Madeline Licker Feingold, Ph.D.  2011, Updated by TSBC in 2022

Family-building through sperm donation can be an emotionally complex process. Yet it is also one that helps many make the dream of having a family become their reality!

Often, parents who want to tell their children about their family’s origins find themselves delaying because they don’t know what to say.  Disclosure to children regarding their donor origins allows for open and honest communication throughout their lifetime, provides children with accurate health information, and lets children know they are loved for exactly who they are. It signals there is no shame in this way of having a family. Alternatively, delaying discussions with children about donor conception  may have unintended and potentially harmful effects, including within  the parent-child relationship and for children’s sense of self. This can further perpetuate the stigma of infertility.

Fertility struggles and emotions

Approximately 15% of all heterosexual partners in their reproductive years experience infertility, with males and females affected at similar rates. The associated emotional experiences can be quite different, however. Historically, cisgender women are more likely to have been socialized to express their feelings, which may help in seeking support and resources. Cisgender men, on the other hand, are often encouraged to suppress emotion, which may lead to isolation and reluctance to seek help. Additionally, the therapeutic resources available tend to be geared towards women’s experiences of infertility, and therapists who specialize in fertility issues are overwhelmingly female-identified. It may also be difficult for some partners to find a therapist who is intimately familiar with how their cultural, religious, and/or ethnic identification may impact their experience of infertility. So what’s to be done?

Struggling with fertility can be an emotionally painful experience that holds implications for partnership, sexual, familial, and social/cultural relationships.   Although much more has been written about cisgender women’s reactions to infertility, all people, regardless of gender identity, may become overwhelmed by feelings of depression, anxiety, anger, guilt, or grief. Additionally, because society often links sex and reproduction, socially-constructed views of infertility and gender can provoke feelings of shame and low self-esteem. Irrespective of the cause of infertility, the affected party may feel inadequate or unworthy of their partner’s commitment and love.

Partners often have different ways of communicating, which can lead to feeling disconnected or alienated under stress, even in the strongest of relationships. Some engage with others to  gather information  while others turn inward to process independently  Some partners may take an active approach,  consulting with doctors and sperm banks to learn about donor conception, and may feel isolated and alone in their family-building efforts. Others may avoid confronting painful emotions altogether and feel isolated in their pain. It is common for partners to need support in talking about their experience of infertility so that they can understand each other’s thoughts and feelings. Reaching out to close friends and family about feelings of grief and loss may increase connection, and assist partners in opening their own communication. Additionally, a consultation with a mental health professional specializing in donor conception may provide specific information that helps partners more fully understand the process and how it will affect their future family. Such a consultation is also likely to improve communication within the partnership, increase intimacy, and help partners collaboratively make decisions that will significantly impact the wellbeing of their children and family.

Doctors often quickly present donor conception as the natural next step for partners facing male-factor infertility.  However, partners  may experience the road to donor conception as long, winding, and full of mixed emotions.  If you are feeling a sense of loss and grief as you consider embarking on this journey, you are certainly not alone.

The transition to donor conception does not feel natural or easy for many heterosexual partners. Partners  who try to have a baby that shares both of their genetics often are shocked and devastated by the news that it will not be possible. At first consideration, donor conception may not feel like a viable or comfortable option for family-building. Heterosexual partners may be unaware of other people in their community who have used donor assistance.

Many cisgender women experience a sense of  unfairness around infertility. This may include a  mixture of feelings toward one’s partner and oneself, such as  empathy, blame, resentment, and guilt. The thought of using a stranger’s sperm may feel uncomfortable or somehow disloyal.

Many cisgender men , in addition to experiencing the grief and loss associated with not being able to have a genetically-related child may feel worried about the pain and disappointment their  partner could feel. It is common to worry that they  will not feel like the “real” parent, or that the  child will not view them as such.Additionally, it is normal to experience  discomfort with the idea that one’s partner will be using donor sperm. Feelings of jealousy  and fear are common for many , and it is normal for one’s intellectual experience and decision to use donor sperm to compete with one’s emotional experience. While partners may find it extraordinarily difficult to talk about infertility, we have observed that open communication about feelings and shared  grieving is important for the healing process.

This period of grief can be incredibly important before considering whether donor conception is the right next step, acknowledging that complicated emotions may take a winding course even after a child is born. We strongly recommend that partners examine their feelings about what makes a family, and explore whether a genetic link to their child is imperative for them to be a parent.Although infertility may make it impossible for a couple to achieve a pregnancy on their own, donor conception is a form of alternative family building that allows infertile partners to become parents and is a good choice for people who, while acknowledging the importance of genes, believe ultimately that relationships are the foundation of a family.

It is common for partners to avoid discussing infertility with their otherwise-supportive friends, family, and trusted community members. The stigma associated with infertility is well-documented and palpable in the lived experience of many who have had difficulty conceiving. However, we have found that avoidance actually increases future complications.

