Ethics and Policy Reproductive Ethics
RRM Academy Synopsis
Children of donor conception and surrogacy generally adjust well
Children born through egg donation, sperm donation or surrogacy generally showed high adjustment from early childhood to age 14. A review article summarizes a UK longitudinal study with this result. The parents were mostly White, well educated and financially stable.
Key Findings
- The UK study enrolled 51 egg donation, 50 sperm donation and 42 surrogacy families, plus 80 unassisted conception families, and followed them at child ages 1, 2, 3, 7, 10 and 14.
- At the 7-year assessment, 41% of egg donation parents and 28% of sperm donation parents had informed their children of their genetic origins.
- Surrogacy children had more psychological difficulties at age 7 than egg or sperm donation children. By age 10, their psychological adjustment no longer differed from that of the other children.
- At age 14, egg donation families had poorer outcomes than sperm donation families in family functioning and in mothers' acceptance of their adolescents, based on reports from mothers and adolescents.
- Adolescents with knowledge of their origins since preschool had better family relationships and psychological well-being at 14 than adolescents without such early knowledge.
Interpretation
The paper is a single-author review built around one prospective, comparative study across six phases. Group differences are associations. Researchers did not assign families to tell or withhold, and the author notes that parents who withhold may communicate less in general. Participants were predominantly White, of medium to high socioeconomic status and heterosexual couples. The author states that findings may not apply to more diverse families and that replication should be a priority. Studies of families headed by lesbian mothers, single parents and gay fathers are summarized without figures.
RRM Context
Egg donation, sperm donation and surrogacy bypass infertility. They leave open why conception did not occur, and restorative reproductive medicine evaluates both partners to find and treat that cause. The review addresses children's well-being after a family has formed. It reports nothing on how couples came to third-party conception or on evaluation of the cause of infertility.
Abstract
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.
