Egg Donation Families Research Articles

A longitudinal study of families created using egg donation: Family functioning at age 5.

Findings are reported from Phase 2 of a longitudinal study of family functioning in heterosexual-couple families with 5 year olds conceived using identity-release egg donation. Seventy-two egg donation families were compared to 50 in vitro fertilization (IVF) families (ethnicity: 93% White British) using standardized observational, interview, and questionnaire measures. There were no differences between family types in the quality of mother-child or father-child interaction, apart from lower structuring by fathers in egg donation families. Egg donation mothers and fathers reported higher levels of parenting stress and lower levels of confidence and competence than their IVF counterparts. Egg donation mothers reported lower social support and couple relationship quality, greater anger toward their child, and perceived their child as more angry and less happy, compared to IVF mothers. Egg donation fathers showed greater criticism and anger toward their child, less joy in parenting, and were less satisfied with the support they received, than IVF fathers. Children in egg donation families showed higher levels of externalizing problems than IVF children as rated by mothers, fathers, and teachers, whereas they were rated as having higher levels of internalizing problems by teachers only. Externalizing problems were predicted by mothers' lower initial social support, steeper increases in parenting stress and greater concurrent criticism, whereas internalizing problems were associated with poorer initial couple relationship quality as rated by mothers. Both were predicted by fewer gains in reflective functioning. There was a moderation effect such that parenting stress was a stronger predictor of externalizing problems for egg donation than IVF families. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A longitudinal study of families formed through third-party assisted reproduction: Mother-child relationships and child adjustment from infancy to adulthood.

The seventh phase of this longitudinal study investigated whether children born through third-party assisted reproduction experienced psychological problems, or difficulties in their relationship with their mothers, in early adulthood. The impact of disclosure of their biological origins, and quality of mother-child relationships from age 3 onward, were also examined. Sixty-five assisted reproduction families, including 22 surrogacy families, 17 egg donation families, and 26 sperm donation families, were compared with 52 unassisted conception families when the children were aged 20. Less than half of the mothers had completed tertiary education and less than 5% were from ethnic minority backgrounds. Standardized interviews and questionnaires were administered to mothers and young adults. There were no differences between assisted reproduction and unassisted conception families in mothers' or young adults' psychological well-being, or the quality of family relationships. However, within the gamete donation families, egg donation mothers reported less positive family relationships than sperm donation mothers, and young adults conceived by sperm donation reported poorer family communication than those conceived by egg donation. Young adults who learned about their biological origins before age 7 had less negative relationships with their mothers, and their mothers showed lower levels of anxiety and depression. Associations between parenting and child adjustment did not differ between assisted and unassisted reproduction families from ages 3 to 20. The findings suggest that the absence of a biological connection between children and their parents in assisted reproduction families does not interfere with the development of positive mother-child relationships or psychological adjustment in adulthood. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Families created via identity-release egg donation: disclosure and an exploration of donor threat in early childhood

Research questionWhat are mothers’ disclosure intentions and practices from infancy to early childhood, and is perceived donor threat associated with disclosure in identity-release egg donation families when the children are aged 5 years? DesignThis longitudinal study included 73 heterosexual-couple families with infants born following IVF-egg donation at phase one, and 61 families with 5-year-old children at phase two. At both phases, mothers were interviewed about their disclosure intentions and practices. At phase two, mothers were interviewed about their feelings about future donor–child contact. ResultsMost mothers (75.3%) intended to disclose their use of egg donation to their children at phase one; half had begun to do so when their children were aged 5. Most remaining mothers planned to tell, although a minority were uncertain or planned not to disclose. When the child was aged 5, four mothers had started telling them that they could access their donor's identifying information at age 18, and most (84%) intended to do so in the future. Most couples agreed on a disclosure strategy at phase two. Most mothers perceived at least some threat from future donor–child contact, but this was unrelated to their disclosure practices. ConclusionsDisclosure intentions in infancy are borne out in early childhood. Despite perceiving some threat from future donor–child contact, most mothers intended telling their child that they could access the donor's identifying information at age 18. Revisiting these families as the children grow older will be important to understand how the mothers’ perceived donor threat may change over time, and how this is related to family processes.

