A Dearth of Adequate Gamete Donor and Recipient Counseling

Although it’s of vital importance that parents and donors be adequately counseled before using a donor or donating, all too often, research demonstrates this is not the case.

• One 2013 published study of 1700 sperm recipients reported that 62 percent did not receive professional counseling before they embarked on conception using donor sperm, and neither did 71.6 percent of their partners.¹
• A 2009 study of 155 egg donors reported that only 37 percent felt they were properly educated and counseled about the potential curiosity of the children they were helping to create.²
• Another 2013 study of 164 sperm donors found that 80 percent said they did not receive any education or counseling about the potential curiosities of donor-conceived people to know their genetic, ancestral, and medical backgrounds.³

Because facilities that sell gametes have not incorporated appropriate and comprehensive counseling services into their business models, parents and donors have not been able to make fully-informed decisions regarding choices that will affect their lives, and their children’s lives, for decades to come.

In-house counselors often promote a decades-old and outdated agenda of secrecy and foster many of the fallacies still peddled by the gamete sellers, e.g., having accurate records of the children born, having limits on the number of children born to any one donor, or regularly updating and sharing medical information with families.

Over the years, there have been many accounts from Donor Sibling Registry parents and donors who were either not counseled at all or who were counseled by therapists who did not seem well-versed or experienced in:

• The importance of early truth-telling about a child’s conception story.

• The importance of acknowledging and honoring the right of all members of the donor family: the donor-conceived person, donors, their families, and parents to be curious about and search for genetic relatives.

• The difficulty of late disclosure and the trauma of finding the truth about one’s donor conception as an adult.
• Knowing about one's medical (physical and mental) family health history is important.
• The fact that donor anonymity hasn't been possible since 2005.⁴
• The intricacies of donor family relationships: the potential complications and many joys of connecting with and defining relationships with newly discovered genetic relatives.

A Study of 1700 Sperm Recipients¹

• Sixty-two percent did not receive professional counseling before they embarked on conception using donor sperm, and neither did 72 percent of partners.

• A higher proportion of those in a lesbian relationship did not receive counseling. A smaller proportion of single respondents indicated that seeking professional counseling never occurred to them.

• Of those who received counseling, 61 percent recalled being advised to tell their child early in life that they were donor-conceived, and nearly one-third were advised to tell their child that genetics don’t make a family. A comparatively lower proportion of single respondents were given this advice.²

A 2021 Study of 363 Egg Donors

• Sixty-six percent received mandatory counseling prior to donation:
• Fifty-seven percent at the fertility clinic, 2 percent at their own counseling center/office, 37 percent at a facility recommended by the clinic, and 4 percent elsewhere.
• Twenty-one percent were counseled by a psychiatrist, 33 percent by a psychologist, 3 percent by a nurse, 1 percent by a doctor, and the balance indicated they just weren't sure.
• Forty-four percent indicated that they did not feel as though the counseling prepared them for possible contact with any resulting children born as a result of their donations.
• Sixty-three percent reported not receiving counseling on potential future fertility issues.
• Thirty percent did not have their medical team/counselor discuss (prior to the donation) any possible medical risks related to the donation.
• Eighty percent said that their medical team or counselor did not discuss or provide information about direct-to-consumer DNA tests (e.g., 23andme, Ancestry.com) that may be used by a parent or child to find them.

A 2012 Study of 244 Non-Biological Parents⁵

• Thirty-nine percent of the women and 57 percent of the men indicated they had professional counseling before utilizing sperm donation.
• Twenty-six percent had counseling arranged by the clinic prior to treatment as it was mandatory.
• Fifty percent had not considered having counseling before they commenced treatment.
• Sixty-one percent of the women and 81 percent of the men who had been counseled were advised to tell their children early in life they were donor-conceived.
• Sixty-nine percent of the women and 43 percent of the men were told that a child is likely to have curiosity about their genetic heritage.
• Forty-one percent of all respondents were told that genetics do not make a family.
• Participants were also asked about any advice they were given by the sperm bank/clinic when undergoing treatment. The majority reported they had received little advice on which type of donor to use (anonymous or open identity).
• Seventy-one percent did not receive any advice about whether to tell their child about the way they were conceived.
• Forty-two percent of the 65 respondents who did receive this advice were advised to do so before the child was 10.
• Thirty-six percent of female and 39 percent of male respondents were advised never to tell their child the truth.
• Fifty percent of women and 57 percent of men were advised to tell others (family, friends, etc.) only on a need-to-know basis.

A 2013 Study on the Experiences and Views of Sperm Donors⁶

• Eighty percent said that they had not received any education or counseling on the potential curiosities of donor-conceived people to know their genetic, ancestral, and medical backgrounds. Several donors noted that because of the anonymity of their donations, they thought that no counseling was needed on this matter.
• Twenty-two percent wished for more information prior to donating. The desired information was centered on the outcomes of their donations, the impact of donor conception and anonymity on the offspring, the laws and policies regarding anonymity, and issues arising from possible contact with offspring.

A 2021 Study of 529 Donor-Conceived Adults

We asked if donor-conceived people had ever sought professional support or counseling regarding their donor conception origins, and more than 29 percent said "yes." Perhaps if their parents had received adequate education and counseling and had been able to make fully informed decisions, this number might have been lower.

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DNA= Donors Not Anonymous

Given the dramatic increase in the use of donor gametes in recent years, in combination with the Donor Sibling Registry and commercially available tools to easily trace familial DNA, the practice of promised/mandatory anonymity for 18 years or forever is no longer sustainable.

Surprisingly though, every single vial of sperm sold is still sold as anonymous, be it for 18 years or forever. During this long transitional period in the field, mental health and medical professionals can assist and empower all donor family members through proper education and counseling, most importantly, regarding the needs and issues of the children being created.