Embryo Donor Conception

Background

I have recently conducted a research project called Decision Making about Embryos in Australia with my colleague Clare Bartholomaeus. This research involved interviews with people, including:

  • Embryo donors and those seeking to donate
  • Embryo recipients and those seeking donors
  • People with embryos in storage or previously in storage
  • Egg donors where resulting embryos were donated to a third party

The interviews focused on a range of key issues, including decision making practices for those who donate or receive embryos, the emotion work involved for both donors and recipients with regards to embryo donation, how kinship ties are understood in the context of embryo donation, and the role of clinics and counselling services in supporting donors, recipients, and donor conceived children.

A full list of my research publications on the topic of embryo donor conception can be found further down the page.

Applications of research findings for practitioners

Our research on embryo donations suggests a number of clear implications for practice, specifically in the field of reproductive counseling. Embryo donation may often bring with it a future orientation, which requires careful managing in the context of counseling prior to donation. Specifically, given that there is no guarantee that children will be born from donations, and even if children are born, and depending on the legislative context, there is no guarantee that they will make contact with donors (or be interested in a kinship relationship). This suggests that entrenched narratives of kinship, whilst potentially applicable in some donor conception contexts, may be entirely inapplicable in other contexts. In other words, it cannot be known ahead of time if children will wish to make contact with donors, and even if they do, what the nature of the relationship will be. This suggests the importance of donors being aware that donating genetic material is not a promissory note: it is no guarantee of any particular outcome.

Applications of research findings for (intending) embryo donors and recipients

In terms of embryo donation, our research would suggest that embryo donation can be emotionally challenging for some women. This is not to suggest that it is inherently more challenging when compared to sperm donation. Rather, it is to suggest that embryo donation typically occurs as a result of women doing IVF, which typically brings its own emotional challenges. Women who undertake IVF for their creating their own families and who later donate remaining embryos may have experienced multiple engagements with fertility counselors, and may experience ‘counselling fatigue’, meaning that some of the topics that could be important to address are ignored or overlooked. This may include being emotionally prepared for the birth of a child, and knowing how to speak to children about embryo donation. This would suggest that fertility counseling in the context of embryo donation requires a specific skill set capable of addressing a range of emotional challenges, including those that may be a product of previous engagements with assisted reproductive technologies.

Resources for practitioners

Australian

The Australian and New Zealand Infertility Counsellors Association. (2018). Guidelines for professional standards of practice: Infertility counselling. Revised 31st August 2018.

The Australian and New Zealand Infertility Counsellors Association. (2007). ANZICA position paper – donor embryos.

The Fertility Society of Australia

Fitzgerald, O., Harris, K., Paul, R. C., & Chambers, G. M. (2017). Assisted reproductive technology in Australia and New Zealand 2015. Sydney: National Perinatal Epidemiology and Statistics Unit, the University of New South Wales.

Fitzgerald, O., Paul, R. C., Harris, K., & Chambers, G. M. (2018). Assisted reproductive technology in Australia and New Zealand 2016. Sydney: National Perinatal Epidemiology and Statistics Unit, the University of New South Wales.

National Health and Medical Research Council. (2017). Ethical guidelines on the use of assisted reproductive technology in clinical practice and research. Canberra: National Health and Medical Research Council.

Legislation on embryo donation in Australia (guide only)

International

ACART (Advisory Committee on Assisted Reproductive Technology) (Aotearoa/New Zealand) – Proposed Donation Guidelines: for family gamete donation, embryo donation, use of donated eggs with donated sperm and surrogacy: consultation document.

Resources for (intending) embryo donors and recipients

Australian
Embryo donation/ART – government sources

Government of South Australia – SA Health – Donor conception register

NSW – Health – The central register

Embryo donation/ART – additional sources

AccessAustralia – Australia’s National Infertility Network

AccessAustralia – Australia’s National Infertility Network – Fact sheet: Donor embryo

Are you donor conceived?

Australian Donor Conception Network

Egg Donor Angels – Embryo donation

Embryo Donation Network

Health Law Central – Gamete and embryo donation

Reproductive Technology Council (WA) – Donor assisted conception

Victorian Assisted Reproductive Treatment Authority (VARTA) (Victoria) – Donor conception

Victorian Assisted Reproductive Treatment Authority (VARTA) (Victoria) – Thinking of donating sperm, eggs or embryos?