Zero or 18

Zero or 18

An exploration of parental age in relation to parents’ psychological health, child adjustment and experiences of being an older parent in families formed through egg donation

Research questionIs parental age associated with parents’ psychological health, couple relationship satisfaction and child adjustment in egg donation families, and how do parents think and feel about their age in relation to parenting? DesignSeventy-two families with a child born after IVF egg donation were included. Mothers were aged between 32 and 51 years and fathers between 31 and 61 years when the target child was born. When the child was aged 5 years, parents were interviewed and asked to complete questionnaire assessments of parenting stress, anxiety, depression, marital quality and child adjustment. ResultsOlder parents experienced more parenting stress and poorer couple relationship quality than younger parents. No differences were found for child adjustment. Qualitative content analysis of the interviews revealed themes related to ‘health and mortality’, ‘giving and receiving support’, ‘treatment and age’, ‘positive aspects of older parenting’ and ‘other’. ConclusionsThis exploratory study found that older parents experienced greater parental stress and poorer relationship quality. Some parents had concerns about their older age, specifically in relation to their health and mortality. It would be important to follow up these families as the child grows older to understand the child's thoughts and feelings about having older parents. Furthermore, findings should be replicated in a larger sample of families formed through egg donation, which includes more younger mothers who have used egg donation.

Parent-child relationship quality and child psychological adjustment in families created using egg donation: children's perspectives at age 5 years.

STUDY QUESTIONWhat are children’s perspectives of the quality of their relationships with their parents and their own psychological well-being in families created using egg donation?SUMMARY ANSWERChildren’s scores indicated good parent–child relationship quality and high levels of psychological well-being, with children in families created using egg donation rating their relationships with their mothers as higher in warmth/enjoyment than children in a comparison group of families created using IVF.WHAT IS KNOWN ALREADYLittle is known about how children in families created through egg donation view their family relationships and their own psychological well-being. Research with 7-and-10-year-olds in anonymous egg donation families has indicated good parent–child relationship quality from children’s perspectives, but studies have not involved younger children or those conceived following identity-release egg donation.STUDY DESIGN, SIZE, DURATIONThis study included 50 children who had been born through egg donation and a comparison group of 43 children conceived through IVF with the parents’ own gametes. Data were collected between April 2018 and December 2019. The sample forms part of a larger longitudinal study examining family functioning in families created through fertility treatment.PARTICIPANTS/MATERIALS, SETTING, METHODSChildren were aged 5 years old and had been born into families with different-sex couple parents. All families were visited at home. Children were administered the Berkeley Puppet Interview, a standardized assessment of parent–child relationship quality and psychological well-being.MAIN RESULTS AND THE ROLE OF CHANCEChildren in egg donation families rated their relationships with their mothers as higher in warmth and enjoyment than did children in IVF families. No differences were found between the two family types in children’s ratings of the father–child relationship, or in children’s ratings of their own psychological well-being.LIMITATIONS, REASONS FOR CAUTIONIt is possible that children who did not consent to take part in the research had less positive perceptions of their family and themselves than children who participated.WIDER IMPLICATIONS OF THE FINDINGSThe findings are relevant to UK clinics offering identity-release egg donation, to parents who have used egg donation to create their family and to individuals and couples considering their fertility treatment options. That children in egg donation families were more similar than different to children in IVF families in their self-concept and perception of their family relationships should prove reassuring.STUDY FUNDING/COMPETING INTEREST(S)This research was supported by a Wellcome Trust Collaborative Award [208013/Z/17]. The authors have no conflicts of interest to declare.TRIAL REGISTRATION NUMBERN/A.

"Making the child mine": Mothers' thoughts and feelings about the mother-infant relationship in egg donation families.

The number of families being created through fertility treatment with donor eggs is increasing yearly. Women who conceive in this way share a gestational but not genetic relationship with their child, yet there is limited understanding of how mothers experience the mother–child relationship during its formative period, infancy. This study explored heterosexual mothers’ thoughts and feelings about the mother–infant relationship in families created through egg donation. Qualitative interviews were conducted with a sample of 85 women who had conceived following egg donation treatment at U.K. fertility clinics. Mothers had at least 1 infant (6–18 months) and were living with the child’s father. Interview data were analyzed according to the principles of thematic analysis. The results showed that egg donation mothers used a range of strategies across the transition to parenthood that enabled them to establish their identity as the child’s mother and facilitated the process of helping them feel that the baby was their own. This process was individual to each woman, with the absent genetic connection varying in significance between mothers. The strategies employed enabled most mothers to adjust successfully to parenthood and manage any ambivalence and uncertainties associated with nongenetic parenthood. Most mothers felt secure and confident in their position as the child’s mother by the end of the first year.

Families Created by Egg Donation: Parent-Child Relationship Quality in Infancy.

