Counselling in egg donation

I specialise in infertility counselling and have done it for years and years and years and, you know, I’m very passionate about it. I work in a London clinic and I also have a private practice.

But over the years I’ve seen a lot of people who are going throughout Altrui and that has been a real privilege, so I’m so glad to be here tonight, it’s absolutely delightful.

A lot of people when they phone me up will have a sort of … bit of … sense of hesitation about whether they really want to come and see me, and what that is often about is that they can’t really make sense of why – why is there such an emphasis on counselling when you’re considering egg donation?

So I thought it might be quite helpful if I start from there, because it’s not very … it doesn’t really help if you start out feeling that this isn’t going to be of any value to you and we very much hope it is.

So there’s a bit of a back story to this, in fact we go back actually to the nineteen eighties which was when the government was planning legislation around IVF and, to their credit, they demonstrated a real awareness that people who suffer from infertility issues really, nearly always find it emotionally devastating and, to be honest, it can be quite the most stressful experience that they’ll ever experience … that they’ll have in their lives.

And also I think we all understand, and the government did then, that if people reach a point where they are learning that they won’t ever be able to have the child that they had envisioned, that they had planned, the child who will be genetically related to them – that is a source of intense grief and loss. It’s very difficult to adjust to the idea that you won’t be able to have the child that you planned and wanted – it’s absolutely massive.

So, as I say, to their credit the government wrote into the legislation that all the IVF clinics must, by law, offer counselling. And I’m so glad about that, and in fact Altrui has simply followed in the ethos of that by having a policy that, before you really get started with Altrui, it’s really best to do a lot of talking and to be confident that it’s what you want to do, rather than get halfway through and find well, no you’re not; of course many people do, but it’s best to do a lot of the thinking and talking about it before you get started.

So one of the reasons for counselling is just support which, you know, it is a good thing, and the other thing is that the clinics and also the government were very well aware that when you think about having a child who won’t be genetically related to you, it is actually a different way of creating a family. It’s not the way that most people set out and expected, and there are … there’s lots of … there’s so much that you need to know. There are implications that you need to consider, not only for yourselves, but also for the child that you might have.

So it just became … has become in most clinics a standard procedure that, you see the consultant, next stop talk with the counsellor, and that’s so that you really get a chance to think about what the emotional and social implications are going to be. That you’re very clear about the legal framework, you know where you’re going to stand legally, and you’ve had the opportunity to think about some really important future aspects, which is, you know, how is it going to be in relation to a child knowing about this, and I’ll say a few more was about that in a while.

So counselling is about support and it’s about discussing the implications and I’m so glad that Altrui also supports it and encourages you so much to do that.

Now I know also that people will tell me that they are worried about me, and I going to be the person who reports back to the clinic, actually writes the report, and gives a recommendation. And so are they going to have to present with me as the perfect parents, so that I write the right kind of report. Now I can’t emphasise enough I simply don’t do that and I don’t think it happens in other clinics. We’re not here to make assessments or judgments, we’re here to help you make informed decisions and, as a result of that I mean, that the absolute principle in counselling is the that counsellors offer confidentiality.You really can’t be expected to be talking openly about everything about that and if necessary talking about your worst fears and your darkest thoughts. You can’t be expected to do that if you think the counsellor is going to report back either to Altrui or to the clinic.

The most that I ever do is if the clinic or Altrui want a statement that I’ve seen people, I have a kind of standard format which sets out that yes I have seen them and these are the things we discussed, but it’s nothing personal about you. And what I do is actually send you that and it’s for you to hand onto whoever, so you’ll know exactly what has been said and certainly there isn’t anything else for me that goes to the clinic, because again confidentiality is just so important.

Obviously some people, having come to talk things through, find that they actually need more time, they may be really struggling with everything that’s happened, and so they may decide to go on seeing me and to try and work through some of that. But it’s not my recommendation, it’s not my decision for them to other pause or, in some quite infrequent occasions, to decide donation is not for them. It’s very much the couple’s decision to do that.

