Given the number of children born using ART since its debut in 1978 and the new techniques that require more biologic manipulation the need to follow the children for physical as well as psychological sequelae has become a concern. McWhinnie maintains that outcome studies about children conceived using ART fall into two broad categories. The first address psychomotor, behavioral and emotional adjustment in the child’s early years as measured by standardized tests based on norms for an age or stage of development. The second address the quality of familial relationships and explore the psychological aspects as they relate to infertility, parenting and child-rearing using qualitative measures such as interviews and life histories.

Multiple authors have published studies comparing singleton children conceived after infertility treatment with naturally conceived singletons. In general, the quality of the parent-child relationship, the psychosocial development of the children and the psychosocial well-being of the parents has been similar. Two authors (Golombok, 1995 & 1996; Van Balen, 1996) have suggested that parents using reproductive technologies reported a more positive relationship with their children than parents who conceived naturally. The majority of studies conducted by multiple authors on IVF families are positive; parents appear to be well-adjusted and parent-child relationships are good.

Children born from gamete donation are of special interest since they are not genetically related to at least one parent and may not be told about the donor. The disclosure decision is troubling for some because they’re not sure it will be in their child’s best interest to have the information; will it help or harm them in the long run? If the parents opt not to disclose the use of donor gametes will keeping this secret have a damaging effect on the family as authors Baran and Pannor suggest? Does the lack of genetic relatedness impact parent-child bonding and affect parenting ability?

Susan Golombok and colleagues (1995, 1996) conducted longitudinal European studies and compared donor insemination (DI) children to adopted children, those conceived by IVF, and those conceived naturally. These studies are based on attachment theory and rely heavily on the emotional environment in the early years as a predictor of the future. The children in these studies ranged in age from four years old to eight years old and all were singletons. The groups for these studies were recruited from four different countries: Italy; Spain; The Netherlands; and the United Kingdom. Both standardized tests and observational methods were used and the conclusions they drew were extremely optimistic. In the initial studies no significant differences were noted in the social or emotional development of the children however the quality of parent-child relationships in DI families, IVF and adopted families was better compared to the control group of families who conceived naturally. An important aspect of these studies is the fact that none of the DI children were told about the use of a donor leading the authors to suggest that a genetic link is less important to the family relationship than the strong desire to have children. This same conclusion was drawn about a group of egg donor (ED) families added in 1998.

In the most recent data published by this group, egg donation parents and their children were followed-up at age 12. What makes this age group especially relevant is that studies suggest early adolescence is a time when adopted children start to exhibit higher rates of behavioral problems than non-adopted children and express greater interest in their birth parents. Although in their prior studies parents and children were functioning well the authors hypothesized that the increasing autonomy that accompanies adolescence might be especially challenging for the egg donation parents. The results of their latest research suggest no differences between the egg donation families and the IVF families however DI mothers were more emotionally over-involved with their children compared to egg donation mothers. The majority of both DI and ED mothers were either undecided or planned not to disclose the use of a gamete donor in an attempt to protect their child from any potential negative effects. For the majority of ED mothers their reasons for not telling the child had not changed from those cited in the first phase of the study.

References:
Baran A, Pannor R. Lethal secrets. New York: Amistad, 1993.

Golombok S, Brewaeys A, Cook R, et al. The European study of assisted reproduction families: family functioning and child development. Hum Reprod. 1996; 11: 2324-31.

Golombok S, Cook R, Bish A, Murray C. Families created by the new reproductive technologies: quality of parenting and social and emotional development of the children. Child Dev. 1995; 66: 285-98.

Hoopes J. Adoption and identity formation. In: Brodzinsky D, editor. The psychology of adoption. Oxford: Oxford University Press, 1990.

Maughn B, Pickles A. Adopted and illegitimate children growing up. In: Robins L, Rutter M, (eds). Straight and devious pathways from childhood to adulthood. Cambridge: Cambridge University Press, 1990, p. 36-61.

McWhinnie A. Gamete donation and anonymity. Should offspring from donated gametes continue to be denied knowledge of their origins and antecedents? Hum Reprod. 2001; 16: 807-17.

Miller B, Fan X, Christensen M, Grotevant H, vanDulmen M. Comparisons of adopted and non-adopted adolescents in a large, nationally representative sample. Child Dev. 2000; 71: 1458-73.

Murray C, MacCallum F, Golombok S. Egg donation parents and their children: follow-up at age 12 years. Fertility Sterility 2006; 85: 610-18.

van Balen F. Child-rearing following in vitro fertilization. J Child Psychol Psyc. 1996; 37: 687-93.