Infertility: Evaluating Parenting Alternatives

The depiction of adoption by the media sometimes creates a scary picture. Couples may discount adoption for fear a child will be taken away from them in the years ahead, or the child will ultimately seek out his or her birth parents. We suggest that even couples who feel adoption is not for them contact adoption attorneys and agencies so that their decision is made in an informed manner, just as the fertility treatment decisions were made.

Donor Gametes

Once you decide to stop pursuing medical treatment and resolve the grief of infertility, it is important to evaluate alternatives to genetic parenting. Here we look at the psychosocial aspects of some of these options.

Gametes refer to sperm or eggs. Sometimes the alternative of donor sperm or donor eggs will be suggested by the physician. You need to recognize the use of donor gametes as an alternative form of parenting. Difficulties can arise if you perceive this as a treatment for infertility. As with the other alternatives, grieving is important for your transition to and acceptance of donor sperm or eggs.

You will need to reevaluate your goals, and know that genetic parenting will not occur. Often a desire to know half of the genetics and to have a pregnancy experience makes the use of donor gametes more optimal than adoption. You and your partner must evaluate the inequity of the genetic contribution. Those who experience feelings of "if not mine, then neither of ours" would do best to pursue adoption or child-free living.

Sperm banks provide couples with a variety of choices with respect to potential donors, yet the same is not true for egg donation. Because of this lack of selection, some couples decide to use known donors. There are positives and negatives associated with this decision. It is often comforting to know the personality, medical, and psychological history of the donor, but uncertainty about potential custody issues exist. The opportunity for privacy is also compromised when a choice is made to use a known donor.

Consideration of disclosure versus nondisclosure is important prior to pursuing a donor. You and your partner need to make preliminary decisions about whether or not the potential child will know about the use of a donor. Discussion of this issue is best facilitated by your evaluations of comfort with secrets and consideration of whether or not it is a child's right to know their genetic origin.

Couples who decide not to tell the child are advised to tell no one in order to prevent concern over accidental disclosure in the future. Those couples who decide to tell the child are encouraged to have this discussion prior to the child's identity formation in adolescence.

For more information on donor gametes, see Infertility: Donor Gametes or Embryo Adoption.