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Heterosexual Couples Using Donor Insemination
Heterosexual Couples Using Donor Insemination
Madeline Licker Feingold, Ph.D. 2011
“My husband is the one who really needs to talk to you, but he won’t make an appointment.”
Approximately 15% of all couples in their reproductive years experience infertility, and there is a general consensus that men and women are affected at similar rates, with roughly 40% of infertility attributable to a male factor, 40% to a female factor, and 20% to unexplained causes. Even though infertility strikes men and women equally, and men and women may feel similar emotions upon being diagnosed, their experience of infertility may be quite different. Society encourages women to express feelings, which helps them seek the support of others and utilize available resources. Men, on the other hand, generally are taught to suppress emotion, increasing isolation and diminishing the possibility of receiving help.
Common Feelings Associated with Infertility
Infertility provokes a painful life crisis that negatively affects marital, sexual, familial, and social relationships. Although much more has been written about a woman’s reactions to infertility, both men and women may become overwhelmed by feelings of depression, anxiety, anger, guilt, and grief. Additionally, because sex and reproduction are linked in our minds, infertility causes many men and women to feel ashamed and embarrassed about their masculinity or femininity and to experience a sense of inadequacy and low self-esteem. Irrespective of the cause of infertility, both men and women may feel profoundly damaged and unworthy of their spouse’s commitment.
Men and women often have different ways of communicating that can lead to being disconnected and alienated from each other. For the most part women tend to engage with others as they gather information and support while men may be more likely to close down and withdraw. Even when a couple’s infertility is attributed to a male factor, women may be the driving force to consult with doctors and sperm banks to learn about donor insemination and may feel isolated and alone in their family-building efforts. It is common for couples to need support in talking about their emotions surrounding 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 couples in opening their own communication. Additionally, a consultation with a mental health professional specializing in donor insemination may provide specific information that helps couples more fully understand what is involved with donor conception and how that will affect them and their efforts to have children. Such a consultation is also likely to improve communication within the couple, increase their intimacy, and help the couple jointly make decisions that will significantly impact the well being of their family.
Donor Insemination: Why Aren’t We Happy?
Doctors often quickly present donor insemination as a treatment for male infertility and the natural next step to take after being diagnosed. In actuality, the road that may bring you to donor insemination is winding and bumpy, and couples are confronted with feelings of loss and grief at every turn. The transition to donor insemination certainly does not feel natural or easy. Most couples have tried to have a baby on their own for a long time and are devastated by the news that they cannot have what they most want—a child that shares both their genes. At first consideration, donor insemination may not feel like a viable option for family building.
As a woman, you may have always assumed that you would be able to conceive a child with your husband, and the unfairness of your situation may shake you deeply, rousing anger and despair. You may have a mixture of feelings toward your husband, ranging from empathy to blame and resentment to guilt, as you struggle with the idea of creating an alternative family. The thought of using a stranger’s sperm may feel uncomfortable, alien, or disloyal.
As a man, in addition to experiencing the grief and loss associated with not being able to have a child that shares your genes, you may feel guilty that you disappointed your wife and caused her pain. You may worry that you will not feel like the “real” father and may be concerned that the child will not see you as his/her dad. Additionally, you may have tremendous discomfort with the idea that your wife will be using another man’s sperm. Even though you know that your wife is not in a relationship with the donor, you may feel jealous and betrayed, and fear that you will think of him when interacting with your child.
While couples may find it extraordinarily difficult to talk about male infertility, it is nonetheless important for them to push through the silence and discomfort and together grieve the loss of the child they were not able to conceive. After a period of mourning, which is an ongoing process because couples will always feel sad about the child they could not conceive, couples can consider whether donor insemination is right for them. Couples must examine their feelings about what makes a family and men, in particular, must question whether a genetic link to their child is imperative for them to be a father. Although male infertility may make it impossible for a couple to achieve a pregnancy on their own, donor insemination is a form of alternative family building that allows infertile couples 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 possible to be sad about the child you did not have and to embrace and love the child that you will have.
Shame, Stigma, and Disclosure
The shame and stigma associated with infertility is well documented in the literature and palpable to any person who has difficulty conceiving. It is common for people to hide embarrassing situations from others; hence couples often do not get help coping with the stigma of infertility. However, avoiding and denying feelings in an attempt to reduce distress is a poor coping strategy because it actually increases problems down the line.