Increasing numbers of children are being born through egg donation and thus do not share a genetic relationship with their mother. Parent–infant relationship quality was examined in 85 egg donation families and a comparison group of 65 in vitro fertilization families (infant M = 11 months). Standardized interview and observational measures were used to assess mother–infant and father–infant relationship quality at the representational and behavioral levels. Few differences were found between family types in parents’ representations of the parent–infant relationship. Differences were found between family types in the observational assessment of mother–infant relationship quality, indicating less optimal interactions in egg donation families. Findings suggest that egg donation families function well in infancy overall, but there may be subtle yet meaningful differences in mother–infant interaction quality.

A longitudinal study of families formed through reproductive donation: Parent-adolescent relationships and adolescent adjustment at age 14.

The aim of the 6th phase of this longitudinal study was to establish whether children born through assisted reproduction involving reproductive donation were at risk for psychological problems following the transition to adolescence at age 14 and, if so, to examine the nature of these problems and the mechanisms involved. Eighty-seven families formed through reproductive donation, including 32 donor insemination families, 27 egg donation families, and 28 surrogacy families, were compared with 54 natural conception families. Standardized interviews, questionnaires, and observational assessments of the quality of parent-adolescent relationships and adolescent adjustment were administered to mothers, adolescents, and teachers. The mothers in surrogacy families showed less negative parenting and reported greater acceptance of their adolescent children and fewer problems in family relationships as a whole compared with gamete donation mothers. In addition, less positive relationships were found between mothers and adolescents in egg donation families than in donor insemination families as rated by both mothers and adolescents. There were no differences between family types for the adolescents themselves in terms of adjustment problems, psychological well-being, and self-esteem. Longitudinal analyses showed no differences between family types in negative parenting from age 7 to age 14, and a weaker association between negative parenting and adjustment difficulties for gamete donation than natural conception and surrogacy families. The findings suggest that the absence of a genetic link between mothers and their children is associated with less positive mother-adolescent relationships whereas the absence of a gestational link does not have an adverse effect.

Constructing and enacting kinship in sister-to-sister egg donation families: a multi-family member interview study.

Although intra-familial egg donation has been practiced for more than 15 years in several countries, little is known about family relationships in this family type. Framed within the new kinship studies, this article focuses on the experiential dimension of kinship in sister-to-sister egg donation families: how is kinship 'unpacked' and 'reconstructed' in this specific family constellation? Qualitative data analysis of interviews with receiving parents, their donating sisters and the donor children revealed six themes: (1) being connected as an extended family; (2)disambiguating motherhood; (3) giving and receiving as structuring processes; (4) acknowledging and managing the 'special' link between donor and child; (5)making sense of the union between father and donor; and (6) kinship constructions being challenged. This study showed the complex and continuous balancing of meanings related to the mother-child dyad, the donor-child dyad and the donor-father dyad. What stood out was the complexity of, on the one hand cherishing the genetic link with the child allowed by the sisters' egg donation, while, on the other, managing the meanings related to this link, by, for instance, acknowledging, downsizing, symbolising, and differentiating it from the mother-child bond. (A Virtual Abstract of this paper can be accessed at: https://www.youtube.com/channel/UC_979cmCmR9rLrKuD7z0ycA).

Parent psychological adjustment, donor conception and disclosure: a follow-up over 10 years.

What is the relationship between parent psychological adjustment, type of gamete donation (donor insemination, egg donation) and parents' disclosure of their use of donated gametes to their children. Disclosure of donor origins to the child was not always associated with optimal levels of psychological adjustment, especially for fathers in donor insemination families. Cross-sectional analyses have found mothers and fathers who conceived a child using donated sperm or eggs to be psychologically well-adjusted, with few differences emerging between parents in gamete donation families and parents in families in which parents conceived naturally. The relationship between mothers' and fathers' psychological well-being, type of gamete donation (donor insemination, egg donation) and parents' disclosure decisions has not yet been examined. In this follow-up study, data were obtained from mothers and fathers in donor insemination and egg donation families at 5 time points; when the children in the families were aged 1, 2, 3, 7 and 10. In the first phase of the study, 50 donor insemination families and 51 egg donation families with a 1-year-old child participated. By age 10, the study included 34 families with a child conceived by donor insemination and 30 families with a child conceived by egg donation, representing 68 and 58% of the original sample, respectively. Families were recruited through nine fertility clinics in the UK. Standardized questionnaires assessing depression, stress and anxiety were administered to mothers and fathers in donor insemination and egg donation families. Mothers and fathers in both donor insemination and egg donation families were found to be psychologically well-adjusted; for the vast majority of parents' levels of depression, anxiety and parenting stress were found to be within the normal range at all 5 time points. Disclosure of the child's donor origins to the child was not always associated with optimal levels of parental psychological adjustment. For example, disclosure was associated with lower levels of psychological well-being for certain groups in particular (such as fathers in donor insemination families), at certain times (when children are in middle childhood and have a more sophisticated understanding of their donor origins). Owing to small sample sizes, the value of this study lies not in its generalizability, but in its potential to point future research in new directions. Donor insemination and egg donation families are a heterogeneous group, and future research should endeavour to obtain data from fathers as well as mothers. Support and guidance in terms of disclosure and family functioning might be most beneficial for parents (and especially fathers) in donor insemination families, particularly as the child grows older. The more that is known about the process of disclosure over time, from the perspective of the different members of the family, the better supported parents and their children can be. The project described was supported by grant number RO1HD051621 from the National Institute of Child Health and Human Development. The content is solely the responsibility of the authors and does not represent the official views of the National Institute of Child Health and Human Development or the National Institutes of Health. The authors have no conflict of interest to declare.