When left unexamined, the shame and stigma associated with infertility may negatively impact decision-making by causing people to keep secrets. For example, some cisgender men may agree to move forward with donor conception as long as no one, including the child, is told about the donor. For some cisgender women their partner’s experiences of shame and discomfort may lead to  maintaining secrecy in hopes of  easing their partner’s emotional pain and enhancing the bond between child and father.

Many partners may wish to keep donor conception private in order to  “pass” as a “traditional” family. Parents may worry that the donor’s genetic link could someday become a more central focus for their child and disrupt the parent-child relationship. Additionally, it is normal for non-biological parents to sometimes feel resentment toward the genetic connection their partner has with the child.

While these experiences are normal and reasonable responses to the challenges of infertility, , secrecy surrounding donor conception may be harmful for all family members, as it can prevent the opportunity to work through the complicated emotions and grief, and can disrupt the bond between parents and children.  By contrast, early disclosure can help build trust, enhance the child’s pride in the family’s origins, and strengthen family ties.

Many donor-conceived people who discover their genetic origins later in life, either by accidental or intentional disclosure, report having sensed all along that their parents were hiding something. Often, they ultimately learn about their origins under difficult circumstances, and the perceived lack of honesty and openness in the family can cause  psychological harm. Many report hey wished they had been told as children, and that their parents had imbued a sense of pride in their narrative… “We wanted to have you so badly that we went to great lengths to find help.  We’re so glad you’re you, and we’re so glad you’re ours.”

The motivation to mix sperm, while good-intentioned, is based in the desire to erase all traces of infertility and assisted conception. Stigma and shame often underlie partners’  desire to mix the male partner’s sperm with donor sperm in hopes that their child will be genetically linked to both of them.

However, mixing sperm, and subsequently muddling the child’s genetic origins, can also produce emotional harm.  Sperm mixing is a form of nondisclosure, and as with any type of secrecy, it may be harmful to the family system. Sperm mixing may interfere with fully embracing a child as who they are, rather than who the family  originally hoped they would be. Sperm mixing also could negatively impact the intended father’s self-esteem, as well as his relationship with his child, because it conveys that genes ultimately are more important than relationships when it comes to building a family.

The widespread and ever-expanding use of at-home genetic testing (ancestry.com, 23&Me, etc.) means that many donor-conceived people will find out about their family’s donor origins at some point in their life. Even if you do not participate in genetic testing, donor-conceived individuals routinely discover their origins when, unexpectedly, they match with a donor’s distant relative, third cousin, aunt, child, sibling, etc. on a DNA website or do NOT match with family members whom they believe are related. 

As a result, children – whether they are a child, teen or adult – may feel like the “second choice” child, which may impact their  self-esteem and family relationships. The complex emotions surrounding the increasingly-common experience of unexpected discovery has led to an entire network of therapists and peer support groups dedicated to working with people who learn through DNA testing that they were donor-conceived.

When sperm donation took off in the 1980s, fertility specialists, sperm banks, and families could not have anticipated the progress that science has made in the availability of genetic testing, nor the increasingly connected world made possible through the web and social media. It may seem obvious but, to be sure, there will be continued technological and medical evolution over the course of your child’s life. We anticipate that these changes will lead to more and more chances that donor-conceived individuals will discover that a donor assisted their  family.

Research overwhelmingly shows that when children learn about their family’s donor origins at an early age and from their parent(s), they have a more positive experience. When donor conception, is integrated into their life story from their earliest memories with pride, children develop a stable sense of self and of family. When discovery comes later in life or by accident, donor-conceived people repeatedly share that they feel angry, deceived, and resentful. Their trust in their parents may be shattered and they may question their personal identity. Paradoxically, when parents try to eliminate or minimize the donor, the donor may hold greater significance for their child. Correspondingly, parents who choose to share this family information early report greater ease and less uncertainty in the process of telling.

When children learn about their family’s donor origins, they may be curious about the donor—even when they have a strong bond and a loving relationship with their parents. When donor-conceived people are not able to obtain information about their donor, they often feel as if a piece of their identity is missing. Information about the donor can help donor-conceived people answer the question: “Who am I?”

You may be asking yourself, “So then, how do I disclose? What should I say? How old should my child be when I tell them?”  We offer guidance and support around this important decision, including a helpful and hopeful article geared towards heterosexual partners entitled Proud Storytellers and books!

Optimizing your child’s health throughout their life is another important reason to disclose their genetic origins. Your adult child may have grown up believing, and even reported to their healthcare provider, a family medical history that is inconsistent with their genetic origins. Knowledge of the donor’s personal and family medical history at the time of donation, and as the donor and his family ages, will help your child optimize their care and medical screening throughout the course of their lifetime.

