Recently, as a professional ethicist I attended a lecture on perinconception health in which evidence was presented on Health risks generated by what happens to the parents from 12 weeks before conception until 8 weeks of pregnancy. One of the issues was the effect of obesity in either parent roducing genetic effects that predispose to obesity in the child, even if the family did not have a history of obesity beforehand. Some early results were discussed of a major project to assess the health of IVF adults. It was said that there was strong evidence of insulin resistance in IVF adults. That predisposes to a range of adult disorders including diabetes and polycystic ovarian disease in women. It was suggested that the insulin resistance might have something to do with the culture media used for embryos. I am aware of a project involving 93% of IVF adults conceived in the Australian State of Victoria. I would be interested in any other long term follow-up projects assessing the adult health of IVF conceived people.
I am a mental health professional specializing in working with infertility patients. I am also an adoptive mother. Part of what I do at work is prepare people for the implications of using a donor. The most challenging topic we discuss is the issue of whether the couple will tell their child how s/he were conceived.
As an adoptive mother, I am 100% pro disclosure. I feel it is a child's fundamental right to know who they are at every level. Yes, it's confusing as a parent to know how much or when to disclose, but that confusion can be eradicated with some solid education and preparation. Part of what you sign up for when you build your family in a non-traditional way is that you will have to parent your child about how to deal with that difference.
To be honest, I myself, could not imagine using a donor because I don't understand the intense need for genetic link or to be pregnant. Yet, I find myself in the position of counseling many individuals who have chosen a very different path from the one I have chosen in life. At times I have even considered shifting the focus of my practice away from infertility so that I can feel more comfortable with my work. Then I think of the importance of the discussions I have with people and rationalize that at least I am a voice for donor-conceived children. At least, I bring their voice into the picture before couples even become pregnant.
I am amazed at the number of clinics, physicians, and agencies that really do not give even one second of thought to the needs of the children that are being conceived via "third party reproduction." As a nation, we need to get a conscience about what we are doing here. Yes, it's nice when an infertile couple is able to build a family, but what about the children? Shouldn't their needs be in the mix from the very beginning too? I think it is ridiculous that a donor-conceived child would need to "research" to find out their genetic origins. Give me a break. What if you had to do that? Is it fair?
I would like to say that most of the mental health professionals who specialize in infertility really do understand the complexity of these issues and support openness around donor conception. I feel proud of that and feel that we are having an impact on couples that come through our offices. However, until all couples and donors are required to consult with us so we have a chance to open everyone's eyes early in the process, it will be an uphill battle. I conduct my consultations with donors and couples using ASRM's ethical guidelines for third party reproduction. The guidelines are solid, but not mandatory, so if a clinic or agency chooses not to adhere to them, there is nothing anyone can do. Consequently, many people go into arrangements with donors pretty clueless about parenting issues and implications for their donor-conceived offspring. We need to change this situation. It's not fair to donors, intended parents, and especially to donor-conceived children.