Non-Anonymous Donation Arrangements: Why Not?   Contemporary psychological wisdom encourages disclosure of a child's genetic history. The belief being that everyone has a right to their biological heritage and that to not disclose will cause undue damage to family relationships and a child's sense of self. This is a far cry from prior convention, which was to never tell because disclosing would jeopardize the family bond and cause a child to question his sense of belonging. This lore was past down from the worlds of traditional adoption and early sperm banking policy. It is within this context that egg donation programs have emerged and flourished.   Egg donation programs initially followed the sperm-banking model where anonymity and secrecy were the rule. Because egg donation practices are so much more involved than sperm donation, the psychological community was reluctantly invited in to offer assistance in how to best guide practitioners and potential parents through this complex reproductive option.   In time, medical experts accepted psychological thought whereby secrecy and non-disclosure was not serving the best interests of the children that were being created through these means. Educating both the medical and patient communities about the upside of avoiding family secrets became the mental health professional's challenge; however, convincing the medical practitioners has not been as simple.  We are faced with a quandary when we fast-forward to where we are now. The general consensus is that parents are becoming more comfortable with disclosing and children have a right to know about their genetic history. What information should parents have at their disposal? The burning question remains, what can parents tell if they have participated in an anonymous donation arrangement. Whether this is an informational questionnaire or some photographs, what can they really say about the woman who so generously offered her eggs.   Why is it that the screener, the doctor, the nurses, and adjunct staff all get to meet the egg donors? But those that have the greatest emotional investment in her are kept at bay. It just doesn't make sense. When a child asks about the donor, what can this parent shareÉ.an application, a few pictures and the claim that Dr. So and So thinks well of her. Why are we encouraging anonymous donations?Ê What purpose do these types of arrangements serve? The often-quoted reason is to protect patients and donors. Protect them from what? What is the threat? My claim is there is no threat and that patients and donors alike are obliged to fully disclose all pertinent information to the children they are collectively creating.   This responsibility can only be fulfilled by both recipients and donors actually meeting one another at the outset and making an informed decision regarding whether they want to proceed with the process of donation. It also allows parents to create a warm and sensitive birth story to share with their children. Recipients have a responsibility to their child and to themselves to meet their donor and feel good about the eggs they are about to embrace. Needless to say, donors also have an obligation to offer their eggs to people they respect in an effort to minimize future doubts or regrets about the individuals they have helped become parents. I have donors report that meeting their recipients makes their entire experience more personal and meaningful. In the same vein recipients report a burden of shame being lifted from their shoulders when they actually meet their donor.   Another, often mentioned, concern reported by agencies has to do with the egg donor pool drying up and that there will be a paucity of donors if they were required to donate non-anonymously. Granted there may be some donors who would choose not to donate but there are sure to be others that would welcome the prospect of meeting their recipient. Perhaps, it might even open the donation doors and bring in donors that were previously disturbed by the anonymity policy of many programs.   One of the biggest obstacles to non-anonymous arrangements is shame. It drives patients underground with their fertility secret causing them to avert facing their reproductive struggles openly. Because they have failed to procreate in the traditional sense, they metaphorically bury their head in the sand toting the adage Òout of sight out of mindÓ. If the donor is not seen, then she doesn't really exist. Not a particularly healthy approach to building a family.   Yet another misconception regarding open donation is the belief that anonymity fosters protection. This is the rhetoric of many donation programs. The claim is that children will fare better if arrangements are made anonymously, assuming anonymity will not challenge a family's legitimacy. It guards against a donor from intruding and laying claim to the child. Needless to say, donors don't donate because they want children nor are they interested in the recipient's child. Open donation does not threaten a mother's struggle with entitlement as the authentic parent, in fact, it allows her to face her perceived nemesis and prevent the family from forever being haunted by the donor's imagined presence.   As mental health professionals, we have an obligation to our patients and the medical practitioners we work with and that is to call into question policies of secrecy and anonymity and help our patients acknowledge their truths by approaching egg donation with all eyes wide open. There is not better way to do this than by donor and recipient looking into one another's eyes exchanging smiles, sentiments of gratitude, warm feelings as well as apprehensions. Let's not go along with what many of us know in our heart of hearts is not in the psychological best interests of the families we are all helping to build. If secrecy is unhealthy and disclosure is healthy-then how in the world does anonymity make sense?

