Experiences of Donor Conception

Parents, Offspring and Donors through the Years

Caroline Lorbach

• Publisher: Jessica Kingsley Publishers
• ISBN:
  9781846427114
• Topic: Medizin
• Subtopic: Sexuelle Gesundheit & Sexualität

Drawing on the experiences of parents, offspring and donors and including her own and her family's story, this thought-provoking and informative book explores the process of donor conception. From finding out about an infertility problem, to considering whether - and how - to tell the children about their conception, and how those children feel as the adult offspring of a donor, she provides practical suggestions as well as in-depth consideration of the emotional and ethical issues involved.

Lorbach takes the reader step-by-step through the process of deciding to use donor conception, choosing a donor, and discussing the decision with others - and considers the perspective of the donor alongside those of parents and offspring. Tackling difficult subjects such as disclosure and offspring's access to information about the donor, this important book is a much-needed resource for health, counseling and social work professionals as well as for the couples and families themselves.

1

Male Infertility

I always imagined that in an infertile male you’d see it, it would be visual, he’d be a skinny little runt, a sick looking person but not so. (Julian, infertile and father of two DI sons)

Male infertility is a subject that seems to scare men. I remember my husband coming home after a Christmas party at work. He had been sitting at a table with a few men, including his boss who mentioned that he had seen Patrice’s photo in the newspaper. Patrice told everyone around the table that he had been interviewed about his infertility. At that point his boss said ‘Oh’ and left the table. No one else seemed keen on talking about the subject except one man who muttered, ‘I wouldn’t wish something that bad on anyone.’

How many of us have met an infertile man? Most would answer ‘never’, but can we be sure? It is a subject that is still hidden away and one that people rarely talk about. Why do people shy away from talking about male infertility? The answer is not a simple one; it is closely tied up with mens’ image of themselves and societies image of men. One answer may lie in the physical differences between men and women. In a woman the ovaries that provide her ability to conceive children are never seen, release of an egg is not visible. However, in a man, just about everything is in the open. Because of this, sex and fertility are in many minds inextricably linked. It can be difficult to separate a man’s ability to conceive children from his ability to have sexual intercourse. All over the world people seem to closely connect male fertility to virility; conceiving a child is considered by many to be proof of manhood.

Why do people make jokes about men ‘firing blanks’ when no jokes are made about women not having eggs? The jokes about male infertility usually tend to be told by men. Maybe they don’t want to accept that infertility is something that can happen to anyone so they make light of it. But then again, even some women seem to have a problem with male infertility; there is a feeling that men need protection from talking or even thinking about it.

Infertility is in itself not a life-threatening condition, and when men discover that they are infertile their emotional reactions can vary tremendously. For some it is a hurdle to overcome before they can realize their dreams of fatherhood. For others the news can be devastating, as it was for Ralf. ‘When I got my first diagnosis, I fell into a deep black hole, because I realized what that meant to me and Claudia. We could never have a child together in the biological sense.’

Others have expressed similar feelings:

I am 100% sterile and infertile…as a male the initial shock of being diagnosed as infertile was like a jolt of lightening hitting my body. I was completely devastated. To some degree I still am, however there is nothing I can do. (Peter)

I couldn’t believe it, I thought it could be a mistake, something wrong with the test. (Julian)

I always wanted to have my own kids, I was thinking that I was going to grow old and lonely. (Paul)

Well, I felt that it was the end of the world, I couldn’t talk to anybody, I didn’t want to talk to anybody, I kept it all bottled up. (Laurie)

It can be extremely difficult for couples having difficulties in conceiving to talk about the issue.

After a year of trying to have a baby Gillian finally sat me down and said, ‘We have to talk about this.’ To be perfectly honest it had passed through my mind that one of us might have a problem but I hadn’t dwelt on it, I kept hoping that we would conceive so that I didn’t have to think about it. (Mark)

Another couple, Michael and Vivianne, had been trying to conceive for some time. Michael knew how worried Vivianne was about it so he decided to go for a sperm test.

We’d been trying for some time and I decided to take the matter into my own hands. I didn’t tell Vivianne at the time that I went to see the doctor. You hear things all the time, it’s always on the woman’s side but I knew it could be her or it could be me. I went for a test and they said to bring a sperm sample. The result was hard to believe because I have a brother in France and he’s a father; so I went a second time, I needed a second opinion. They told me the sperm count was zilch, zero. I went home and said, ‘Look, Vivianne, I need to talk to you, stop worrying, I’m the one who’s at fault.’ I don’t know the reason, it could have been a serious case of mumps, or I could have been born with something. The strange part of it is for her to have been on the pill for so many years and then find out I’ve been shooting blanks. For me, I could cope; it was watching Vivianne, denying her children. Watching someone else go through this, that was the difficult part.

The decision to undergo medical investigations may come after years of trying to conceive, as in Richard’s case.

We were married in December 1984 and decided, as many newly-weds do, to hold off starting a family until we had the house and garden set up safely for children. We briefly tried for a baby in 1988, but with long service leave coming up in 1989 we decided to wait again. Heather did not want to become pregnant and be traveling overseas as well. We thought the romantic settings of Europe such as Paris or Rome might relax us enough for our family to begin. We returned after a wonderful three-month holiday but with no success. By late 1989, we had been having sex without precautions for over a year. Heather felt there might be a problem so she went along to the family doctor for a checkup.

However, the doctor suggested we both be tested to rule out any problems on either side. I felt a little concerned, but not overly so. If there was a problem, I felt sure that in this day and age it could easily be sorted out.

The doctor requested a semen sample that came back as low – less than one million sperm. I was referred to a urologist who found, on examination, a varicocele in my left testis. He suggested they tie off the blood vessels that were interfering with the sperm production and assured me it was a simple day surgery. Good results had been achieved in the past in raising sperm levels like mine to six million.

