Modern science has made it is possible for a child to be genetically and non-genetically related to five parents at the same time: the intended parents, the egg donor, the sperm donor and the gestational carrier. The many combinations of how to conceive and carry a child are daunting in their complexity and they have deep implications for the the individual, couple, unborn and future child, children already existing and extended family members. A diagnosis of infertility is the first step in the process of alternative family building and each of the options available to prospective parents needs careful and thorough consideration.
The extent to which an individual and couple are ready to move on to alternative ways of bringing a child in to the world is dependent on their ability to grieve the loss of reproduction in the traditional manner. The implications of being unable to typically conceive a child are vast and may include shock, fear, depression, shame, anxiety, and a loss of a sense of self. A genetically linked child is the optimal outcome for most people who desire to have a family and coping with loss due to infertility is an important step before moving on to options that include egg, sperm and embryo donation and surrogacy.
Sperm donation has been done for approximately 100 years and only in the past 30 years has egg donation been an option. Embryo donation is also relatively a new option but the number of embryos is limited due to most parents choosing not to donate. Sperm donation is considered easier than egg donation in that sperm production does not involve invasive medical procedures. Egg donation involves medical intervention to stimulate egg production after which, the eggs are extracted for fertilization. There are differences in how men and women react to an infertility diagnosis and it is important to take those differences in to consideration when presented with the idea of sperm, egg and embryo donations and surrogacy.
There are many factors to consider when contemplating the use of donor sperm, eggs, embryos and a surrogate. Each individual is seen at some point in the process as the patient and is therefore, the focus of attention. With that in mind, there is a constant shift of focus from a hope for a normally conceived child to an infertility diagnosis, to a sense of loss, to alternative options, to making the best/most informed choice, to understanding the legal, cultural, financial, religious issues, to a loss of control, to trust and ultimately to having a baby. The importance of having guidance through this process cannot be stressed enough. Individuals and couples facing the use of donors and surrogates cannot possibly contemplate all the issues that can arise, therefore psychoeducation and emotional support are essential components for making the experience as positive an empowering as possible.