Children born through reproductive donation: a longitudinal study of psychological adjustment

Parenting and children's adjustment were examined in 30 surrogacy families, 31 egg donation families, 35 donor insemination families, and 53 natural conception families. Parenting was assessed at age 3 by a standardized interview designed to assess quality of parenting and by questionnaire measures of anxiety, depression, and marital quality. Children's adjustment was assessed at ages 3, 7, and 10 using the Strengths and Difficulties Questionnaire (SDQ). Although children born through reproductive donation obtained SDQ scores within the normal range, surrogacy children showed higher levels of adjustment difficulties at age 7 than children conceived by gamete donation. Mothers who had kept their child's origins secret showed elevated levels of distress. However, maternal distress had a more negative impact on children who were aware of their origins. The absence of a gestational connection to the mother may be more problematic for children than the absence of a genetic link.

A longitudinal study of recipients' views and experiences of intra-family egg donation

For the past 10 years, we have been carrying out a longitudinal investigation of egg donation families in the UK; a subsample of recipients in these families had a child by egg donation from a sister or sister-in-law. In response to the current debate over the practice of intra-family donation, together with the general lack of available data on the consequences of donation between family members, we examined recipients' experiences of donation between sisters and sisters-in-law. We analysed data from a subsample of recipient mothers who were taking part in a larger investigation of gamete donation families. Mothers were visited at home and interviewed when their child was aged 1, 3, 7 and 10 years. Data from nine recipient mothers whose egg donor was either their sister or sister-in-law were examined to assess the nature of mothers', fathers' and the child's relationship with the donor, and whether mothers had disclosed the nature of their child's conception to others, including the child. The majority of recipient mothers reported positive relationships between the donor and members of their family (themselves, their partner and their children). Most mothers were happy with the donor's level of involvement with the child and reported that they and the donor maintained their social roles within the family, i.e. as mother and aunt, respectively. By age 10, two children had been told that they had been conceived using egg donation, both of whom had been told the identity of the donor. Although the sample was small, this study provides the first longitudinal data on the experiences of families created using donated gametes from a family member. Intra-family donation between sisters or sisters-in-law can be a positive experience for recipients during the first 10 years following the child's birth. Studies that are specifically designed to look at donation between family members are needed to better evaluate the practice.

Secrecy, disclosure and everything in-between: decisions of parents of children conceived by donor insemination, egg donation and surrogacy

This study examined families where children lack a genetic and/or gestational link with their parents. A total of 101 families (36 donor insemination families, 32 egg donation families and 33 surrogacy families) were interviewed when the child was aged 7 years. Despite a shift in professional attitudes towards openness, about half of the children conceived by egg donation and nearly three-quarters of those conceived by donor insemination remained unaware that the person they know as their mother or father is not, in fact, their genetic parent. By contrast, almost all the surrogacy parents had told their child how they were born. A majority of parents who planned never to tell their child about their conception had told at least one other person. However, qualitative data indicated that to categorize families as ‘secret’ or ‘open’ is inadequate. In fact many parents engage in ‘layers’ of disclosure about their child’s conception, both with their child and with family and friends.

Families created through surrogacy: mother-child relationships and children's psychological adjustment at age 7.

Each year, an increasing number of children are born through surrogacy and thus lack a genetic and/or gestational link with their mother. This study examined the impact of surrogacy on mother-child relationships and children's psychological adjustment. Assessments of maternal positivity, maternal negativity, mother-child interaction, and child adjustment were administered to 32 surrogacy, 32 egg donation, and 54 natural conception families with a 7-year-old child. No differences were found for maternal negativity, maternal positivity, or child adjustment, although the surrogacy and egg donation families showed less positive mother-child interaction than the natural conception families. The findings suggest that both surrogacy and egg donation families function well in the early school years.

