The aim of this study was to examine whether there was variation in levels of psychological adjustment among children conceived through Assisted Reproductive Technologies using the parents’ gametes (homologous), sperm donation, egg donation, embryo donation and surrogacy. Information was provided by parents about the psychological functioning of 769 children aged 5 to 9 years who had been born using ART (from the five groups described). Comparisons were made between the different conception groups, to UK national norms and, for a sub-sample of multiple births, to an age-matched twin sample. No differences were found between the conception groups except that fathers from the egg donation group rated children higher in conduct problems compared to other ART groups. No effects were observed by ART treatment type (ICSI vs. IVF, GIFT and IUI). There was some evidence of lower conduct problems and prosocial behaviour among children conceived through homologous IVF compared to national norms. Taken together, however, consistent differences between groups and in comparison to naturally conceived children were not apparent for mother- or father-rated adjustment problems. Children conceived with assisted reproductive technologies, regardless of whether they are genetically related or unrelated to their parents or born by gestational surrogacy do not differ in their levels of psychological adjustment. Nor do they appear to be at greater risk of psychological adjustment problems in middle childhood compared to naturally conceived children.
Adams DH et al., 2022·Journal of developmental origins of health and disease
While donor-conceived children have similar mental health outcomes compared to spontaneously conceived children, there is an inconsistency between studies investigating mental health outcomes of donor-conceived people in adulthood. This study is an online health survey that was completed by 272 donor sperm-conceived adults and 877 spontaneously conceived adults from around the world. Donor sperm-conceived adults had increased diagnoses of attention deficit disorder (P = 0.004), and autism (P = 0.044) in comparison to those conceived spontaneously. Donor sperm-conceived adults self-reported increased incidences of seeing a mental health professional (P < 0.001), identity formation problems (P < 0.001), learning difficulties (P < 0.001), panic attacks (P = 0.038), recurrent nightmares (sperm P = 0.038), and alcohol/drug dependency (P = 0.037). DASS-21 analysis revealed that donor sperm-conceived adults were also more stressed than those conceived spontaneously (P = 0.013). Both donor sperm and spontaneously conceived cohorts were matched for sex, age, height, alcohol consumption, smoking, exercise, own fertility, and maternal smoking. The increase in adverse mental health outcomes is consistent with some studies of donor-conceived adult mental health outcomes. These results are also consistent with the Developmental Origins of Health and Disease (DOHaD) phenomenon that has linked adverse perinatal outcomes, which have been observed in donor-conceived neonates, to increased risk of chronic disease, including mental health. Further work is required to reconcile our observations in adults to contrary observations reported in donor-conceived children.
Ever since the birth of the first baby born through in vitro fertilization in 1978, advances in reproductive technologies have raised new concerns about the outcomes for children. In this article, I summarize research on children born through assisted reproduction involving a third party, that is, children born through egg donation, sperm donation, and surrogacy, with particular attention to the findings of a longitudinal study of children born to heterosexual couples in the United Kingdom. The assisted reproduction families generally showed high levels of family functioning and children's adjustment from early childhood through to adolescence, suggesting that biological relatedness is less important than positive parent-child relationships for the well-being of children conceived by third-party assisted reproduction. Similarly, studies of families created by third-party reproduction with two mothers, single mothers, two fathers, and single fathers have shown that these families function well.
Donor Gametes and Surrogacy · Donor Conceived Outcomes
Ilioi E et al., 2017·Journal of child psychology and psychiatry, and allied disciplines
The question of whether children should be told of their biological origins is one of the most controversial issues regarding the birth of children through donated eggs, sperm, embryos or surrogacy. In the sixth phase of this longitudinal study when the children were aged 14 years, family relationships and adolescent adjustment were examined in 87 families created through reproductive donation and 54 natural conception families. The quality of family relationships was assessed by standardised interview with mothers and by standardised questionnaires and an observational measure with mothers and adolescents. Adolescent adjustment was assessed using standardised questionnaires. Systematic information on whether and when parents had told children about their biological origins was obtained at earlier phases of the study. There were no overall differences between disclosing families and either nondisclosing or natural conception families. However, within the disclosing families, more positive family relationships and higher levels of adolescent wellbeing were found for adolescents who had been told about their biological origins before age 7. The earlier children born through reproductive donation are told about their biological origins, the more positive are the outcomes in terms of the quality of family relationships and psychological wellbeing at adolescence.
Donor Gametes and Surrogacy · Donor Conceived Outcomes
Pregnancies achieved from oocyte, sperm or embryo donation are unique, since they have resulted from donor gametes that are immunologically foreign to the mother. Thus, studying the obstetric outcome of such pregnancies may shed some light on the pathophysiology of preeclampsia, particularly in women conceiving with donated embryos, since the entire fetal genome is allogenic in these pregnancies. In this retrospective cohort study, a total of 144 women were studied. Of these, 72 were infertility patients who had conceived as a result of sperm, ovum or embryo donation and the other 72 women were age- and parity-matched control patients who became pregnant with their own gametes, either spontaneously, or following intrauterine insemination with their partner's spermatozoa. Study patients were divided into three groups depending on the origin of the donated gametes. Group 1 consisted of pregnancies achieved by intrauterine insemination with washed donor spermatozoa (n = 33). Group 2 included women who conceived using donated oocytes (n = 27) and group 3 consisted of women who conceived as a result of embryo donation (n = 12). The incidence of pregnancy-induced hypertension in the donated gametes study group was 12.5% (9/72) compared with 2.8% (2/72) in the control group. In addition, pre-eclampsia was diagnosed in 18.1% (13/72) of the donated gametes study group compared to 1.4% (1/72) in the age- and parity-matched controls. The increased incidence of gestational hypertension in pregnancies resulting from donated gametes gives evidence for a maternal genetic component, with an equally strong fetal influence, in the complicated aetiology of gestational hypertension, and pre-eclampsia in particular.