by Andrea Bryman, LMFT
It has taken many years to create the niche I have in my profession, a mental health therapist specializing in egg donation and surrogacy. I have learned that people are not gray on the subject of third party reproduction. They have strong opinions. Once all the opinions have been aired (this can take awhile), one of the first things I am asked is “What am I looking for when I talk with a potential egg donor?”
I thought I would start this initial blog by discussing four of the main areas that I emphasize in my evaluation of an egg donor: her family mental health history, her stability, her desire to be a donor, and her ability to make an informed decision to be a donor.
In exploring a donor’s family mental health history it is important to gather information regarding any potential psychiatric diagnoses. Some diagnoses are linked to genetic predispositions that can be passed onto a child. If there is a diagnosis, i.e., depression -it is important to determine whether it was triggered by an event, which would be considered situational or whether it is an organic disorder. I also discuss family history of alcohol or substance abuse. There is potential fora genetic predisposition to alcoholism that both the recipients and donors should be aware of.
Finally, I explore any emotional, physical or sexual abuse the donor may have experienced and if they have received any professional help.
A donor who has experienced some abuse without seeking help may find the donation process can trigger unresolved issues related to the abuse. Above all else, my hope is for the donor to have a positive experience.
One of the major concerns for many intended parents is whether a donor will be stable enough to follow through with all that she needs to do throughout her cycle. There is a vast amount of information to digest, forms to be filled out, appointments to attend and medications to be administered. A donor will need a lot of support throughout the process.
There are many aspects in exploring a donor’s stability – her living situation, her career, her upbringing and current relationship with her parents and siblings, her social network, her personal relationships and any possible legal issues she may have experienced. It is important that a donor be able to form and sustain healthy relationships as well as manage conflict resolution. More importantly, you want to be sure that she will to do what she is supposed to do!
What is the donor’s motivation to donate? Why would she want to inject herself with medications and undergo medical evaluations and procedures?
While initially enticed by the monetary compensation, most donors after learning more about the process have an altruistic yearning to want to help others while helping themselves. In determining a donor’s desire to help others, it is significant to understand how she learned about the process, why she wants to donate, if she has told others about her desire to donate, what she plans to do with the money she receives from the donation and how she feels about the future contact and disposition of her eggs and the embryos they create.
Lastly, after determining a donor’s mental well-being, her stability and her motivation, it is very important to determine if the donor is cognitively mature enough to make an informed decision to be a donor. I gather this information by exploring the donor’s educational background and her self-perception. This information determines if she knowledgeable enough to have the ability to educate herself about the egg donation process and understand the potential medical and psychological issues that may arise. Is she able to seek out information and ask questions or does she passively take the information given to her? Often I encourage donors to talk with other who have donated before to get peer guidance in addition to professional guidance. The bottom line on informed consent is “Does the donor really understand what she is agreeing to?”
To say “Choosing an egg donor is a difficult process” is an understatement. It is important to realize that many donors have just as many questions about the intended parents as the intended parents have of the donors. We interpret data and evaluate information to ensure suitability. We educate others and ourselves. We hope that all parties are being truthful and forthright.
Andrea Bryman is a licensed Marriage and Family Therapist with a specialty in assisted reproduction, which includes mental health assessments and evaluation of egg donors and surrogates. Andrea’s focus on assisted reproduction stemmed from her own personal experience with infertility over 15 years ago when she was beginning her family. Since that time, Andrea has had three children, two with methods of assisted reproduction. She continues her professional growth in the field of infertility through research and involvement as a professional member of the American Society for Reproductive Medicine including their mental health professional group, the American Fertility Association, European Society of Human Reproduction and Embryology and Resolve. Andrea is the Past Psychological Chairperson on the board of directors for the Egg Donation and Surrogacy Professional Association. She currently serves on the board of directors for Fertile Action and the advisory board of Parents Via Egg Donation.Return to Blog