Forums

AccessAustralia – Australia’s National Infertility Network – Community forum

Australian Donor Conception Forum

Bub Hub – Fertility assistance

Egg Donation Australia (forum)

Essential Baby – Donor conception support

Solo Mums by Choice Australia – Our forum

International

Donor Conception Network (UK)

Donor Sibling Registry

Embryo Adoption Awareness Centre (US)

Government of Canada – Egg, sperm and embryo donation (Canada)

Human Fertilisation & Embryology Authority (UK) – Donating your embryos

Human Fertilisation & Embryology Authority (UK) – Using donated eggs, sperm or embryos in treatment

Infertility Network (Canada)

National Embryo Donation Center (US)

National Gamete Donation Trust (UK) – Embryo donor

National Registry for Adoption (US) – Embryo adoption

National Registry for Adoption (US) – Embryo donation

Nightlight Christian Adoptions (US)

Books/sources with personal stories

ABC Australian Story – Lexie’s village

Carolyn Martinez – Our donor baby

Embryo Donation Network – Donor

Embryo Donation Network – Recipient

Embryo Donation Network – Donor conceived children

Lovett, N. (2017). Lexie’s village: A new kind of family. Paddington, NSW: RZ Publishing.

Picture books

Assisted Reproduction: Books for Children – Embryo donation

Creating a Family: The National Infertility & Adoption Education Nonprofit – Books for children conceived through embryo donation

My research publications

Bartholomaeus, C., & Riggs, D.W. (2019). Embryo donation and receipt in Australia: Views on the meanings of embryos and kinship relations. New Genetics and Society, 38(1), 1-17.

Riggs, D.W. (forthcoming). Diverse pathways to parenthood: From narratives to practice. Elsevier.

Other research publications (selected)

Australian

Access Australia. (2008). The utilisation and meaning of human embryos and eggs: A survey of Access Australia members. Rhodes, NSW: Access Australia.

Chandler, E., Stuhmcke, A., Millbank, J., & Karpin, I. (2013). Rethinking consent, information giving and counselling concerning stored embryos within IVF treatment. Journal of Law and Medicine, 20, 759-772.

de Lacey, S. (2005). Parent identity and ‘virtual’ children: why patients discard rather than donate unused embryos. Human Reproduction, 20(6), 1661-1669.

de Lacey, S. (2007). Decisions for the fate of frozen embryos: Fresh insights into patients’ thinking and their rationales for donating or discarding embryos. Human Reproduction, 22(6), 1751-1758.

de Lacey, S. (2007). Patients’ attitudes to their embryos and their destiny: social conditioning? Best Practice & Research Clinical Obstetrics & Gynaecology, 21(1), 101-112.

de Lacey, S., & Norman, R.J. (2004). What should we do with donated embryos that may be genetically affected? Human Reproduction, 19(5), 1065-1068.

de Lacey, S., Rogers, W., & Richards, B. (2010). Directed embryo donation: Free choice or discrimination? Journal of Law and Medicine, 18(1), 169-177.

Fuscaldo, G., Russell, S., & Gillam, L. (2007). How to facilitate decisions about surplus embryos: Patients’ views. Human Reproduction, 22(12), 3129-3138.

Hammarberg, K., Johnson, L., & Petrillo, T. (2011). Gamete and embryo donation and surrogacy in Australia: The social context and regulatory framework. International Journal of Fertility & Sterility, 4(4), 176-183.

Hammarberg, K., & Tinney, L. (2006). Deciding the fate of supernumerary frozen embryos: a survey of couples’ decisions and the factors influencing their choice. Fertility and Sterility, 86(1), 86-91.

Kirkman, M. (2003). Egg and embryo donation and the meaning of motherhood. Women & Health, 38(2), 1-18.

Kirkman, M. (2003). Parents’ contributions to the narrative identity of offspring of donor-assisted conception. Social Science & Medicine, 57(11), 2229-2242.

Kirkman, M. (2008). Being a “real” mum: Motherhood through donated eggs and embryos. Women’s Studies International Forum, 31(4), 241-248.

Kovacs, G.T., Breheny, S.A., & Dear, M.J. (2003). Embryo donation at an Australian university in-vitro fertilisation clinic: Issues and outcomes. Medical Journal of Australia, 178(3), 127-129.

McMahon, C.A., & Saunders, D.M. (2009). Attitudes of couples with stored frozen embryos toward conditional embryo donation. Fertility and Sterility, 91(1), 140-147.

