Children conceived using donor eggs or sperm have the same outcomes in terms of well-being as children conceived without donors.
However, they are more likely to have identity difficulties and trust issues. Secrecy and anonymity about your genetic background can have a profound impact on well-being, the authors say. They warn that children and adults conceived with donor gametes have not been targeted by the assisted reproduction industry and that more information is needed on the well-being of adults.
The study is published today in the journal British Journal of Obstetrics and Gynecology By researchers at King’s College London. The study is the first systematic review of studies investigating the psychological experiences of people conceived through sperm donation during childhood and adulthood and is the largest body of evidence for this group.
More than 70,000 donor-conceived people have been born in the UK since 1991, when records began, with a significant number unknown before then, although little is known about their long-term psychological consequences.
The review examined 50 studies and 4,666 donor-conceived children and adults, mostly from high-income, English-speaking countries, and found that most studies showed equivalent or better outcomes in donor-conceived people, including higher scores for well-being, self-esteem and warmth in relationships.
The results also showed that children fared better when they were told they had been conceived through donation at a young age. In the UK, donor anonymity has been illegal for those conceived after 2005, but children must wait until they are 18 to access the information.
However, there is no legal obligation for families to tell their children the truth about their genetic lineage. The proliferation of commercial, at-home DNA tests can reveal family secrets and yield life-changing results. Often, it is adults, who were conceived before 2005 and have no legal right to information about their genetic identity, who have been left out of research and forgotten by the fertility industry.
First author Dr Charlotte Talbot, who graduated from King’s College London and is a PhD academic at the University of Birmingham, said: “This is the largest body of evidence we have on the well-being of children and adults conceived with donors, but it is a complicated picture. While most outcomes are the same or better for this group than for people conceived without donors, qualitative studies revealed common themes related to mistrust and concerns about genetic inheritance.
Lead author Professor Susan Bewley of King’s College London said: “Donor-conceived children are always planned and wanted, as one or more of their parents would have had fertility problems. This could explain better relationships with their family. and greater well-being. However, much of the conversation about innovation in the assisted reproduction industry focuses on customers and potential parents rather than the people they want to create. “We need to be better at putting the needs and priorities of donor-conceived children at the center.”
Laura Bridgens, Founder of Donor Conceived UK (DCUK), said: “Using a gamete donor for conception is a lifelong, intergenerational process with far-reaching societal implications. DCUK welcomes this systematic review as it highlights the need to continue to consider the long-term needs and outcomes of donor-conceived individuals into adulthood. The Government and the fertility industry have a duty to listen to the voices of donor-conceived adults in order to create a future where intervention by the charitable sector is not necessary and to right the wrongs of the past.”