In this webinar, Giuliana Baccino, Psychologist and PhD in Health Sciences has been discussing psychological criteria for recipients, and she has addressed a very important, and difficult question on egg donation treatment and if it is for everyone.
Nowadays, we are used to seeing different types of families in day-to-day life. Some of them are created through egg donation treatments, but are donor eggs for everyone? This is a question that is often asked. What should be looked at when egg donation is recommended to a couple or a woman? The first thing could be mental and physical illnesses, but there is no scientific evidence that tells us whether these kinds of illnesses can harm the relationship or the woman and the child or not. There is no scientific evidence regarding socioeconomic status or the motivation for being a mother. However, there is clinical evidence regarding age. There is evidence of when it is better to have kids and when there might be some issues regarding age.
The motivation for being a mother
During the first consultation with a woman who wants to undergo egg donation, there is always a question: Why do you want to become a mother? Possible answers:
- every woman has to be a mother
- I always wanted to share my genes with my child
- my partner wants to have children
- I want to be a mother, no matter what
- I always wanted to have someone to love unconditionally
- motherhood is more than genes
The next question always follows: Why do you want to become a mother through an egg donation treatment? Possible answers:
- my doctor says that in spite I cannot share my genes with my baby, I will love him anyway
- I don’t want to lose my relationship with my partner
- I promised my parents that they will have a grandson
- I always wanted to share my love with the baby, raise him, teach him, guide him
- I don’t mind if my baby shares my genes or not
- having a child is our family project, despite the way this child will come into our lives
There are different types of answers, so do you think that these 3 first scenarios or answers are the same when we are talking about a future mother-child relationship? Do you think that it will be the same for this future mother-child relationship if this mother went through the treatment because her doctor says so?
Maternal age
The second thing that should be looked at is age. We should be looking at risks and benefits for the woman and the future child. There are medical risks related to older age, for example, low birth weight, and premature birth significantly increase when the maternal age is over 40. When a woman is over or equal to 43, there is an increased risk of preeclampsia, intrauterine growth retardation, stillbirth, and placenta abruption. Other risks include gestational diabetes, hypertension, premature rupture of the membranes, etc., all these risks are needed to be clear and explained to the patients before they go ahead with the treatment.
There are also benefits for women of an older age to have children. Medical benefits are, for example, non-transmission of their genetic illnesses, and endometrial preparation is easier than ovarian stimulation. Psychosocial benefits involve greater financial and economic security in older ages and more nurturing child-rearing.
There might also be some risks and benefits for the future child. The medical risks include pre-term, lower birth weight, transfer to the neonatal ICU, neonatal death as well as 5 minutes Apgar score less or equal to 7 or intrauterine growth restrictions. It has also been demonstrated that daughters born to mothers aged between 40 and 49 years old lived almost 9 years less than daughters born to mothers aged 20-29, while sons born to older mothers lived almost 6 years less than sons born to younger mothers. Some data on the child’s expected age at the time of the mother’s death showed that a woman at 35 years old at the child’s birth is expected to live 81 years, so she will share with her son 46 years of her life. The mother’s probability of death by the child at age 5 is 0.54, but looking at a mother who is 55 years old at the child’s birth, she will share approximately only 28 years of the child’s life and the probability of death by the child at age 5, is 2.70
This kind of information also needs to be taken into account when you’re deciding to go for egg donation treatment. You have to be informed not only because of you but also because of your offspring.
Risks and benefits for future children
Regarding psychosocial risks, all children report feelings of embarrassment and experience testing on their parent’s age, they have increased difficulty relating to parents who are so much older, and they engage in less active play with their parents because of the older age of the parents, the children feel they grow up earlier than their peers, for example, they also have a constant fear of the risk of parental death and when this loss is in childhood, that the child is at risk for emotional and behavioural problems as psychiatric disorders including anxiety, depression, post-traumatic stress disorder, alcoholism, etc.
It has been reported that they have also lowered self-esteem and they are put in a caregiver role to take care of their parents to help them more and so they have less time for school, work, extracurricular activities and friends.
There are also some benefits for the future child, for example, lower risk of exposure to physical punishment and abuse and financial and economic security. The research has demonstrated that once they are parenting, older parents begin to acknowledge that they are worried about how their age and death may impact their child.
Taking it all into account, do you think that a woman is suitable for an egg donation treatment at any age?
Take home messages
- if you have doubts regarding being a mother through egg donation treatment before making the decision, you should consult with a psychologist or a counsellor about your fears and doubts
- don’t rush, take into account your age and all the risk and benefits
- make your own decisions, although not everyone likes them