Millbank, J. (2018). The role of professional facilitators in cross-border assisted reproduction. Reproductive Biomedicine & Society Online, 6, 60-71.

Millbank, J. (Online First 2018). What is the responsibility of Australian medical professionals whose patients travel abroad for assisted reproduction? Medical Law Review.

Millbank, J., Chandler, E., Karpin, I., & Stuhmcke, A. (2013). Embryo donation for reproductive use in Australia. Journal of Law and Medicine, 20, 789-810.

Millbank, J., Stuhmcke, A., Karpin, I., & Chandler, E. (2013). Enhancing reproductive opportunity: A study of decision-making concerning stored embryos. Report. University of Technology Sydney.

Millbank, J., Stuhmcke, A., & Karpin, I. (2017). Embryo donation and understanding of kinship: The impact of law and policy. Human Reproduction, 32(1), 133-138.

Millbank, J., Stuhmcke, A., Karpin, I., & Chandler, E. (2013). Enhancing reproductive opportunity: A study of decision-making concerning stored embryos. Report. University of Technology Sydney.

International

Amor, D.J., Kerr, A., Somanathan, N., McEwen, A., Tome, M., Hodgson, J., & Lewis, S. (2018). Attitudes of sperm, egg and embryo donors and recipients towards genetic information and screening of donors. Reproductive Health, 15(1).

Applegarth, L.D. (2006). Embryo donation: Counseling donors and recipients. In S.N. Covington & L.H. Burns (Eds.), Infertility counseling: A comprehensive handbook for clinicians (2nd ed., pp. 356-369). Cambridge, UK: Cambridge University Press.

Aznar-Lucea, J., Martínez-Peris, M., & Navarro-Illana, P. (2016). Frozen embryo adoption. TheraPeía, 8, 103-120.

Baccino, G., Salvadores, P., & Hernández, E.R. (2014). Disclosing their type of conception to offspring conceived by gamete or embryo donation in Spain. Journal of Reproductive and Infant Psychology, 32(1), 83-95.

Baldassi, C. (2006). Babies or blastocysts, parents or progenitors?: Embryo donation and the concept of adoption. Master of Laws unpublished dissertation, University of British Columbia.

Bangsbøll, S., Pinborg, A., Andersen, C.Y., & Andersen, A.N. (2004). Patients’ attitudes towards donation of surplus cryopreserved embryos for treatment or research. Human Reproduction, 19(10), 2415-2419.

Blyth, E. (2012). Guidelines for infertility counselling in different countries: Is there an emerging trend? Human Reproduction, 27(7), 2046-2057.

Blyth, E., Frith, L., Paul, M.S., & Berger, R. (2011). Embryo relinquishment for family building: How should it be conceptualised? International Journal of Law, Policy and the Family, 25(2), 260-285.

Blyth, E., Lui, S., & Frith, L. (Online First 2017). Relationships and boundaries between provider and recipient families following embryo adoption. Families, Relationships and Societies.

Carsley, S. (2013). Conceiving a feminist legal approach to frozen embryos: Exploring the limitations of Canadian responses to disposition disputes and donor anonymity. Master of Laws unpublished dissertation, University of Toronto.

Castillo, L.N. (2015). The relationship between embryo recipient couples’ decision for disclosure and attachment style: A mixed-methods study. Doctor of Psychology unpublished dissertation, Biola University.

Childress-Beatty, L. (2014). Embryo donation: Psychological aspects. In J.M. Goldfarb (Ed.), Third-party reproduction: A comprehensive guide (pp. 113-120). New York: Springer.

Collard, C., & Kashmeri, S. (2011). Embryo adoption: Emergent forms of siblingship among Snowflakes® families. American Ethnologist, 38(2), 307-322.

Corley, S.O., & Berg, J.W. (2014). Embryo donation: Ethical issues. In J.M. Goldfarb (Ed.), Third-party reproduction: A comprehensive guide (pp. 121-129). New York: Springer.

Crockin, S.L., & Nussbaum, L.M. (2014). Embryo donation: Legal aspects. In J.M. Goldfarb (Ed.), Third-party reproduction: A comprehensive guide (pp. 101-112). New York: Springer.

Cromer, R. (Online First 2019). Making the ethnic embryo: Enacting race in US embryo adoption. Medical Anthropology: Cross-Cultural Studies in Health and Illness.

Davis, J. (2014). Frozen hope: The phenomenological experience of embryo adoption. PhD unpublished disseration, Biola University.

