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(and Four Strategies for Hopeful Recipient Parents to Begin to Address Them)
Donor eggs are gametes provided by someone else to assist individuals or couples facing infertility building their families. Donor eggs are typically utilized due to significant female factor infertility (like diminished ovarian reserve, advanced age, premature ovarian failure, etc.), genetic issues, or those in need of eggs due to family makeup, gender identity or sexuality. Donor eggs are often the route chosen to enhance the likelihood of successful conception and pregnancy for those who might be otherwise unable to conceive and birth a healthy child.
Donor eggs are often floated as an idea within the infertility world and providers who serve hopeful gay dads-to-be pursuing surrogacy. Rarely are the full implications of using donor eggs discussed or all options surrounding donor eggs explored. Unfortunately, this limits future parents' abilities to examine how donor conception may shape their family and their future child's life.
There are a number of ethical issues with donor eggs - and not all routes to parenthood through donor egg IVF are created ethically equal. There are many ethical and moral issues when it comes to donor conception and how donor-conceived people (DCPs) , donors and recipient/intended parents are treated. Some of these will only be addressed by policy reform on state and federal levels - and I fully support the amazing advocates fighting for those changes. This post will dive into four ethical issues (which is not all of them!) and some ways future parents can mitigate these particular ethical issues to a certain degree as they continue on their journey.
1. Troubling donor recruitment tactics
Certain egg donor programs will recruit young donors using questionable methods. Often recruiting off college campuses and turning to social media platforms to showcase the items that could be purchased with the monetary compensation for donating (i.e. dancing on TikTok with designer purses). These tactics work to get donors in the door but are not necessarily aimed at attracting donors who are focused on helping build families or those who recognize the implications for themselves and any future children (donor-conceived and raised).
How to mitigate this concern?:
When choosing to pursue donor conception with donor eggs, don’t just look at what the program uses to recruit you, the hopeful intended parent - but what they use to recruit donors.
Read the webpages geared toward donors including the FAQ page
Check their social media accounts (especially on TikTok)
Check their name as a hashtag (i.e. #TheGreatVirginiaEggDonorBank) and search it as a keyword (i.e. "The Great Virginia Egg Bank"
Look at who has tagged them (they’ll use donors as influencers)
Now, notice what they are using as motivators to donate. Making money/buying expensive things or helping build family? Is there any information about the implications for being the genetic parent of donor-conceived children? Is there any support for donors post-donation? Are they discussing how updated information will be disseminated or if donors and intended parents (and donor-conceived people) can contact each other?
If you see things that concern you, this may be one area you can think more about.
2. lack of informed consent
Implications counseling and psychoeducation is not always enough - for donors or for recipient parents. For example, the future donor-conceived child’s potential desire to know more about their genetic parent/family, as well the need for medical history updates after the date of donation are not always discussed at length either party. Not all recipients and donors fully informed about the benefits of disclosed donation and many are not even given the option of disclosed donation (plenty of donor programs still only seek unidentified donors.) The donor-conceived child's future needs and desires are not always discussed either. When the focus is on creating a child, as opposed to creating and the many years ahead for that child, there's far more likelihood for a fully-informed decision.
How to mitigate this concern?:
Make it your job to learn about donor conception from sources beyond your bank/clinic/provider. USDCC is chock full of great information to start out.
Read up on what donor-conceived adults and allies have been advocating for regarding access to their information, their parent(s)’ donor, etc. If you like data over anecdotes, take a look at the We Are Donor Conceived surveys and see what large groups of DCPs are saying.
If a disclosed donor feels uncomfortable, consider exploring it more with a consult through Donor Conceived Community before making a decision.
3. Lack of regulation
There are huge legal gaps and little oversight regarding donor conception within the United States. While there are some FDA requirements in place for managing gametes from a medical handling perspective (like STD testing), there are no legal limits on the number of children than can be created from one donor, no requirements to verify medical history, and no limits on the number of egg retrievals. The majority of “rules” are actually guidelines from the American Society for Reproductive Medicine. While all professionals are expected to follow them, are no legal consequences for not doing so.
How to mitigate this concern?:
Support the amazing advocacy work being done by the DCP and allied community!
Work with providers who appear reputable and most aligned with best practices, including updating medical information, listening to donor-conceived people, supporting disclosed donors, etc.
Work to grasp the limitations and realities of an under-regulated industry and make decisions through that lens.
Thoroughly read any contracts provided to you and consider going through them with a qualified attorney through the Academy for Adoption and ART Attorneys (AAAA). While your contract may be "standard," it may still have pieces that concern you when you read them.
4. ignoring Donor-conceived voices
Many donor-conceived people and their allies have been incredible advocates and quite vocal about their concerns with the fertility industry. While some providers have made practice changes based on the lived experiences of DCPs and the research that they’ve done, others have attempted to downplay these concerns. There continue to be providers promoting anonymous donation, secrecy and other deeply concerning practices. Why? Likely in the name of profits. There are messages that DCPs are preventing those facing infertility and LGBTQ+ family building from becoming parents - when, in fact, plenty of DCPs are fighting for safer practices for those families and the children they create.
How to mitigate this concern?:
Make it your business to listen to the voices of donor-conceived voices and their allies - and not just the “grateful” ones or the “happy” ones (often used for marketing!) Listen to the voices that are difficult for you to hear. Read their books, listen to their podcasts, follow their accounts, read the We Are Donor-Conceived surveys. Take it in. If you find yourself saying, "well, that's terrible but I'm the exception to the rule," because it's uncomfortable, ask yourself why you're the exception. What choices are you making that make you that exception? Will your child agree you're the exception? After doing this work, review the practices of the providers you’re considering, ask the tough questions, and see how aligned they are with what you’ve learned from donor-conceived people and their allies.
In conclusion, as a recipient or intended parent through donor conception, you hold more power than you may know - both as the "consumer" when pursuing donor eggs, and as the parent to future donor-conceived people. Remember that power as you make your difficult decisions. I'm rooting for you.
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