Parents can increase the ability for their child to obtain information about the donor by selecting a donor who is willing to share their identity once the child turns 18. Even if you are uncertain about whether you will want your child to know the donor, you can leave the door open for the child to have a choice by selecting a donor in the Identity-Release® Program. Partners often report that, upon transitioning into parenthood,  they feel less concerned with  maintaining secrecy around donor conception, and more concerned with providing for their  child’s needs and answering their questions, including questions about their donor. . As previously-discussed,, the stigma of infertility may cause partners to keep the use of a donor a secret from family, friends, and even their child, and to choose an anonymous donor.  Research on donor-assisted reproduction demonstrates that early disclosure is the most beneficial for families,especially for the children. Selecting an open-identity donor gives your future child the option to learn more about the donor and their genetic origins.

We welcome you to be in touch with us at TSBC to discuss your concerns around donor conception and/or disclosure.  We are also happy to share a list of support people who are experts in family building through donor conception.

Building a Family with the Assistance of Donor Insemination by K.R. Daniels (2004), Dunmore Press, New Zealand. Daniels is a social worker who has worked with intended parents, families, donors and donor-conceived people for the last 30 years. He is known not only for his compassion and insight, but also as one of the world’s leading academic authorities on this way of having a family.

Donor Conception Network. Non-judgmental online space offering information, support, community and resources (including many books on how to talk to kids) to anyone involved in donor conception, whether personally or professionally. UK-based, but takes the same approach as us. Has a helpful Why Tell? summary. Offers excellent workshops.

VARTA (Victorian Assisted Reproductive Treatment Authority). One of the most extensive websites in the world with resources on assisted family building and open-identity donation.

TSBC Helpful Websites: Male Infertility

Access to information in French (French laws differ, but supporting parents does not!)

Consultations, Support

SF Bay Area

Joelle Ehre, MA, LMFT provides supportive psychotherapy and reproductive counseling to individuals and partners seeking to build their families using gamete donation. Specialties include infertility, couples  therapy and intended parent consultations for reproductive clinics. American Society for Reproductive Medicine’s Mental Health Professional Group member. Oakland CA and online, 510-788-0804.

Tracy Jones, LCSW is a therapist who specializes in pregnancy and infant loss, who has also counseled both women and men around issues of (in)fertility. Her practice is 100% virtual, and she is able to see clients throughout California. Her populations include Mocha Moms, heterosexual identified individuals and men. Virtually throughout California, [email protected], (510) 473-2263

Madeleine Katz, Psy D provides consultations, education, and resources to help individuals and partners  considering and/or doing family building through assisted conception. American Society for Reproductive Medicine’s Mental Health Professional Group member. San Francisco CA, 415-937-0425

Michelle Sicula, MA, JD, is an experienced Licensed Marriage and Family Therapist providing individual and couples therapy for clients building their families through sperm, ovum, or embryo donation or using a gestational carrier.  Michelle supports clients experiencing infertility, coping with perinatal loss, and/or making decisions about how to build their family or whether to live child-free.  Michelle is certified in Emotionally Focused Couples  Therapy (“EFT”) and is an active member of the American Society for Reproductive Medicine’s Mental Health Professional Group member.  San Francisco and Oakland CA, 510-457-1246, [email protected]

Los Angeles & Surrounds

Elaine Gordon, PhD. Elaine’s goal is to help individuals build healthy families with the help of donors and/or gestational carriers. Be sure to check out resources at her website. American Society for Reproductive Medicine’s Mental Health Professional Group member. Los Angeles CA, 310-454-0502, [email protected]

Carole LieberWilkins, MA, MFT, provides psychoeducational consultations and individual and  couples counseling around family building with sperm, egg and embryo donation and/or surrogacy. Carole is well known for her work on talking with children about family building. She is a founding member of Resolve of Greater Los Angeles and a member of the American Society for Reproductive Medicine’s Mental Health Professional Group. Los Angeles CA, 310-470-9049, [email protected]

Tonya Wood, PhD provides psychotherapy, consultation, psychological evaluations, education, and resources to help individuals and families through the infertility/reproductive process.  American Society for Reproductive Medicine’s Mental Health Professional Group member. Los Angeles CA, 310-404-1816

Minnesota

Deborah Simmons, PhD Expert in pregnancy loss & infertility counseling, including psychoeducation for donor eggs, donor sperm, and surrogacy. Twin Cities MN, 612-324-1207

New York City, New Jersey & surrounds

Dorian Kavanagh, LCSW.  Specializing in infertility, adoption, complex family building and DNA surprises. Dori has particular interests in third-party reproduction. Member of American Society for Reproductive Medicine’s Mental Health Professional Group and of Postpartum Support International.New Jersey, New York, 917-923-5497 [email protected]

Lisa Schuman, LCSW. The Center for Family Building. Helps you develop a family-building plan and link you to the latest resources; offers monthly support groups – all accessible online. American Society for Reproductive Medicine’s Mental Health Professional Group member. New York 212-874-1318

Additional providers