Children conceived by using egg or sperm donors have the same well-being outcomes as non-donor conceived people.
However, they are more likely to have identity difficulties and issues with trust. Secrecy and anonymity about their genetic parentage can have a profound impact on well-being say authors. They warn that children and adults conceived using donor gametes have not been centered in the assisted reproductive industry and more information is needed about adult wellbeing.
The study is published today in the British Journal of Obstetrics and Gynaecology by researchers King's College London. The study is the first systematic review of studies investigating the psychological experiences of donor conceived people through 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, and a significant unknown number before this date, however little is known about their long-term psychological outcomes.
The review looked at 50 studies and 4,666 donor conceived children and adults, mostly from high-income Anglophone countries, and found most studies showed equivalent or better outcomes in donor conceived people including higher wellbeing scores, self-esteem and relationship warmth.
The findings also showed children fared better when they were told they were donor conceived early. In the UK, donor anonymity has been against the law for those conceived after 2005 but children must wait until they are 18 years old to access information.
However, there is no legal requirement for families to tell their children the truth about their genetic lineage. The proliferation of at-home commercial DNA testing can reveal family secrets and yield life-changing results. It is often adults, who were conceived before 2005 and have no legal right to information about their genetic identity, who have been left out of the research and been left behind by the fertility industry.
First author Dr Charlotte Talbot, who graduated from King's College London and is an Academic Foundation Doctor, affiliated with the University of Birmingham, said: "This is the largest body of evidence we have for wellbeing for donor conceived children and adults but it's a complicated picture. While most outcomes are the same or better for this group than non-donor conceived people, qualitative studies revealed common themes relating to mistrust and concerns about genetic heritage."
Donor conceived children are always planned for and wanted, as one or more of their parents would have had fertility issues. This might explain better relationships with their family and higher wellbeing. However, much of the conversation around innovation in the assisted reproductive industry concentrates on the customers and potential parents rather than the people they want to create. We need to be better about putting donor conceived offspring's needs and priorities at the center."
Susan Bewley, Senior Author, Professor, King's College London
Laura Bridgens, Founder of Donor Conceived UK (DCUK), said: "The use of a gamete donor for conception is a life-long intergenerational process with far reaching social implications. DCUK welcomes this systematic review as it highlights the necessity for further consideration for the long-term needs and outcomes of donor conceived people into adulthood. There is a duty of care by the government and the fertility industry to listen to the voices of adult donor conceived people to create a future in which charity sector intervention is not needed to repair the mistakes of the past."
The paper, Comparing the psychological outcomes of donor and non-donor conceived people: A systematic review, can be read in the British Journal of Obstetrics and Gynaecology.
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