The current landscape of fertility treatment is evolving all the time, which translates into what can be a dizzying array of reproductive options – from gamete donation, to different types of genetic testing, to various treatment protocols, and more. As a clinical psychologist and specialist in reproductive mental health, I often work with individuals and couples who are grappling with these options, including those that are trying to decide whether to use donor eggs to conceive.
Intended parents often face this decision after having endured losses and hardships as they have worked to build their families. The decision to use donor eggs – whether due to issues with ovarian reserve/egg quality, a genetic issue with one’s eggs, being in a same-sex relationship, or wanting to start a family as a single parent – can bring hope and joy, as well as fear, sadness, and stress.
On the one hand, donor eggs can significantly increase the chances of successfully conceiving, which can bring hope and relief. On the other hand, the decision to use donor eggs can also bring grief – grief over the loss of one’s genetic connection to a future child, as well as grief that one’s future family may be different than one had imagined it would be.
This post is intended 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, including de-identified (“anonymous”) egg donation (such as from an egg bank or an internal program at a fertility clinic) and directed donation (eggs donated from someone that one knows personally), for the purposes of this blog we will discuss the emotional aspects of using donor eggs more generally.
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 own 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 to this is that we as humans are hard-wired to want to procreate – we know this – so if you are asking yourself this question, you may be feeling ashamed that you have the same hormonally- and brain-based drive to reproduce that many of the rest of us do. If you accept that you too possess this human drive, and that there are evolutionary reasons for it, it may help you manage your fear and shame as you face these difficult decisions.
Will I regret using an egg donor? Will I regret NOT using an egg donor?
I have a bit of a romantic answer to this question: I think that as humans, we all make meaning out of our experiences and try to weave them into our life stories. No matter how your family-building story 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, regardless of whether a baby is donor-conceived or not, bonding is a process and does not typically happen overnight. There is a wide range of when a parent begins to bond with a baby. For some bonding may begin in utero, for others when a baby is born, and for others when a baby is older. One study showed that most mothers of donor-conceived babies felt secure and confident in their role as a parent 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, which is extremely common and is 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 higher in warmth and enjoyment than did children born via traditional IVF. There was no difference between the two groups in terms of 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 you are committed to your family. We know from attachment theory that the most important factors in supporting secure parent-child attachment are relational in nature – meaning, the presence of consistent, sensitive, honest, and reliable caregiving, and the child’s inherent knowing that they are unconditionally loved and wanted.
Grieving Process
Psychologist Dr. George Bonnano’s theory of grief, as outlined in his book, tells us that humans are innately resilient and that we 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. In order to move through the grief that you are experiencing in a way that gets you to a place where you feel able to make a decision about 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 harder to manage. It is also extremely important to connect and talk with people you trust about your grief.
Coping with Donor Egg IVF
Fertility challenges, particularly when they take place over a prolonged period of time, can be stressful and emotionally intense. Stress is a normal reaction to infertility, and making the decision to use donor eggs can be difficult. For ideas about practical ways to cope with your stress, see this wellness sheet.
If you are feeling overwhelmed by your experiences, know that you are not alone. Please reach out to trusted friends, family members, and professionals for support. Remember that you are in the middle of your family building story. This emotional journey, while challenging and unwelcome, 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.