Making Your Decision

Is donor conception right for me/us?

This is a decision that sometimes takes a while to make.  Donor conception is not right for everyone, although it is the only way that lesbians can have a child genetically connected to one partner.  Some may feel that adoption offers a more equal situation for both women; that fostering could offer fulfillment or that remaining a couple without children is the most positive way forward. Making a decision that you feel is right for you and any children you may have, means spending some time exploring the many aspects of this decision. 

Reading and hearing other people’s experiences can be life changing when the same old thoughts and feelings keep going round in your head and you (and your partner) have run out of new approaches to the subject.

There are several things you can do –

  • Join DC Network.  In 2014, even after 21 years of DCN, we still think the most important part of our work is breaking the isolation by putting people in touch with each other.  See Benefits of Membership
  • Come on a Preparation for DC Parenthood workshop.  These are for people who have still to make up their minds if donor conception is right for them and those who have chosen to go ahead but want to learn more.
  • Read the appropriate Letters in a Planning a Family series that are aimed at would-be parents of egg or sperm donor conceived children
  • Read one or more of the books in our library that are recommended for your situation.  If you are a UK or Irish member you can borrow them free of charge.  Also read on-line, download or buy the Telling and Talking booklet for parents of children aged 0 – 7.  The beginning sections are essential reading when making your decision.

Each of us seems to be handling this differently.  Is this OK?

It can often seem that each partner has a different approache to decision making, particularly when issues have a strong emotional component. 

We all communicate differently. Stereotypes assume women like to have an on-going conversations, chat on fertility forums, research the internet and read anything they can get their hands on and these may or may not relate to your situation, or to only one of you.

Different responses by individuals and between couples are common but the stress of fertility difficulties and treatments can reveal the cracks in relationships that have not been so obvious in better times.  Alternatively, they can bring couples closer together.  The challenge is to find a way to respect each other’s way of dealing with the situation and move forward together in your decision making. 

What can help is –

  • Reading the appropriate Letters in Planning a Family series which address this topic
  • Joining DCN and coming to local meetings or national conferences where lesbian women or couples can meet separately in groups. 
  • Attending a Preparation for DC Parenthood workshop where, again, there is an opportunity for lesbians on their own or as part of a couple to meet and talk .
  • Talking with a counsellor.  They can help it feel safe to talk about things that feel scary to say.  Every UK clinic has at least one counsellor available, but you can also find someone outside of your clinic via the British Infertility Counselling Association www.bica.net

Where to have treatment

Choosing a fertility clinic can feel like a very fraught process.  If you are lucky enough to be funded for your treatment then you may have little or no choice about where your GP refers you, but as the majority of fertility procedures take place in the private sector, the choice can feel confusing and daunting.  And that is even without contemplating going abroad as many people are now doing.

In the UK we have a regulatory body, the Human Fertilisation and Embryology Authority that provides enormous amounts of information about each and every UK fertility clinic.  Read the information about the clinics that are accessible to you or carry out the particular treatment that you require (you can search on different criteria on the HFEA website www.hfea.gov.uk).  You will find that success rates are pretty similar for most clinics and what might mean most to you is how easy it is for you to get to the clinic (you will probably be going there a lot), how efficient they are (do you get fast responses to emails or ‘phone messages) and how you feel they treat you as a person.  You can tell quite a lot from an initial ‘phone call and even more by visiting in person.  Behave like a very friendly and courteous assertive consumer and ask all the questions you need to.  They are providing a service you are paying for at a very vulnerable time of your life.

Some lesbian couples prefer the idea of using a known donor, someone from their friendship group or possibly the brother of the woman who will not be carrying the baby.  If you are considering this way of conceiving it is VERY important that you spend a considerable amount of time talking with your potential donor about the expectations that each of you has for the future and that you draw up an agreement between you.  This will be taken into account, although it will not be binding, should a dispute end up in court.  Seeking legal guidance and counselling is sensible and can help facilitate arrangements that will benefit everyone.  See below for further information about known donors.

