What the therapists says about choosing between donor and adoption
What would the therapist Tina Teglgaard say to the couple who have undergone a lengthy period of fertility treatment, both with IVF and ICSI, but whose doctor now presents them with the option of donor (egg or sperm) or adoption?
22. juli - 2022
Tina Teglgaard is a fertility therapist with personal experience of involuntary infertility. She has more than 10 years’ experience as a certified fertility therapist, so works regularly in this capacity at several private clinics in Denmark. She also organises workshops and networking meetings for people suffering from involuntary infertility.
What would you say to a couple in this situation?
First I would advise them not to answer the doctor immediately. They should tell the doctor that they need some time. You should never make such a big decision so quickly. You need to talk through every possible consideration and feeling.
For the next week or even more, the couple need to sit down and talk about what's important to them.
Is it parenthood that’s important for you? Is it about starting a family together or is it crucial for the process to be biological with genes from both of them?
What are their values, and what is important to them in this parenthood process?
What is the first stage in this process of consideration?
They should start by asking their doctor about EVERYTHING. Any questions they may have. So, when they get home, their discussion will be based on all the answers, rather than a lot of “maybe, what about?” etc.
Then the couple needs to talk through all the difficult things. At this point, some people may find it helpful to seek professional help to talk about the difficult things too.
I find with my own clients that men can find it easier to accept the use of sperm donors than women the use of egg donors. Most of the time, it's because they don't want to ask their partner to go through any more because of reduced sperm quality. Because the use of sperm donors can actually mean that their partner can get pregnant. They have a feeling that now they can help fix the problem instead of standing on the sidelines feeling powerless. If this is what it takes to succeed, then go ahead.
Most women I’ve met find egg donation a really difficult and major decision. I won't speak for everyone, but many women (and couples) dream of passing on their genes. But it’s a process. You start at home in the double bed, then maybe IUI, then IVF etc. So, in the process, their boundaries naturally move. Many couples may have thought at an early stage that they would draw the line at egg donation and adopt instead. But when they actually come to the point, they're still open.
The women and couples are so grateful for the help and the fact that it’s actually possible with a donor, even though it can feel transgressive.
When I was in fertility treatment myself, we actually ran a process of adoption on the side. It gave me peace of mind that I was going to be a mother one way or another. At that time, egg donation was not an option in the same way. If it had been today, I would have clearly gone for egg donation rather than adoption. For me, it's like steering a middle course. In relation to adoption, you also need to remember that the older you get, the harder it can be to adopt. You also have to expect that the children you adopt will be a bit older. I think egg donation is an obvious choice especially for women who are older and who have a lower egg reserve.
The couple have to figure out what is more important: genes and biology or having a family together.
What if they disagree about the decision?
Then things get really difficult. And this is really where it can get tough for a relationship. Again, I would recommend seeking help.
It's too much responsibility to sit at home in the living room. No one wants to be the one who gets their way and then gets blamed for their partner not having the children they dream of, or blamed their partner being an unhappy parent because their genes don’t get used. I know I'm a therapist, but I'm a huge advocate for seeking help. No one should be able to blame anyone at a later stage.
What do a couple need to think about in terms of using a donor?
They need to explore their options. It's a good idea to use fertility clinics and sperm banks, and apply their advice and guidance. For some people, appearance is important - the child looks as much as possible like them. Others have different priorities. You can get help finding donors who match your criteria and learn more about the difference between open and closed donors.
What do a couple need to think about in terms of adoption?
They need to be aware that it isn’t easy. They need to seek information at an early stage to learn about the options. You also have to remember that the older you are, the older the child you have may actually be. You need to be ready to cope with such a situation, because you won't necessarily get an infant.
Finally, at the risk of repeating myself, discussion is paramount. This is not about whether or not to buy a house together. If you can be patient and agree on what path to take, most people will be a lot happier and calmer.
If you can't get pregnant in any other way, pregnancy with a donor is a wonderful option. I know a lot of people who have used both kinds of donors, and they feel just as much like parents as the rest of us. It should be regarded as another option for becoming someone's mother or father.