A family regardless of kinship

Text: Cecilia Odlind, first published in Swedish in Medicinsk Vetenskap no 3, 2016

HOW WOULD YOU FEEL if you found out that your mother or father was not your biological parent? It might be an uncomfortable thing to contemplate. But do genetics actually have such a big role to play? Someone who knows more about this issue is Claudia Lampic, psychologist and researcher at the Department of Neurobiology, Care Sciences and Society at Karolinska Institutet. She is interested in the ethical issues that arise when children are conceived by means of egg or sperm donation. How do you talk to a child about it? When should you talk to the child? And does it affect the relationship between the child and the parents?

Every year, thousands of children are born in Europe thanks to egg and sperm donations. This route is often chosen if one parent’s sex cells do not function, but the statistics also include children born to lesbian women. In 1985, Sweden was the first country in the world to introduce a law prohibiting anonymous donation.

The legislators chose to view the issue from the perspective of the child: Every individual adult must have the right to find out their genetic origin if they so wish. This was a position founded on research undertaken into adoptees; it can be important to know where you have come from to help develop your own identity.

But in many countries eggs or sperm can still be donated anonymously, and there is a lively international debate on whether or not or not this is a good thing. Some people are of the opinion that each individual should be able to decide for themselves how they form their family, while others claim that it will soon be impossible to guarantee future anonymity because of increased genetic traceability.

But by no means all children born from donated eggs or sperm want to explore where they have come from. According to Claudia Lampic’s reckoning, there are currently more than 500 children in Sweden over the age of 18 who have been conceived through sperm donation since the law was introduced in 1985. Of those, it turns out that only a surprisingly small number – around 20 – have made contact with the relevant clinic to find out who their donor was.“I think it is a good thing that a child has the opportunity to find out about their genetic background,” says Lampic. “Many people in Sweden claimed that no-one would want to be a donor in those circumstances. But that’s not how it has turned out.”

“We don’t know why more of them have not taken this step, but we suspect that many of them are unaware that they were conceived using donated sperm,” says Lampic. “And we can’t contact them and ask; that would be unethical, as they may not know their origins themselves. It depends on the parents telling them.”

HER RESEARCH GROUP is, however, planning to interview both those who have requested information about their donor and the donors themselves.

“That will give us important information about the psychosocial consequences of a donor-conceived child getting the details of, and perhaps contacting, their donor.”

These days, it is recommended that people who undergo assisted reproduction treatment with donated eggs or sperm tell their children, ideally as early as possible. How far this happens is still not entirely clear, and this is one of the research areas that Lampic is interested in.

A good ten years ago, working with colleagues at the universities of Uppsala and Lund, she started up a register of people who had either donated or received eggs or sperm. Patients were recruited from seven clinics between 2005 and 2008. There is also a control group that started IVF treatment during the same period but using their own sex cells. The register has enabled them to follow these individuals and their children on an ongoing basis.

In a study, when they asked heterosexual couples on the register with children aged between one and four, around 15 per cent of them had already started talking to their children about how they were conceived. About 80 per cent of them planned to tell their children when they were older. They are currently undertaking a follow-up study with the children now aged seven.

“We haven’t yet collected in all the data, but it seems as though many people who planned to talk to their children when they were a bit older have now actually done so,” says Lampic.

SHE GUESSES THAT IT IS more common to talk openly about these issues nowadays. The fact that lesbian couples and, since last spring, single women in Sweden have the right to have children by themselves by means of sperm donation has probably led to a more open mindset.

“In these circumstances the donation aspect is quite obvious. These days we are more open to alternative ways of forming a family. If parents are reluctant to tell their children, it may be because they are worried that their relationship with them will deteriorate.”

“But there is no indication of this in our research,” says Lampic. “The seven-year-olds that found out that they were conceived through a donor reacted neutrally or were curious about it. International research shows that if the child as an adult later chooses to contact the donor, it is not with the aim of seeking out a new parent; it is more that they want to understand themselves better.”

Other researchers have compared the relationships in families where the children have been told about their origin with relationships in families where the children have not been told, and they have not been able to identify any clear differences.

“So from that point of view there is no evidence to suggest parents should act in one particular way,” says Lampic. There can also be risks involved in not telling the child. If later in life the child accidentally discovers that key personal information has been deliberately withheld by people close to them, it can be quite traumatic.”

Over the years, she has nonetheless gained a greater understanding of the different ways the issue can be viewed.

“Talking openly about donor-assisted conception also means that a parent has to reveal their infertility and that may be something they want to keep to themselves.”

She has also met parents who want to put off telling their child until they are mature enough to be able to grasp the consequences of it all themselves and thus ‘own’ the information in their dealings with the outside world. But the longer they wait, the more difficult it may be to bring the issue up.

“However, I must emphasise that research shows that all is not lost even if the child is older,” she says. “Given the right support and preparation, you can tell a child even in their teenage years or when they are an adult. But you need to be prepared for strong reactions.”

DONORS ARE ALSO INCLUDED in the register built up by Lampic and her colleagues, and so the research has included their experiences too. It shows, amongst other things, that the donors are generally positive about being contacted by any donor-conceived children and that about a quarter would like to be offered guidance if any such contact was made.

In another study, they also asked the donors how many children they could consider giving rise to. Many of them had no opinion, but around half thought the limit should be somewhere between one and ten children. In Sweden, an individual can donate eggs or sperm to a maximum of six families, thus limiting the number of potential half-siblings. But in some countries there are no such limits, which means a person may have a hundred half-siblings.

“Up to now, the aim has been mainly to avoid half-siblings unknowingly forming relationships and having children together, but now that it is becoming more common for donors and donor-conceived children to have contact it is important to think about the psychological consequences,“ says Lampic. “So I think it’s good that there is a limitation in place.”

She has also found through her research that forming a family with donated eggs or sperm does not seem to have any negative effects on the relationship between the parents. However it is clear that it can give rise to much speculation, and sometimes Lampic suspects that the donor has too prominent a place.

“It’s normal for an individual to try to find physical and mental similarities with their children or their parents,” she says. “It’s a way to create a sense of solidarity within a family but also to achieve an understanding of different characteristics and ways of reacting or being. But those of us who share our genetic origin with our relatives know that, even in spite of this, we can sometimes be surprised by certain characteristics or feel alienated by them. But that is not something that is talked about so much.”