If you are thinking about going abroad, as many couples needing egg donation in particular are now doing, there is no one body that can give information about the standards and success rates in overseas clinics.  Some countries have regulatory bodies and others do not.  Most overseas clinics have doctors and staff who speak English but independent information, if it is available at all, may only be available in the local language.  It may be worth trying to get some information from the local infertility patient organization. 

See our guidance document on Donor Conception Treatment outside the UK for a comprehensive overview of the range of short and long-term issues that need thinking about when considering going abroad.

What can help when choosing a clinic is –

  • Checking out the Human Fertilisation and Embryology site www.hfea.gov.uk and then personally contacting the clinics that interest you.  Have a pre-prepared list of questions to talk with the donor co-ordinator about.
  • Talking with others who have made these decisions before you.  Forums like the private one on this site for DCN members or Fertility Friends can be a way of getting unofficial information and impressions from others going through treatment.  But you need to remember you are only getting individual experiences and points of view this way.
  • Making a spread sheet of the clinics that interest you and comparing waiting lists, prices, accessibility, availability of donors etc. 

Treatment options: 

Most clinics offer a choice of treatments which can be ranked in order of complexity, with the simplest unmedicated donor insemination (DI) or intra-uterine insemination (IUI) at one extreme, and highly medicated invitro-fertilisation (IVF) with intra-cytoplasmic sperm injection (ICSI), and egg donation, egg sharing or embryo donation at the other.  Many clinics will only offer some of these options, but you should be allowed to choose to start at a moderate level of intervention before upping the stakes if you don’t succeed, or to go straight to the top level if that’s what you prefer.  At all stages, the pricing should be clearly explained, including all the extras and options.  If you need donated eggs, you can consider the option of egg-sharing or embryo donation, which are not available everywhere.  The clinic staff should be willing to discuss all the options so you can make an informed choice.

Choosing your donor

All clinics, whether in the UK or abroad, will try to match you with a donor of a similar physical type. Beyond that, there may or may not be a choice, according to availability and/or clinic policy.  In the UK recipients can usually know something about the donor as a person and may be able to have a personal message that has been written by the donor for a child.  UK clinics vary in how much they encourage donors to write about themselves and include in this message.  Some people struggle when offered a donor who does not meet one of the criteria that feels important to them.  Sometimes this has to do with the donor’s build or colouring or sometimes their family medical history or level of education.  Whilst it can be important to feel at ease with the description of the donor one Network couple has spoken poignantly about having to let go of 'trying to create a perfect image of us'. They found that having a little bit of information about potential donors was tantalising but ultimately unhelpful. Now their children are growing up, however, they wish they had more information to pass on to them.

In most countries in Europe where UK residents go for egg donation, very little information is available about donors.  Some clinics in Spain will not even confirm if the donor is Spanish or not.  In the USA enormous amounts of information are available and there may be the possibility of girlhood photos and/or a voice message.  Identifiable donors are available via some agencies in the US.  South African egg donation agencies also offer good donor information and the possibility of contact.

Types of donor

UK clinics have varying supplies of egg, sperm & embryos: some have been successful at recruiting as many donors as they need, and others no longer recruit their own donors.  Many non-recruiting clinics have arrangements to import sperm and eggs from abroad, or they might have links with a clinic abroad where you would go for part or all of the procedure .  There are varying categories of donors, the main ones being as follows:

Anonymous donors:  these donors have been promised that the recipients and their offspring will never be given identifying information.  This is no longer allowed in the UK, but is an option in the USA and the rule in many other countries.

Identity release donors:  ID release donors are those whose identifying details will be released at a certain age to the offspring. This has been the law in the UK since April 2005, with 18 being the age at which the offspring have a right to the identifying information.  It is important to note here that this information does not guarantee that the donors can be found, as they may have moved, maybe abroad, or even no longer be alive. There can’t be any guarantee that they will be available or willing to meet your child.  Any egg or sperm imported to the UK must meet UK legal requirements, so the donors will also have agreed for their details to be released.

