The Stigma of Talking About In Vitro


• Does talking about your experience with in vitro make you feel uncomfortable? • Does telling others that you needed to use infertility treatments and donor assistance to create your family, make you feel "less than"? • Do you want your children to feel comfortable and proud about their origins?

Talking with Children Conceived Through Donor Insemination, IVF with Egg Donor or Surrogacy By Ellen Singer, LCSW-C The Center for Adoption Support and Education

There was a time when adoption was shrouded in secrecy to protect all parties involved: adoptive parents from the shame of infertility, birth mothers from the shame of out of wedlock pregnancy, and adoptees from the stigma of being “illegitimate.” That time refers roughly to the 1930’s and 1940’s. Today, of course, adoption is viewed in a very different light with an emphasis on honesty, openness, and something to be celebrated as opposed to hidden. Although controversy continues to exist regarding adoption practices such as transracial and open adoption, there is no controversy about the expectation that at some point, adoptive parents will talk with their child about his/her adoptive status and share the facts related to how their child came to be part of the family.

Unlike adoption, however, no such clear expectation for disclosure exists for parents who conceived their child through alternative family-building methods such as donor insemination or in vitro fertilization (IVF) with an egg donor or surrogacy.  

Both prospective parents and parents who have successfully conceived with the help of a third party continue to be counseled by some medical and mental health professionals that it is not necessary to share the circumstances of the child’s conception with their child – that it is not necessary for the child to know the truth about how he came to be part of his family. The rationale for this position includes respect for the infertile parents’ privacy as well as the desire to protect the child from emotional harm, especially in light of those people in our society who are opposed to assisted reproductive technologies. Because this rationale seems so similar to the basis for secrecy around adoption that existed at least two generations ago, it is no wonder that many mental health and adoption professionals disagree vehemently with this stance. Lois Melina, for one, represents the view that children conceived with the assistance of a donor or surrogate have the same rights as adopted children to know the truth about their origins.

In her book, Making Sense of Adoption (1989), Melina writes, “We should acknowledge that children conceived through donor insemination (donor egg, surrogacy) share many issues with those who are adopted in a traditional way.” This position does not ignore the many differences between families formed by adoption and those created with donor assistance or surrogacy but acknowledges that children conceived with donor assistance or surrogacy have the right to know that they are not biologically related to one of their parents.

The subject of disclosure versus secrecy received much public attention about six years ago because of former Secretary of State Madeleine Albright’s story (raised as an Episcopalian, during her tenure asSecretary of State, it was revealed to her that her maternal grandparents had been Jewish) and the Academy Award-nominated movie, Secrets & Lies (1997). Because it is not possible in this article to address all of the concerns behind the various viewpoints related to the subject of disclosure to children, readers are encouraged to contact RESOLVE, Inc. for information on resources that address these issues.

This article is intended for those families who plan to or who are already in the process of sharing information with their children about their conception as well as parents who are still wrestling with this challenging decision and couples who are considering these alternative family-building methods. 

Parents of both adopted children and parents of children conceived with donor assistance or surrogacy often ask questions about how to discuss their child’s “story” with them. Many of the same principles that apply to talking with adopted children, i.e., age-appropriate sharing of information, honesty, and conveyance of positive messages about how the family was created, also apply to children conceived with donor assistance or surrogacy.

The following information is a summary of a paper written by Kris Probasco, a clinical social worker from Liberty, Missouri, entitled Discussion With Children About Their Donor Conception,1993 . Ms. Probasco writes, “As with all children, children brought to families by donor conception need to feel valued, accepted and be provided with unconditional love.” She advises parents to “take advantage of moments that children naturally provide to give information about all types of families (e.g., single parent families, families with many children, families with one child) and the importance of loving and belonging within a family.” More specifically, all discussions with children should place emphasis on “acceptance of the total child, acceptance of the donor as a good person, and recognizing that donor conception is basically one person helping others to become a family with children.” However, Ms. Probasco advises that “the age of telling be geared to the individual child and its family, recognizing that children’s sophistication and capacity to understand varies from family to family and culture to culture…..

Parents need to bear in mind that, as in all educational processes, informing is not a one-time event, but rather a building-block process.” Melina, Probasco, and others all agree that children should have the details about how they came into the family before they enter adolescence. (Information related to the donor or surrogate may impact their teen’s struggle with identity issues and parents must be prepared to assist them.) 

Simple explanations of reproduction can take place during the preschool years when children begin to ask questions about where babies come from, that in order to be born, there is a joining of a woman’s egg and a man’s sperm and then the baby grows in the woman’s body. Further discussion regarding reproduction continues into the school-age years. Probasco writes, “At this time, the story may continue to unfold in the following way--‘there are some people who are not able to make a baby, their sperm or egg don’t work properly, or the mother’s body cannot carry a baby. Remember we told you that we got help from a doctor and we want to explain what happened for you to be born.’” Probasco notes that it is important to include the following points in the story: “you were born just like everyone else,” “Mom and Dad worked together in their decision to become your parents,” “the donor or surrogate is a person who wanted to help people become parents,” and “the following are the people who know about how you came to our family.”

As children grow, depending upon their level of curiosity and maturity, questions and information given will become increasingly more detailed regarding: 1) the parents’ motivation in choosing this alternative to have children; 2) the description of all third parties involved, such as physicians, sperm banks, sperm or egg donor, surrogate; 3) an explanation of the donor’s or surrogate’s motivation for helping (parents can refer to articles on donor attitudes or if the donor is known, they can ask him/her to talk with their child);and, 4) genetic, medical, and other background information may be shared as parents continue to convey positive feelings about the donor or surrogate.

Most important, throughout all discussions and all stages of the child’s development is the need for parents to recognize and acknowledge their children’s feelings. Every child is different, and parents must assess their own child’s needs. Confusion, sadness, and pain are appropriate responses. Just as an adopted child may wish he had been born to his adoptive parents, a child conceived with donor assistance may experience a sense of loss that he is not biologically/genetically related to both parents.

Rather than protecting children from painful feelings through secrecy, parents who disclose information need to believe that children can be helped to cope with painful feelings. Parents can convey to their children that they experienced similar feelings and that they can be counted on to understand and to help their children cope with these feelings.

While adoptive parents must prepare their children for unkind attitudes, questions, and remarks about adoption, it is also important for parents to prepare children conceived with donor assistance or surrogacy for the sad fact that not everyone will understand or be supportive of why some people choose this method of family building. Probasco advises that parents can say, “We can help you think through who you would like to tell and what details would be appropriate to share. We want you to know that this is your story and we feel proud of the way you came to our family. We also want you to understand that if it is your wish to maintain privacy regarding your beginnings, you have our support for that choice.”

Many adoptive parents join support groups to help them ensure that their children will grow up knowing other families like themselves. While adoptive parents have a number of support groups to affiliate with, it can be difficult for parents whose children were conceived with donor assistance or surrogacy to find other families like theirs. One suggestion is to contact your local chapter of RESOLVE who may be able to assist you, or to ask your physician to help connect you with her other patients who like you, may wish to meet other families. Like adoptive families who benefit from professional guidance when needed, families conceived through donor assistance may also consider professional assistance related to sharing their child’s story as well as supporting their children through the feelings they may experience as they make sense of their story.

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