiments in her article “The new underclass” by stating:
…allowing technology to willfully create an underclass of people who are unaware of their genetic background and to support parents in denying their children their biological history is to continue the social, medical, and emotional disadvantages that have been suffered for generations by adopted people. (Burstyn 2004)
As the Donor Sibling Registry has grown and the need for it been expressed worldwide, founder Wendy Kramer has tried to use the media to familiarize the public with the needs and desires of some donor offspring to know where they came from and to whom they are connected. She has surveyed 751 offspring and found that although the vast majority are happy, well-functioning people, they have a need to know their genetic relatives. For some, it is simple curiosity: “Whom do I look like?” or “Where did this interest or talent come from?” For others, there is a need to know up-to-date medical information. Not surprisingly, many donor offspring become most curious around times of major life events such as marriage and becoming parents themselves.
Egg donation, together with other assisted reproductive technologies (ARTs), also directly led to the ability to evaluate embryos carefully and eliminate defective ones before they are transferred to the uterus. While this increases the chance that couples will have healthy babies, it has sparked the debate about creating “designer babies.” Just how much say should individuals have about what type of baby should be created or destroyed? This illustrates two central ethical dilemmas: should people be allowed/encouraged to create “designer babies” and how can “fertility tourism” be regulated?
Questions arise also about the donors: as they prepare to donate, are they being adequately counseled on the potential long-term consequences of their donation? These include possible medical problems. In their 2009 paper “US oocyte donors: a retrospective study of medical and psychosocial issues,” Kramer, Schneider and Schultz raise concerns about the risks of ovarian hyperstimulation, including future infertility and some evidence of increased risk of uterine, breast and other cancers. The 2011 film Eggsploitation sounds a louder alarm bell. It follows three former donors who encountered serious medical problems that they relate to egg donation. A common theme is that prospective donors are not adequately counseled about potential medical risks.
Another concern for donors is how they will feel about their offspring. Donor agency advertisements appeal to prospective donors by telling them of the happiness they will bring to people who want and deserve to be parents. What the ads do not focus on is what it will mean for these women—and their parents, siblings, children—to have genetic offspring that they do not know. I (Ellen) recently had a phone call from a woman who donated her eggs ten years ago “at a time when I was not thinking at all about having children” and who had recently been found by the recipient couple. The donor spent three “amazing” days with the family but returned home with unexpected feelings “that I can’t begin to explain.” She went on to say that everything seems different now that she is married and thinking about starting a family. More significant, she said she was “unprepared for the intense feelings of love” she has for the child she helped create.
Finally, the recipients. Egg donation has allowed older women, many of whom have entered menopause, to turn back their biological clocks and give birth. There are reports of women in their late 50s, even 60s, having babies. While this is still not a common occurrence, egg donation allows its possibility. This forces us to ask: is this a good thing? Some argue that if a woman in her 50s is married to a man in his 30s, why shouldn’t they have a child together? Others support this option for a different reason: they say that age brings a wisdom and maturity that can be as valuable in parenting as youthfulness and energy. Either way, the question must be asked: is it fair to a young adult in his mid-20s to have a parent or parents in their late 70s?
Another ethical concern for recipients involves the promotion of anonymity. Until recently, donors and recipient women were often discouraged, sometimes even prevented, from meeting one another. Fortunately, as a result of increasing work with families doing open adoptions, awareness is growing of the potential benefits to the recipient, as well as to the donor and child, of meeting someone you will, in a sense, be connected to for life. It is increasingly common for donors and recipients to meet and to transform anonymous donation into a new form of known donation. These meetings may not include fully identifying information, but both donors and recipients proceed with egg donation aware that, in some ways, they will have a lifelong connection. In her article “Parents Anonymous” in New Ways of Making Babies Cynthia Cohen, writes:
The special nature of this gift—assistance in bringing a child into being—obligates recipients to express their gratitude by viewing donors as more than anonymous surds. It obliges recipients to view them as actual, characterizable, morally considerable persons who are deserving of respect and appreciation. Donors are individuals whose needs, interests, and rights ought to be taken into account in the process of gamete donation. Givers also incur a moral obligation when they provide a gift—the obligation to give a complete gift and not just part of one. The gift that gamete donors give includes their genetic material. To complete this gift, donors must provide recipients, and ultimately the resulting children, with relevant information that may be carried with the genetic material. (Cohen 1996, p.95)
Who chooses egg donation?
Let’s imagine that you are standing in the “departure lounge for egg donation.”
It’s a large, busy space, and you are, most likely, feeling somewhat bewildered. Whatever it is that brings you to consider egg donation, you are not where you once expected to be in your family-building journey. Yes, this departure lounge offers you hope and opportunity, but you are probably feeling a bit dazed. As you look around you at others considering egg donation, you will see a variety of people and a range of expressions on their faces. Some are weary travelers—they have been struggling to become parents for a long time, and their faces reveal the arduousness of their journey. Others look excited and energetic—perhaps this is their first departure lounge. Some women stand alone, some with their husbands or partners, and you may notice a few male couples, as they too have joined the ranks of those considering and pursuing egg donation.
In the pages that follow we will introduce the various situations that bring women and men to egg donation. We will also identify some of the specific questions and challenges that face each cohort of prospective egg donor parents. We hope that familiarizing you with fellow travelers will help ease your journey.
Primary ovarian insufficiency
Because women in their 20s and early 30s are assumed to have young, healthy eggs, most women in this age group do not anticipate infertility—at least not infertility due to egg quality. Sadly, there are young families who excitedly decide to have a baby only to learn that the woman has “bad eggs.”
Because there has been no reason
