Third Party Options
My doctor says that the quality and quantity of my sperm isn’t good enough to father a child and we are not interested in IVF with ICSI. What are our options?
Some, but not all fertility clinics, offer the option of using sperm from a donor who is known to you (e.g., a friend or family member who has agreed to donate his sperm). In Canada, the sperm from a known donor must go through a six-month quarantine and screening process to ensure that there is no transmission risk of HIV infection. Consequently, there is a significant waiting period involved with this option.
Prior to selecting a donor, most fertility clinics will ask you and your partner to speak with a counsellor who can help you decide if this is an option you are both comfortable with. The counsellor will help you consider the short- and long-term implications of using donated sperm, for you and for your future child(ren).
My doctor says I’ve waited too long to have a child and that my eggs are too old. What are my family building options?
Adoption is another family building option that you might want to consider. Check with your local adoption agencies for information about domestic and international adoption possibilities.
For more information about adoption in Canada, check out the Adoptive Parents website.
For information about international adoption for Canadians click here.
For general information about adoption, including a section on international adoption, check out The Adoption Guide.
I have been asked to be an egg donor. What does it involve and where can I get more information about the process?
Women who are considering donating their eggs should know that there are psychological and physical risks involved. Women who donate their eggs anonymously often wonder about the outcome of their donation and whether the donation resulted in the birth of a child or children. Role clarity and setting appropriate boundaries are issues that women commonly face when they donate to a friend or family member.
The physical risks of egg donation are related to the fertility medications that are used to induce the development and release of a number of eggs. GnRH Agonists such as Lupron, are used at the start of the process. These medications affect the functioning of the pituitary. There are a number of side effects associated with GnRH Agonists, with the most common being headaches, hot flashes, mood swings, insomnia, and short-term memory loss. The daily injections that are introduced later in the process to stimulate the development of multiple eggs (follicles) frequently can cause bloating and weight-gain. The most significant risk is a condition called ovarian hyperstimulation syndrome (OHS). OHS is relatively rare but serious. It can require hospitalization and may impact a woman’s future fertility. Some women also find the egg retrieval process physically uncomfortable. Similar to IVF, the long-term impact of the process on future fertility still remains to be determined. The risks are likely to increase with repeated cycles/donations.
Policies on egg donation differ between countries. In Canada, donors cannot be paid for their donation. However, they can be compensated for any expenses that are incurred during the donation process. In the United States there is no national legislation limiting compensation to egg donors.
Many egg donors feel proud of helping an infertile individual/couple, particularly in cases when the donation is to a close friend or family member. However, before considering donating their eggs, it is important for women to understand the risks involved, their motivations for donating, and their beliefs/desires about their future relationship with, and feelings about, their genetic offspring. These are the issues that are typically addressed in pre-donation counselling.
RESOLVE includes a helpful sheet about the questions that women should ask themselves when considering being an egg donor. Read it here.
The New York State Task Force’s Advisory on Assisted Reproductive Technologies published a booklet called: Thinking of Becoming an Egg Donor? It provides some important information on the procedure and women’s experiences of being an egg donor. The information on legal and financial considerations are only relevant to the United States. Read it here.
To read more about the physical risks involved with egg donation, click here.
To read more about the medications used to induce ovulation, click here.
I have been asked to be a sperm donor. What does it involve and where can I get more information about the process?
There are no known physical risks associated with sperm donation, although some men find it challenging to have to produce fresh semen samples in a clinic setting. In terms of psychological impact, you might experience short term regret or sadness after donating. Long term, you will likely feel a sense of pride and well-being for having helped someone you care about become a parent.
The National Gamete Donation Trust in the UK has put together helpful information for those considering being a sperm donor. Read it here.
Prior to becoming a donor it will be important to discuss and agree upon what role, if any, you will have in the life of a child or children produced through your donation. You will also want to reach an agreement with the recipients about whether or not your identity will be disclosed to any offspring produced as a result of your donation.
Gestational surrogacy requires tremendous trust and commitment on your part and on the part of the woman who carries your child – your surrogate. As well as the medical assessment required for this type of arrangement, most clinics require that you and your partner, and your surrogate and her partner (if she is in a relationship) meet with a counsellor to discuss the range of issues including roles and readiness, expectations, and short-and long-term implications during the pregnancy and after the child is born.
In Canada, the law prohibits payment to a surrogate, other than for basic expenses she has to incur prior to, during, and following the pregnancy. You can find out more about the Canadian legal implications of using donor eggs, sperm or surrogacy here.
The American Society for Reproductive Medicine has put together a booklet on third party reproduction, some of which is relevant to Canadian audiences. Read it here.
The Organization of Parents Through Surrogacy has some helpful resources and personal stories about building a family through surrogacy. Read more here.
Psychosocial and Legal Issues
Certainly if you are considering any of these third-party reproductive options, prior to proceeding with treatment you will need to meet with a mental health professional who specializes in assisted human reproduction. If you elect to work with a surrogate to help you create your family, you will also want to meet with a lawyer to have a legal contract drawn up between you and your surrogate.
You can find out more about the Canadian legal implications of using donor eggs, sperm or surrogacy here.
This article talks about the emotional aspects of considering using a donor or third party reproduction. Read it here.