Known donors:  a known donor is someone whom you may have known for some time, or met with the intention of using as a donor.  Since 2009 same sex couples who are civil partners are the legal parents of any child conceived, even if this is outside of an HFEA licensed clinic.  If a couple are not civil partners then the sperm donor will be the legal father if insemination takes place privately.   Insemination with sperm from a known donor can take place at a licensed clinic, thus giving all parties the full protection of the Human Fertilisation and Embryology Act.  If contemplating using a known donor it is highly recommended that you take advice from a solicitor specialising in this area of law before going ahead, www. nataliegambleassociates.com

Family donors: this is where a family member donates their eggs or sperm.    These arrangements can provide a happy compromise when everyone is well prepared and supported.

Egg-share donors:  some clinics will offer younger women the option of donating some of their eggs in exchange for reduced charges or free fertility treatment. 

Donated embryos:   donated embryos are usually embryos that have been frozen when too many were produced in one cycle of treatment.   At a later date, the parents decide they will not be using them to increase their own family and donate them.  In this situation, your child might later discover that they have full genetic siblings and donor parents in another family.  In some overseas clinics embryos may be created from surplus eggs and sperm from a bank, rather than having been produced as a result of another woman’s treatment cycle.

Altruistic donors:  this is the term used for egg donors who are not going through a cycle of treatment themselves .  In the UK, eggs donors are compensated to the tune of £750, and sperm donors at £35 per donation. Iimported gametes should also meet this requirement but this is hard to police.  If you are going abroad, the providers of sperm or eggs may have been paid significant sums of money, which bears two risks: it may entice the donor to exaggerate their desirability (e.g. education & achievement) or minimise their flaws (e.g.family illness), or it may encourage vulnerable people to donate when they do not fully accept the implications of their action e.g. young women donating eggs without taking heed of the risks of the treatment. 

The decision about the type of donor may depend on many factors.  Do you have a brother or sister (or other close relative) who could donate to you?  Does this solution feel like one you could be comfortable with?  How would both your extended families feel about it?  Would a friend you have known all your life be the right person to help create your family or would you prefer a donor who is unknown to you but could be known to a child from age 18.  These are intensely personal decisions and good counselling can help with this.

In the interest of donor conceived people DCN campaigned for the ending of donor anonymity and the law changed to this effect in the UK from April 2005.   It is possible to find identifiable donors in some other countries but in most places overseas frequented by British people, donors are anonymous.  See the following section What about the child for comment on this.

What can help with making the decision about the type of donor –

  • Imagine the story you might tell your child at different ages about your choice.  Can you feel proud, comfortable and confident about your decision? If not, your child may not either.
  • Join DCN to be in touch with others who have considered all these options before you.  We have a group of members who are using a donor from within their family and we have other members whose donor is a family friend.  Most members attending UK clinics have used donors unknown to them but (from 2005 only) identifiable to the child from age 18.
  • Read the section in the Telling and Talking booklets about Using a Known Donor.
  • If you are seriously considering using a known donor from within or outside the family, talk this over with the counsellor at your clinic or have some independent counselling sessions as well as consulting a solictor.  These can be helpful in challenging you with difficult thoughts and feelings that may be avoided when talking as a couple or with your potential donor.  All good clinics will want all parties to the donation, including the partner of the donor, if there is one, to have counselling before going ahead with treatment.  The British Infertility Counselling Association www.bica.net can help you find an appropriately qualified counsellor.

What about the child?

As a same sex couple you are likely to be giving some thought about how to manage not having a dad in the family.  This will be something that your child will notice anytime from age two onwards, so you need to think from early on how you will answer this question and support your child in responding to the questions of others.  Research has shown that children of lesbian couples tend do very well.  If you can feel proud, comfortable and confident about the decisions you have made then your child is likely to as well.

What can help in keeping the child in mind –

  • Join DCN in order to talk with lesbian parents of donor conceived children about how they made their decisions and what life is like in a DC family.
  • Read the Telling and Talking booklets for insights into how children change in their understanding of their beginnings as they grow up.