When left unexamined, the shame and stigma associated with infertility may negatively impact decision-making by causing people to keep secrets. For example, men may agree to move forward with donor insemination as long as no one, including the child, is told about the donor. Women, sensing their husband’s shame and discomfort, may believe that maintaining secrecy will ease their husband’s emotional pain as well as ensure a positive relationship between the child and his/her father. Additionally, adding to a couple’s desire to keep donor insemination a secret is the ease with which they can “pass” as a traditional family. Because they will look like a traditional family, with a mother, father, and child, no one need ever find out about their path to parenthood.
In reality, secrecy surrounding donor insemination may be enormously destructive. As a man you may never work through the painful emotions associated with infertility causing shame and embarrassment to fester and negatively impacting your relationship with your child as you cannot fully embrace your role as father. The donor may always lurk in the shadows as he holds the DNA trump card. Additionally, you may feel less entitled to parent than your wife leaving you feeling powerless, resentful of the connection your wife has with the child, and like the “odd man out” in the family.
Additionally, just because parents do not tell their children about donor origins does not mean that children remain unharmed or unaware. Many donor-conceived people reported feeling discomfort in their family because they sensed information was being withheld. Oftentimes they learned about their origins under difficult circumstances and the lack of honesty and openness in the family, rather than the reality of donor conception, produced psychological harm.
Another way in which stigma and shame may manifest is in a woman’s desire to mix her husband’s sperm with the donor sperm so that she and her husband can hang on to the hope that their child will be genetically linked to his/her father and that she and her husband will have their child together. The motivation to mix sperm seems based in the desire to erase all traces of infertility and donor insemination. However, mixing sperm does not change the reality of infertility. Couples know that donor insemination was recommended because conception was not possible without a third party.
As a woman you may feel that mixing the donor’s sperm with your husband’s sperm will allow you to feel closer to your child and to your husband. Sperm mixing is a form of nondisclosure, and as with any type of nondisclosure, it may be destructive to your family. For example, sperm mixing may interfere with you fully embracing your child as you will be clinging to, and more highly valuing, the child you and your husband could not have. Sperm mixing also could negatively impact your husband’s 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. Additionally, imagine that your child discovered that he was born through donor insemination from DNA testing or some other circumstance after you told him otherwise. Your child may feel like the “second choice” child, hurting his esteem and creating mistrust in the parent-child bond.
Building Healthy Families with Donor Insemination
It appears that when children learn about their donor origins at an early age, they have a more positive experience. When donor conception, from their earliest memories, is integrated into their life story, children develop a stable sense of self and of family. When disclosure happens later in life, or comes out by accident, donor conceived people often feel angry, deceived, and resentful. Their trust in their family may be shattered and they may question their personal identity. When parents try to eliminate the donor, the donor may hold more significance for their child. Correspondingly, parents who chose to disclose early report greater ease and less uncertainty with the disclosure process.
When children learn about their 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 find out 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?”
Parents can ensure that their child will be able to obtain information about the donor by selecting a donor who is willing to share his identity once the child reaches the age of legal maturity. Even if you are uncertain about whether you will want your child to know the donor, you can leave the door open for this possibility by choosing an open-identity donor. Once you become a parent, your priorities may change and you may feel less worried about maintaining secrecy and more concerned with providing for your child’s needs and answering his/her questions, even if your child’s queries are about the donor.
When diagnosed with infertility both men and women may feel overcome by depression, anxiety, shame, anger, and grief. Before moving ahead with donor insemination, it is important for couples to grieve the loss of the child they were not able to conceive, work through the painful emotions associated with infertility, and explore their beliefs and values about what makes a family. When considering alternative family building through donor insemination, the stigma of infertility may cause men and women to keep the donor a secret from family, friends, and even their child, and to choose an anonymous donor. While secrets may have debilitating effects on each family member, harm the parent-child relationship, and perpetuate the stigma of infertility, disclosure allows for open and honest communication, provides children with accurate health information, and lets children know they are loved for exactly who they are. Early disclosure seems to be the most beneficial to families, and open-identity donation will ensure that your child will not be left with unanswered questions about his donor.
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.
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 310-454-0502 email@example.com
Madeleine Katz, Psy D provides consultations, education, and resources to help individuals and couples considering and/or doing family building through assisted conception. American Society for Reproductive Medicine's Mental Health Professional Group member. San Francisco 415-937-0425
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 310-470-9049, firstname.lastname@example.org
Dr. Deborah Simmons Expert in pregnancy loss & infertility counseling, including psychoeducation for donor eggs, donor sperm, and surrogacy.
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 310-404-1816