The current landscape of fertility treatment is evolving all the time. This evolution translates into a dizzying array of reproductive options. These options include gamete donation, different types of genetic testing, various treatment protocols, and more. As a clinical psychologist and specialist in reproductive mental health, I often work with individuals and couples grappling with these choices. This includes those who are trying to decide whether to use donor eggs to conceive.
Intended parents often face this decision after enduring losses and hardships while working to build their families. The decision to use donor eggs can bring hope and joy. However, it can also bring fear, sadness, and stress. There are several reasons why someone might consider donor eggs. These include issues with ovarian reserve or egg quality, a genetic problem with one’s eggs, being in a same-sex relationship, or wanting to start a family as a single parent.
On one hand, donor eggs can significantly increase the chances of successfully conceiving, bringing hope and relief. The decision to use donor eggs can also bring feelings of grief. This includes grief over the loss of one’s genetic connection to a future child. It also provides grief that one’s future family may be different from what one had imagined it would be.
We aim to provide support and guidance around the emotional aspects of using donor eggs to conceive. We will address common concerns about using donor eggs, the grieving process, and coping with donor egg IVF.
While there are various ways that people pursue egg donation, we will discuss the emotional aspects of using donor eggs more generally. This includes de-identified (“anonymous”) egg donation and directed donation, where eggs are donated by someone personally known to the recipient.
Common Concerns with Using Donor Eggs
Is it selfish to use donor eggs?
Patients often ask me if it is selfish for them to use donor eggs to conceive when using their eggs is not possible. Similarly, patients who are doing traditional IVF sometimes ask this question, too, worrying that investing so much money and labor into having a child is a selfish choice.
My response is that humans are hard-wired to want to procreate. We know this, so if you are asking yourself this question, you may feel ashamed. You might feel ashamed that you have the same hormonal and brain-based drive to reproduce that many of the rest of us do. Accepting that you possess this human drive can help you manage your fear and shame. Understanding that there are evolutionary reasons for this drive may also assist you as you face these difficult decisions.
Will I regret using an egg donor? Will I regret NOT utilizing an egg donor?
I have a romantic answer: Humans make meaning from our experiences and weave them into our life stories. No matter how your family-building tale unfolds, you will make meaning of your experiences. When you make meaning, it can help you manage feelings like regret.
Many patients who had a donor-conceived baby tell me that they cannot imagine having a different child than the one that is theirs.
Will I be able to bond with a baby that isn’t genetically related to me?
There is a common misconception that bonding with a baby happens instantaneously. The reality is that, regardless of whether a baby is donor-conceived or not, bonding is a process. It does not typically happen overnight. There is a wide range of when a parent begins to bond with a baby. For some, bonding may start in utero, while for others, it may begin when the baby is born. For some, bonding may occur when the baby is older. One study showed that most mothers of donor-conceived babies felt secure and confident in their role as a parent. This was true by the end of the baby’s first year of life.
If you find that you are having difficulty bonding with your baby, please reach out to your provider for support. This may be a sign that you are experiencing a Postpartum Mood Disorder, such as depression or anxiety. These disorders are extremely common and are treatable.
What if my child does not see me as their real parent?
One study found that children born via egg donation rated their relationships with their mothers as warmer and more enjoyable than children born via traditional IVF. There was no difference between the two groups regarding the children’s ratings of their relationships with their fathers. Another study showed the importance of disclosing to a child from a young age that they are donor-conceived, as it supports the child’s identity development and positive parent-child relationships.
How do I, as a psychologist, interpret that information? If you are going through the process of receiving donor eggs, you have a strong desire for a child and are committed to your family. We know from attachment theory that the most critical factors supporting secure parent-child attachment are relational, consistent, sensitive, honest, and reliable caregiving and the child’s inherent knowing that they are unconditionally loved and wanted.
Grieving Process
As outlined in his book, psychologist Dr. George Bonanno’s theory of grief tells us that humans are innately resilient and can manage loss. He shares that experiences of grief and loss, while extraordinarily painful, can be transformative and deepen interpersonal connections and one’s appreciation for life.
Everyone experiences grief differently, and grieving is not a linear process. There is no right or wrong way to grieve. To move through the grief that you are experiencing in a way that gets you to a place where you feel able to decide whether to use donor eggs, you will need to notice, name, and accept whatever it is you are feeling with as little judgment of yourself as possible. If you avoid or try to talk yourself out of your feelings, your grief may become more complicated to manage. Connecting and talking with people you trust about your grief is extremely important.
Coping with Donor Egg IVF
Fertility challenges, mainly when they take place over a prolonged period, can be stressful and emotionally intense. Stress is a normal reaction to infertility, and deciding to use donor eggs can be difficult. See this wellness sheet for ideas about practical ways to cope with stress.
If you feel overwhelmed by your experiences, know you are not alone. Please get in touch with trusted friends, family members, and professionals for support. Remember that you are in the middle of your family building story. While challenging and unwelcome, this emotional journey can ultimately lead to profound joy, fulfillment, and resilience.
Resources:
You can find a list of qualified mental health professionals that are specially trained in reproductive mental health through the American Society for Reproductive Medicine Mental Health Professional Group Directory.
There are support groups available for those facing fertility challenges, including support groups specifically for those using donor eggs to conceive, through RESOLVE.
Read books, listen to podcasts, and access online resources that can help you feel connected, reassured, and informed about fertility challenges and using donor eggs:
Recommended reading:
Let’s Talk about Egg Donation: Real Stories from Real People
We Are Family: The Modern Transformation of Parents and Children
Three Makes Baby: How to Parent Your Donor-Conceived Child and the companion Workbook
The Other Side of Sadness: What the New Science of Bereavement Tells Us About Life After Loss
Recommended podcast episodes:
SART Fertility Experts Podcast – episodes on egg donation
Additional resources can be found on the American Society for Reproductive Medicine Mental Health Professional Group Third-Party Reproduction Resources page and at RESOLVE.
This blog was authored by Rachel Eshel, PsyD
Dr. Rachel Eshel is a Psychologist and a member of the American Society for Reproductive Medicine Mental Health Professional Group and Postpartum Support International. She received a Bachelor’s degree from Tufts University and a Doctorate of Psychology degree from Pace University. She completed her pre-doctoral psychology internship at Children’s Hospital Los Angeles / University of Southern California Keck School of Medicine and her post-doctoral psychology fellowship at Westchester Institute for Human Development in New York.