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Third-party donation - What are the different options?

"Third-party donation" refers to the use of eggs, sperm, or embryos donated by a donor (third person) to help an infertile couple or individual (referred to as the "intended recipient") to become parents. A donor may be anonymous or known to the intended recipient.


The scope of third-party donation also includes the use of a surrogate, either gestational surrogacy (in vitro fertilization) or traditional surrogacy (artificial insemination).  

Egg donation

With egg donation, one woman (the donor) "donates" her eggs so that another woman (the recipient) can try to conceive.

With egg donation, the recipient undergoes in vitro fertilization (IVF) in the usual manner, and the donor may receive fertility medications to stimulate her ovaries to produce of multiple eggs. Simultaneously, the recipient may also take medications to synchronize her menstrual cycle with the donor's so her body will be prepared to receive the embryo. The donated eggs are then fertilized in a laboratory and the embryos are implanted in the recipient's uterus.


In general, egg donation is an option for women who:

  • Are older and have not succeeded in conceiving using other assisted reproductive procedures (such as intrauterine insemination and IVF)
  • Have reached menopause prematurely
  • May carry a genetic disorder (determined through blood testing)
  • Have undergone repeated, unexplained miscarriages

Sperm donation

Sperm donation to conceive a child is an alternative if the male partner:

  • Does not produce sperm or produces very poor-quality sperm
  • Has a potentially inheritable genetic disorder that he does not want to pass on to his offspring
  • Has undergone radiation or chemotherapy treatment that may impact sperm quality

Receiving donated sperm is also an alternative for single women and same-sex couples who want to conceive.

Embryo donation

With embryo donation, donor eggs are fertilized with sperm from the donor's partner or with donor sperm. There are women who undergo IVF and choose to donate unused fertilized eggs to women then have the eggs implanted. 

Surrogacy

A surrogate is a woman who carries a pregnancy for another woman. The two types of surrogacy are:

  • Traditional surrogacy: The use of the surrogate's egg with the sperm from the male partner of an infertile couple. Legally, the couple or female partner must adopt the child after it is born.
  • Gestational surrogacy: The surrogate carries a pregnancy created by the egg and the sperm of two other people. For example, a woman with functioning ovaries who has a malformed uterus or no uterus may choose to use IVF with her partner and then have the resulting embryo transferred to a gestational surrogate.

Emotional considerations for donation or surrogacy

Fertility treatment can often be fraught with frustration and challenging emotions. The donation or surrogacy decision can add to the stress, and may impact your relationship as a couple. Therefore, it is often recommended to seek psychological counseling before going through these procedures.

In addition, as you can imagine, donation and surrogacy often entail complex legal hurdles. Therefore, it's important before proceeding to consult an attorney who specializes in third-party reproduction .

What to explain to children who were born using third party donation

Couples or individuals pursuing third party donation (donor sperm, donor egg, donor embryo or surrogacy) often have major concerns about the impact on children conceived through this family building method.

Often, parents are unsure whether to tell their children about their genetic origins. If they do choose to tell their children, they don't always know how to talk to them about this difficult and complicated subject.

Most of the time, it is in the best interest of your child and your family to let your child grow up knowing that while they are not genetically related to one or both of their parents, that has no relation to the amount of love they have for the child. The reasons for this approach include:

  • Children often sense when something is being hidden to them.
  • Secrets in families can be damaging.
  • Children who “detect” there is something wrong in their family usually assume that it is about themand they tend to assume the worst.
  • Family secrets almost never stay secrets forever.
  • When hidden information finally comes out, the child's sense of betrayal can be even worse than the actual information revealed.
  • Betrayals in families often cause trust issues.

The initial step in disclosure is for parents to look at their own feelings about surrogate or donor conception. For example, the couple can evaluate whether both parents agreed to this path to parenthood. Or, did the couple grieve the loss of the child they thought they were going to have and raise? This acknowledgement also recognizes that there is a third person or another family that is somehow connected to their childa parent that is neither their mom or dad. Parents sometimes feel threatened by this, which is normal. A lot of headway can be made before parents accept their infertility and before they are comfortable with using a donor or surrogate.

In most cases, as the infertile partner comes to terms with his or her infertility and has the chance to grieve that they will not have a the genetic child, they will become more empowered, even entitled, to parent a child who does not share their genes.

How to share information with your child

An essential and sometimes one of the most difficult issues that partners confront is sharing their family building information with family, friends and their child. Initially, the information shared relates to the pregnancy, but ultimately, of course, the information is about the child and family.

Typically, couples feel comfortable sharing this private information only with close contacts, including obstetricians and pediatricians, and immediate family members and good friends.

The decision to share family-building information with your child can be anxiety-producing. Couples sometimes worry that if their child knew that donor gametes were used in their conception, it would impact and shrink the parent-child bond. Some parents want to shield their child from the pain that this knowledge might cause them. You should weigh these concerns against the potential burden of keeping such an important secret. When sharing this information, you can send a loving and affirming message about the desire to have your child, emphasizing family openness and resilience.

Dealing with the issues and emotions of third-party reproduction

Working through the various issues and feelings when making the decision to use third-party reproduction will enable you to make informed choices and make it easier to pursue a realistic vision for building your family.

Third-party reproduction is a multifaceted process that requires potential parents to resolve social, legal, and ethical issues. In general, the recent increase in egg donation has required prospective parents to reconsider the social and ethical impact that this approach has on themselves, their children, and the egg donors.

For couples who have experienced the anguish of unsuccessful infertility treatment, using donated eggs or sperm can be a wonderful conception alternative. Each failed conception attempt can leave couples discouraged, with intense disappointment due to unfulfilled dreams, and feelings of sadness, anger, grief, or exhaustion. Using third-party reproduction offers optimism, with the possibility of pregnancy, and potentially having a child who is genetically connected to one parent. Prospective parents considering this approach need to address their feelings and issues, just as with many major life decisions.

One initial important step in this process is to mourn the loss of the traditional child and family that you imagined having. As a couple, you should work to understand what these personal losses mean to you, both as partners and individually.

There are couples who are aware that they may need to use third-party reproduction if their treatment approaches aren't successful. Other couples are shocked, upset, and disheartened when their doctors suggest it as an option. 

On a final note, the grieving process cannot be expedited; one partner may need more time than the other to come to terms with the new reality. "Working through" the series of losses helps set the foundation for moving forward with clear knowledge and understanding. 

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