So I hope that’s clear, and that I just want to try and give you a bit of an outline of what to expect. In a way I can only tell you what to expect if you come and see me, but I don’t think I’ve I’m so different from other counsellors around the country. The first thing that I’m really interested to hear from you is what your story is. What I want to really understand is what’s happened since you first thought of having a family; what happened to you; what are the things that got in the way; and very importantly how have you coped, have you dealt with those things and where are you at now with it.

So it’s quite useful, I think, people to reflect and be able to compare maybe how they were from the beginning and how hopefully they feel they’ve been able to move on. It’s also, I think, in the same sort of vein, useful to talk about but you know, just to remember back to what was it like on that day when you first discovered it was going to need to be egg donation. That could be quite painful, obviously. The reason for doing that is to then consider how is it now and how have you got from then to now and are you feeling that that journey you’ve made has left you feeling resolved enough about not be able to have the child who’s genetically related. To be able to embrace it and make it the option that is going to really be fulfilling and I can’t tell you, we have somebody who’s going to be speaking a little bit later about having a child through donation, but I know countless countless couples who had such joy from egg donation, but other people who, if they’d gone ahead at the time that I first met them, it might not have been so good but they’ve had … there’s been more things they’ve had to have to work through.

It is also, as I think you know has been mentioned, it’s really important that you understand where you stand legally, and there is a whole legal framework in the UK, and it wouldn’t be right if you went ahead with egg donation without being absolutely clear what that is.

The great news, the really good part, about the UK legislation is that anyone who gives birth to a baby in the UK is the legal mother. So as donors this is the way donors want it, this is the way, you know, you would want it. You are the legal mother and donors don’t have any rights or responsibilities in relation to the child and we all feel that is the proper way for it to be and it’s a safeguard for all concerned.

But the children do have information rights and it’s been a little bit of a reference to what those information rights are. In fact it starts well, that … most people I meet are planning to tell their children, and that’s something that we will talk about it later and I’ll mention something in a moment, but that at sixteen the legal rights of donor conceived people are to ask if they are donor conceived. So if you have treatment you will be on a government register as having treatment and your donor information will be alongside you, and so 16 year olds, or 16+ year olds, simply can go along to the register and ask if they are donor conceived. It’s something that you need to know and be part of your thinking about whether or not you plan to tell any child that you had.

They also have a right, there has been reference to the biography the profile that donorses provide, and most donors are enormously generous with this profile, because they do it with a child in mind as well as the couple in mind. And from 16 young people have an absolute right to see that profile. In fact it is available to you and we very much hope that is something that you share, you know, from the from the start as part of your talking with your child as they grow and understand their origins. But that’s what they can do at 16.

It’s also … a provision has been made with that for the fact that donors can donate to more than one couple, and if they do so anonymously it means that any child you have may have genetic half siblings in other families, or one other family. And that sets up a situation where they are genetically half siblings but they can’t identify who they are, so there is, even though it is infinitesimally small, there is a risk that young people can meet in the future and inadvertently get into a relationship as boyfriend/girlfriend and actually be half siblings. So from 16, which is the age when people legally young people legally can have a sexual relationship, they are able to check that their boyfriend or girlfriend is not their half sibling and that’s again a very important safeguard for them.

As you’ve heard already, at 18 it … their rights are just like people … those who are adopted, so they do get a right to know who the donor is, and it’s full enough information for them to be able to trace the donor. The donors go into this in full understanding that from 18 young people can know the name, date of birth, last known address and district where they were born, so they could trace them. And I … what you have to take into consideration is that if you have, in the future, a son or daughter who chooses to do that, you yourselves might find yourself connected to the donor as well as to other families who have genetic half siblings related to yours.

So those sorts of implications take some getting used to and in counselling we do quite a lot of talking around what that might feel like, and trying to help people prepare for that eventuality, so that it’s not sprung on them at some point later. And that, you know, understandably can be very difficult.

The other final area that we talk a lot about is the whole process of sharing this information with children and luckily we know an awful lot about that now and there is a fantastic support network called the Donor Conception Network. If you haven’t found it already, do look at their website they have such a mass of information on the website, they have children’s books, they have guidance, they have lots of audio visual material.