Egg donation parents and their children: follow-up at age 12 years

To assess the quality of parenting and psychological adjustment of egg donation families as the child approaches adolescence in comparison with donor insemination (DI) and IVF families. A study of 17 egg donation families, 35 DI families, and 34 IVF families with a 12-year-old child. Standardized interview and questionnaire measures were administered to mothers and children. Follow-up of families recruited from three assisted conception units in the United Kingdom. Mothers and their 12-year-old children conceived through egg donation, DI, and IVF. Mothers and children were interviewed and administered questionnaires. Parents' marital and psychological state, quality of parent-child relationships, father's contribution to parenting, and children's socioemotional development. No differences were found between the egg donation and IVF families. The differences between egg donation and DI families reflected lower levels of sensitive responding of egg donation mothers toward their children compared with DI mothers. Donor insemination mothers were more likely to be emotionally over-involved with their child than egg donation mothers. The egg donation children were well adjusted in terms of their social and emotional development. The findings are discussed in relation to the different pattern of genetic relationships between egg donation and DI families and the secrecy surrounding the use of donated gametes to conceive a child.

Surrogacy families: parental functioning, parent–child relationships and children's psychological development at age 2

Findings are presented of the second phase of a longitudinal study of families created through surrogacy. At the time of the child's 2nd birthday, 37 surrogacy families were compared with 48 egg donation families and 68 natural conception families on standardised interview and questionnaire measures of the psychological well-being of the parents, parent-child relationships and the psychological functioning of the child. The surrogacy mothers showed more positive parent-child relationships, and the surrogacy fathers reported lower levels of parenting stress, than their natural conception counterparts. The surrogacy children did not differ from the natural conception children with respect to socio-emotional or cognitive development. Surrogacy does not appear to impact negatively on parenting or child development in families with 2-year-old children.

Families created by gamete donation: follow-up at age 2

Findings are presented of the second phase of a longitudinal study of families created through gamete donation. At the time of the child's second birthday, 46 donor insemination families and 48 egg donation families were compared with 68 natural conception families on standardized interview and questionnaire measures of the psychological well being of the parents, parent-child relationships and the psychological development of the child. The gamete donation mothers showed a trend towards greater pleasure in their child accompanied by a perception of their child as more vulnerable, with egg donation mothers tending towards greater pleasure and donor insemination mothers tending towards greater concern. The fathers did not differ on any of the variables under study. The findings from this recent cohort add further weight to the growing body of research showing that the absence of a genetic link between a parent and a child does not necessarily jeopardize the development of a positive relationship between them.

Parenting infants conceived by gamete donation.

In recent years, concerns have been raised regarding the potentially negative consequences of gamete donation for parent-child relationships. Findings are presented of a study of families with an infant conceived by gamete donation. Fifty donor insemination families and 51 egg donation families were compared with 80 natural conception families on standardized interview and questionnaire measures of the psychological well-being of the parents, the quality of parent-child relationships, and infant temperament. The differences that were identified indicated more positive parent-child relationships among the gamete donation than the natural conception parents, accompanied by greater emotional involvement with the child. Comparisons were also carried out between the donor insemination and the egg donation parents on their experiences of gamete donation. In contrast to the findings of earlier investigations, the donor insemination and egg donation parents appeared to be more open toward disclosing the donor conception to the child. It was concluded that infants conceived by egg or sperm donation did not appear to be at risk for parenting difficulties.

To tell or not to tell: The decision-making process of egg-donation parents

Little research has examined the views of parents of children conceived as a result of the use of donated eggs (egg-donation parents) on whether, what and how to tell their children about the way in which they were conceived. Thus, the aim of the present study was to assess the pattern of disclosure in egg-donation families. A representative sample of 17 egg-donation families with a 3-8-year-old child was recruited through UK fertility clinics. All mothers were administered a standardized interview assessing the extent of their disclosure and the main reasons for their decision. Content analysis was carried out on the transcripts from the interviews with the mothers. Not one set of parents had told their child at this stage, and 47% had no intention of telling their child about the way in which they were conceived. Twenty-nine per cent intended to tell their child in the future. Nearly two-thirds had told a friend or family member. Non-disclosure largely stemmed from a desire to protect the child, a belief that there was no need to tell, and a desire to protect the mother. Reasons for intending to disclose to the child included the belief that he or she had a right to know, and to avoid disclosure from someone else. Egg-donation parents with a 3-8-year-old child appear to resemble donor insemination parents in that they tend to favour a position of non-disclosure. The findings demonstrate the importance of understanding the views of egg-donation parents themselves, if openness is to be encouraged in these families.