THURSDAY, June 3 (HealthDay News) -- Explaining where babies
come from prompts anxiety in many a parent. But having to
incorporate information on test tubes or sperm donors into the
story can make an already sensitive subject even more
Yet that's the reality facing a growing number of parents.
As assisted reproduction technology, in which someone other than
the intended parents donates eggs or sperm, has become increasingly
common, more parents are grappling with a dilemma similar to what
adoptive families have faced for decades: How should you tell your
children about their origins?
In the United States alone, infertility affects about 7.3
million couples, according to the U.S. Centers for Disease Control
and Prevention. But the success and availability of sperm donors,
egg donors and traditional surrogates have allowed those unable to
conceive on their own to still have children. Worldwide, about
200,000 babies are born each year with the help of assisted
reproduction, according to the International Committee for
Monitoring Assisted Reproductive Technologies.
The success of donor-assisted conception, however, has forced
more parents to tackle the decision of whether to disclose to their
child his or her genetic history. Some worry that disclosure will
upset the child or possibly diminish the adults' role as
But the American Society for Reproductive Medicine contends that
a child has the right to know. A report in 2004 by the society's
ethics committee stated that children have a fundamental interest
in their genetic heritage and medical histories, and the group
supports full disclosure beginning as early as 3 years of age.
"Tell early and often," says psychologist Andrea Braverman, director of complementary and alternative medicine at Reproductive Medicine Associates of New Jersey and an ethics committee member.
Braverman argues that children can and should be told before
they can even comprehend the idea. But at this early stage in
development, she said, parents must tell the story in the simplest
terms. For example, she said, small children might not understand
the concept of eggs and sperm, but they could understand a story
about parents who wanted a baby very much but needed some extra
help. Over time, then, the story should be gradually expanded with
more specific information to suit the child's age and maturity
level, she said.
Clinical psychologist Christine Kodman-Jones said that
explaining complex concepts to children, even in simple terms,
might seem daunting, but waiting until adolescence to disclose
information about a child's conception can be disruptive.
"Young adults already have a lot on their plate," she said. "If parents delay disclosure, it becomes an issue. The longer parents wait, the bigger it gets."
Children also need the whole story, Braverman said. "In time,
technological advancements could make it much easier for genetic
information to be revealed," she explained. "If children gain
pieces of information inadvertently, it sends the message that
their parents are ashamed or not comfortable with the situation."
And the American Society for Reproductive Medicine warns that
anything less than full disclosure could contribute to depression,
confusion or low self-esteem on the part of the child.
Still, the decision to tell children about their genetic history
is a personal one, and not everyone believes that full disclosure
would be appropriate in every situation.
"It's a gray area," Kodman-Jones said. "Children guide us with their questions. Some need to see pictures and require a lot of details. Others may be overwhelmed by too much information and want a very short answer. It's all specific to the child."
Braverman, too, said that it's not a one-size-fits-all scenario.
"All the stakeholders must be considered -- donors, parents and
children," she said. "There are some cultures in which children
born through assisted reproduction technologies would not be
accepted. Ultimately, we must be respectful of parents to make
their own decisions."
And in a world where reproductive technology continues to
advance, Kodman-Jones advises parents to take a more holistic and
sophisticated approach to the issue of disclosure.
"We all want clean and simple connections," she said. "It's just not life. Some relationships are just more complex than others."
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