Ethics Committee of the American Society for Reproductive Medicine. (2018). Informing offspring of their conception by gamete or embryo donation: an Ethics Committee opinion. Fertility and Sterility, 109(4), 601-605.

Finger, R., Qi, Y., Fabian, M., Keenan, J., & Stoddart, R. (2012). Experiences of families inquiring about donating or adopting embryos: Results of an online survey. Adoption Quarterly, 15(1), 57-66.

Finger, R., Sommerfelt, C., Freeman, M., Wilson, C.K., Wade, A., & Daly, D. (2010). A cost-effectiveness comparison of embryo donation with oocyte donation. Fertility and Sterility, 93(2), 379-381.

Frith, L., & Blyth, E. (2013). They can’t have my embryo: The ethics of conditional embryo donation. Bioethics, 27(6), 317-324.

Frith, L., Blyth, E., & Lui, S. (2017). Family building using embryo adoption: Relationships and contact arrangements between provider and recipient families—a mixed-methods study. Human Reproduction, 32(5), 1092-1099.

Frith, L., Blyth, E., Paul, M.S., & Berger, R. (2011). Conditional embryo relinquishment: Choosing to relinquish embryos for family-building through a Christian embryo “adoption” programme. Human Reproduction, 26(12), 3327.

Goedeke, S. (2014). Understandings and experiences of embryo donation in New Zealand – a discursive analysis. PhD unpublished dissertation, Auckland University of Technology.

Goedeke, S., & Daniels, K. (2017). The discourse of gifting in embryo donation: The understandings of donors, recipients, and counselors. Qualitative Health Research, 27(9), 1402-1411.

Goedeke, S., & Daniels, K.R. (2017). Embryo donation or embryo adoption? Practice and policy in the New Zealand context. International Journal of Law, Policy and the Family, 31(1), 1-19.

Goedeke, S., & Daniels, K. (2017). Towards an understanding of embryo donation in New Zealand: The views of donors and recipients. In R. Shaw (Ed.), Bioethics Beyond Altruism. Cham: Palgrave Macmillan.

Goedeke, S., & Daniels, K. (2018). We wanted to choose us: How embryo donors choose recipients for their surplus embryos. Journal of Reproductive & Infant Psychology, 36(2), 132-143.

Goedeke, S., Daniels, K., & Thorpe, M. (2016). Embryo donation and counselling for the welfare of donors, recipients, their families and children. Human Reproduction, 31(2), 412-418.

Goedeke, S., Daniels, K., Thorpe, M., & Du Preez, E. (2015). Building extended families through embryo donation: The experiences of donors and recipients. Human Reproduction, 30(10), 2340-2350.

Goedeke, S., Daniels, K., Thorpe, M., & du Preez, E. (2017). The fate of unused embryos: Discourses, action possibilities, and subject positions. Qualitative Health Research, 27(10), 1529-1540.

Goedeke, S., & Payne, D. (2009). Embryo donation in New Zealand: A pilot study. Human Reproduction, 24(8), 1939-1945.

Goedeke, S., & Payne, D. (2010). A qualitative study of New Zealand fertility counsellors’ views and practices regarding embryo donation. Human Reproduction, 25(11), 2821-2828.

Kato, M. (2014). Giving a gift to the gift: Women’s experiences of embryo donation in Japan. Anthropological Forum, 24(4), 351-363.

Kawwass, J.F., Crawford, S., Hipp, H.S., Boulet, S.L., Kissin, D.M., & Jamieson, D.J. (2016). Embryo donation: National trends and outcomes, 2000 through 2013. American Journal of Obstetrics & Gynecology, 215(6), 747.e741-747.e745.

Keenan, J.A., Gissler, M., & Finger, R. (2012). Assisted reproduction using donated embryos: outcomes from surveillance systems in six countries. Human Reproduction, 27(3), 747-752.

Kingsberg, S.A., Applegarth, L.D., & Janata, J.W. (2000). Embryo donation programs and policies in North America: survey results and implications for health and mental health professionals. Fertility and Sterility, 73(2), 215-220.

Lee, J., & Yap, C. (2003). Embryo donation: A review. Acta Obstetricia et Gynecologica Scandinavica, 82(11), 991-996.

Lyerly, A.D., Steinhauser, K., Voils, C., Namey, E., Alexander, C., Bankowski, B., . . . Wallach, E. (2010). Fertility patients’ views about frozen embryo disposition: results of a multi-institutional U.S. survey. Fertility and Sterility, 93(2), 499-509.