I was self-conscious of the procedure. I told no one at work about it, and only rang my supervisor after it was over, to inform her I was in hospital for a small operation of a private nature. I was worried people would find out about the problem. After all, this operation would fix it so there would be no need to inform anyone.

Our doctor referred us to a professor at W. Hospital. He ordered more tests and after the results came back, our options were limited to DI. The sperm test showed less than 300,000 viable sperm, or less than one percent chance of conceiving naturally.

While talk of female infertility has become more common in the media since the first IVF birth in 1978, male infertility, even though it accounts for approximately 50 percent of fertility problems, does not get the same coverage. This non-exposure must add to the feelings of isolation that many men (and couples) feel when faced with male infertility.

We read sometimes about infertility in newspapers but why should we be the ‘victims’? We couldn’t believe it and didn’t want to believe it, so to be really sure I went to a second doctor and had a biopsy. When I got the final result it was not so hard as the first diagnosis because I had several months to deal with the problem. I am a rational person who looks into the future and not back. I think it was harder for Claudia than for me to get this diagnosis and to get it confirmed twice. (Ralf)

Some men know that they might become infertile because of medical treatments for cancer or other conditions. These days counseling usually goes hand in hand with such treatments and the risk of infertility is discussed. Men are usually given the opportunity to freeze their own sperm for possible future use. Unfortunately, many years ago this was not always an option.

I had actually had a kidney transplant about twenty-two years ago and we always had a feeling I might be infertile because of the medication I was put on. So we were kind of prepared for it, but even when we did get the news it was quite disheartening. (Rob)

Tim discovered he had cancer at a young age, an age when illness and fertility are not usually top of the list for a person to be thinking about.

I had cancer, teratoma of the testes, when I was nineteen. I’d only ever had the one testicle and it basically had enlarged. I thought it was a sporting injury and had gone off to a GP at a medical centre, he sort of thought the same thing and didn’t think much of it. Then I woke up one night and the pain was unbearable. Still thinking it was a sporting injury I headed off to a sports clinic. They had one look at it and sent me across the road to a hospital. They did a biopsy on it and then took it out the next day. It all happened in a fair rush.

I suppose at the time I didn’t think much about the infertility, it was more a question of getting on top of the cancer. Self-preservation more than self-promotion.

Tim admitted that not thinking in terms of marriage at the time did not encourage him to think long term about his infertility.

I suppose in terms of really feeling it, it wasn’t until I was a fair bit older. Between twenty-one and my early thirties, to a certain extent, it was more a case of not thinking much of the consequences and taking advantage of the fact and having unprotected sex. It wasn’t really an issue until I came down to thinking about getting married and having children that I thought, obviously, it’s going to have to be a bit different.

Bob was married when he found out that he was infertile and the discovery had a profound effect on his marriage.

I was married in 1974, for eighteen months we tried to have children with no success. All the tests were done on the wife and she was fine so we made an appointment for me to go in and see our local doctor. It was a half-hour trip. We’d gone in, I’d donated some sperm and we’d gone walking around the town for two hours. We went back after the tests were done, walked into the doctor’s office and were told just straight out, ‘Mr Davis, you will never have children.’ It really didn’t make much sense at the time for the simple reason that that it was so to the point, there was no preamble. It wasn’t, ‘I’ve got some bad news for you…’ There was no warning.

It really didn’t sink in for six months but in that six months the wife decided that she wanted to be pregnant and had gone out with a number of other men in the area where I grew up. That created a situation in the marriage that ended it.

The break-up of his marriage and his infertility had a huge impact on Bob’s life.

For the next five years, I went from someone who had a fair bit of common sense and intelligence to someone who really didn’t care about what was going on. It didn’t happen overnight, but in the same period of time I had a motor vehicle accident, then my father died and all those things combined put me into a suicidal frame of mind. There were even thoughts of having let my mother down because I couldn’t provide the grandchildren that she wanted. I was in a frame of mind where I’d become what the Americans call a vagabond: I didn’t live anywhere, I didn’t take proper physical care. It was a very hard time emotionally, and as I started to come out of it in 1979 I turned it to my advantage, I used it as the greatest condom out.

A man who already knows that he is infertile when he enters into a relationship must decide at what point to tell a woman that he can never conceive his own biological children. When should this be done – at the first meeting, after you marry, when she decides that you should meet her parents, when you first sleep together – when? Bob chose to tell Glenda (now his wife) quite early on in their relationship.

I was working in Yass, she was working in Forster on the north coast, we’d written a couple of letters and I’d left the job in Yass and moved up to Forster. Sex in those days was a part of every relationship whether you were married or you weren’t married. Once we started going out, I wanted to try and put her mind at rest about the possibility of causing her an embarrassment, so I told her I couldn’t have children. It had the opposite effect – she thought I was pulling her leg and trying to become sexually involved more easily than through normal channels. It wasn’t for quite a while that she came to even start believing it.

Acceptance of infertility is not always immediate. Some men, while they understand what their doctor is telling them, still live in hope that things might change, that all will be well and that the infertility might go away. My husband, Patrice felt like this.

In mid 1987 when we sat in the office of Caroline’s gynaecologist and were given the blunt news that ‘There are no sperm, the count is zero,’ we were stunned. I don’t recall any thoughts passing through my mind, it was blank. The doctor referred me to a urologist who performed a testicular biopsy. The result came back, a severe blockage, cause unknown and virtually no chance of surgically fixing it.

It’s strange, we knew the cause of the problem, and it was very easy to understand why we couldn’t conceive, but I still clung to the hope that perhap...