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Fertility counsellors consider complex
Participation in the Australian and New Zealand Infertility Counsellors’ Association (ANZICA) webinar program has continued to grow with an excellent response to the most recent presentation in May exploring relationships between embryo donors and recipients and reflecting on the evolution of counselling practice in this field of assisted reproduction.
Guest speaker in the webinar was Dr Sonja Goedeke, a senior lecturer and clinical psychologist at the Auckland University of Technology, whose research focus includes psychosocial and ethical implications of assisted reproductive technologies.
Dr Goedeke said that while embryo donation could be a cost- effective, technically straightforward solution for both donors (who may have ‘surplus’ embryos remaining after treatment) and intending parents/recipients wishing to have a child, it remains a complex practice.
Some counsellors prefer to refer to embryo donation as pre- natal embryo adoption to acknowledge additional complexities association with this treatment. However, ANZICA retains the more clinical and research-based nomenclature of embryo donation.
Embryo donation is legal in all Australian States and in New Zealand, but practice and standards are informed and shaped by local legislation, for example in WA, SA, Victoria, NSW and NZ.
There are also guidelines for this treatment including those of ANZICA, which state that the health and wellbeing of children born as a result of embryo donation should be considered paramount, and that donor offspring should be made aware of their genetic origins and be able to access information on their donors.
The National Health and Medical Research Council (NHMRC) also has guidelines relating to the health and psychological well-being of all participants, while the RTAC Code of Practice stipulates that all parties have counselling prior to treatment, in part to identify any potential risk factors.
Dr Goedeke said there was limited international followup research in relation to embryo donation, but she reflected on the results of a small New Zealand study
involving 22 donors (10 couples and two individuals) and 15 recipients (five couples and five individuals). Outcomes included:
• recognition that genetic links between donors and donor-conceived offspring can be held to “bestow immutable social ties” and that knowledge about genetics may be seen as critical in terms of identity and well-being;
• identification of parallels with adoption experiences;
• donors and recipients refer to donors in relation to offspring
as “extended family”; and
• implications in comparing embryo donation as giftgiving versus mutual exchange.
Sonja Goedeke
Highlighting psychosocial issues between donors and recipients and life course implications of forming families in this way
In relation to genetics, donors in the NZ study were clear that the recipients were the parents, but also considered resulting offspring as “partly theirs” with a desire for open identity and disclosure. Recipients acknowledged donor connections and had a desire to best manage disclosure and openness.
In comparing embryo donation with adoption, donors felt donation was easier emotionally than relinquishing a child they had gestated, but they expressed some concerns about the lack of formal parenting assessment of recipients. For recipients, a significant benefit of embryo donation was the ability to experience the full journey of pregnancy, birth and parenting, seemingly more like a “normal family.”
In terms of creating an ‘extended family’ through embryo donation, donors felt this concept allowed them to maintain an interest and have a degree of ongoing involvement, but with clear boundaries.
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