MacCallum, F. (2009). Embryo donation parents’ attitudes towards donors: Comparison with adoption. Human Reproduction, 24(3), 517-523.

MacCallum, F., & Golombok, S. (2007). Embryo donation families: Mothers’ decisions regarding disclosure of donor conception. Human Reproduction, 22(11), 2888-2895.

MacCallum, F., Golombok, S., & Brinsden, P. (2007). Parenting and child development in families with a child conceived through embryo donation. Journal of Family Psychology, 21(2), 278-287.

MacCallum, F., & Keeley, S. (2008). Embryo donation families: A follow-up in middle childhood. Journal of Family Psychology, 22(6), 799-808.

MacCallum, F., & Keeley, S. (2012). Disclosure patterns of embryo donation mothers compared with adoption and IVF. Reproductive BioMedicine Online, 24(7), 745-748.

Machin, L. (2011). A hierarchy of needs? Embryo donation, in vitro fertilisation and the provision of infertility counselling. Patient Education and Counseling, 85(2), 264-268.

McMahon, C.A., & Saunders, D.M. (2009). Attitudes of couples with stored frozen embryos toward conditional embryo donation. Fertility and Sterility, 91(1), 140-147.

Moller, N., & Clarke, V. (2016). New frontiers of family: Exploring embryo donation for family building and voluntary childlessness. The Psychologist, 29, 204-208.

Newton, C.R., McDermid, A., Tekpetey, F., & Tummon, I.S. (2003). Embryo donation: attitudes toward donation procedures and factors predicting willingness to donate. Human Reproduction, 18(4), 878-884.

Nordqvist, P., & Smart, C. (2014). Relative strangers: Family life, genes and donor conception. New York: Springer.

Patel, B.G., & Rossi, B.V. (2014). Embryo donation: Medical aspects. In J. M. Goldfarb (Ed.), Third-party reproduction: A comprehensive guide (pp. 95-100). New York: Springer.

Paul, M.S., Berger, R., Blyth, E., & Frith, L. (2010). Relinquishing frozen embryos for conception by infertile couples. Families, Systems & Health, 28(3), 258-273.

Provoost, V., Pennings, G., De Sutter, P., & Dhont, M. (2012). “Something of the two of us”. The emotionally loaded embryo disposition decision making of patients who view their embryo as a symbol of their relationship. Journal of Psychosomatic Obstetrics & Gynecology, 33(2), 45-52.

Provoost, V., Pennings, G., De Sutter, P., & Dhont, M. (2012). A private matter: how patients decide what to do with cryopreserved embryos after infertility treatment. Human Fertility, 15(4), 210-216.

Rizk, M., & Pawlak, S. (2016). A case report of embryo donation: Ethical and clinical implications for psychologists. Journal of Medical Ethics, 42(10), 659-664.

Sauer, M.V. (Ed.). (2013). Principles of oocyte and embryo donation (2nd ed.). London: Springer.

Söderström-Anttila, V., Foudila, T., Ripatti, U.-R., & Siegberg, R. (2001). Embryo donation: Outcome and attitudes among embryo donors and recipients. Human Reproduction, 16(6), 1120-1128.

Taebi, M., Bahrami, R., Bagheri-Lankarani, N., & Shahriari, M. (2018). Ethical challenges of embryo donation in embryo donors and recipients. Iranian Journal of Nursing and Midwifery Research, 23(1), 36-39.

Tasker, F., Gubello, A., Clarke, V., Moller, N., Nahman, M., & Willcox, R. (2018). Receiving, or ‘adopting’, donated embryos to have children: Parents narrate and draw kinship boundaries. Genealogy, 2(3), 35.

Wånggren, K., Alden, J., Bergh, T., & Svanberg, A.S. (2013). Attitudes towards embryo donation among infertile couples with frozen embryos. Human Reproduction, 28(9), 2432-2439.

Wånggren, K., Baban, M., & Svanberg, A.S. (2014). Attitudes toward embryo donation among staff at in vitro fertilization clinics. Acta Obstetricia et Gynecologica Scandinavica, 93(8), 765-770.

Wånggren, K., Prag, F., & Svanberg, A.S. (2013). Attitudes towards embryo donation in Swedish women and men of reproductive age. Upsala Journal of Medical Sciences, 118(3), 187-195.