Non-Anonymous Donation Arrangements: Why Not?

Contemporary psychological wisdom encourages disclosure of a child's genetic history. The belief being that everyone has a right to their biological heritage and that to not disclose will cause undue damage to family relationships and a child's sense of self. This is a far cry from prior convention, which was to never tell because disclosing would jeopardize the family bond and cause a child to question his sense of belonging. This lore was past down from the worlds of traditional adoption and early sperm banking policy. It is within this context that egg donation programs have emerged and flourished.

Egg donation programs initially followed the sperm-banking model where anonymity and secrecy were the rule. Because egg donation practices are so much more involved than sperm donation, the psychological community was reluctantly invited in to offer assistance in how to best guide practitioners and potential parents through this complex reproductive option.

In time, medical experts accepted psychological thought whereby secrecy and non-disclosure was not serving the best interests of the children that were being created through these means. Educating both the medical and patient communities about the upside of avoiding family secrets became the mental health professional's challenge; however, convincing the medical practitioners has not been as simple.

We are faced with a quandary when we fast-forward to where we are now. The general consensus is that parents are becoming more comfortable with disclosing and children have a right to know about their genetic history. What information should parents have at their disposal? The burning question remains, what can parents tell if they have participated in an anonymous donation arrangement. Whether this is an informational questionnaire or some photographs, what can they really say about the woman who so generously offered her eggs.

Why is it that the screener, the doctor, the nurses, and adjunct staff all get to meet the egg donors? But those that have the greatest emotional investment in her are kept at bay. It just doesn't make sense. When a child asks about the donor, what can this parent shareÉ.an application, a few pictures and the claim that Dr. So and So thinks well of her. Why are we encouraging anonymous donations?Ê What purpose do these types of arrangements serve? The often-quoted reason is to protect patients and donors. Protect them from what? What is the threat? My claim is there is no threat and that patients and donors alike are obliged to fully disclose all pertinent information to the children they are collectively creating.

This responsibility can only be fulfilled by both recipients and donors actually meeting one another at the outset and making an informed decision regarding whether they want to proceed with the process of donation. It also allows parents to create a warm and sensitive birth story to share with their children. Recipients have a responsibility to their child and to themselves to meet their donor and feel good about the eggs they are about to embrace. Needless to say, donors also have an obligation to offer their eggs to people they respect in an effort to minimize future doubts or regrets about the individuals they have helped become parents. I have donors report that meeting their recipients makes their entire experience more personal and meaningful. In the same vein recipients report a burden of shame being lifted from their shoulders when they actually meet their donor.

Another, often mentioned, concern reported by agencies has to do with the egg donor pool drying up and that there will be a paucity of donors if they were required to donate non-anonymously. Granted there may be some donors who would choose not to donate but there are sure to be others that would welcome the prospect of meeting their recipient. Perhaps, it might even open the donation doors and bring in donors that were previously disturbed by the anonymity policy of many programs.

One of the biggest obstacles to non-anonymous arrangements is shame. It drives patients underground with their fertility secret causing them to avert facing their reproductive struggles openly. Because they have failed to procreate in the traditional sense, they metaphorically bury their head in the sand toting the adage Òout of sight out of mindÓ. If the donor is not seen, then she doesn't really exist. Not a particularly healthy approach to building a family.

Yet another misconception regarding open donation is the belief that anonymity fosters protection. This is the rhetoric of many donation programs. The claim is that children will fare better if arrangements are made anonymously, assuming anonymity will not challenge a family's legitimacy. It guards against a donor from intruding and laying claim to the child. Needless to say, donors don't donate because they want children nor are they interested in the recipient's child. Open donation does not threaten a mother's struggle with entitlement as the authentic parent, in fact, it allows her to face her perceived nemesis and prevent the family from forever being haunted by the donor's imagined presence.

As mental health professionals, we have an obligation to our patients and the medical practitioners we work with and that is to call into question policies of secrecy and anonymity and help our patients acknowledge their truths by approaching egg donation with all eyes wide open. There is not better way to do this than by donor and recipient looking into one another's eyes exchanging smiles, sentiments of gratitude, warm feelings as well as apprehensions. Let's not go along with what many of us know in our heart of hearts is not in the psychological best interests of the families we are all helping to build. If secrecy is unhealthy and disclosure is healthy-then how in the world does anonymity make sense?