A study carried out by researchers at the University of Cambridge has found no difference in psychological well-being or the quality of family relationships between children who have been conceived by assisted reproduction from third parties (egg donation, sperm or surrogacy) and those born naturally. The research, conducted over two decades, further suggests that informing children about their biological origins, before they start school, can be advantageous for family relationships and healthy adaptation.

The study, the results of which are published in Developmental Psychology, is the first to examine the long-term effects (it has been conducted over 20 years) of different types of third-party assisted reproduction on the upbringing and acceptance of children, as well as the first to prospectively investigate the effect of the age at which children were told they were conceived by egg donation. sperm or surrogacy.

The researchers found that the absence of a biological connection between children and parents in families formed by those born by assisted reproduction by third parties does not interfere with the development of positive relationships between them or in the psychological adjustment in adulthood. These results are consistent with previous assessments conducted at the age of one, two, three, seven, ten and 14 years.

The research thus overturns widely held assumptions that children born by these methods are at a disadvantage when it comes to well-being and family relationships because they lack a biological connection to their parents.

"Despite people's concerns, families with children born through assisted reproduction, whether it's an egg donor, sperm donor or a surrogate, are doing well into adulthood," says Susan Golombok, emeritus professor at Family Research and former director of the Centre for Family Research at the University of Cambridge. who has led the study.

To carry out the work, the researchers followed 65 UK families with children born by assisted reproduction (22 by surrogacy, 17 by egg donation and 26 by sperm donation) from infancy to early adulthood (20 years). They compared these families with 52 others, also from the United Kingdom and during the same time, whose children had been born by conception without assistance.

Early information

The research found that mothers who began telling their children their biological origins in the preschool years had more positive relationships with them and showed lower levels of anxiety and depression as assessed in the interview at age 20. Most of the parents who had disclosed it did so at age four and found that the child took the news well. This suggests that it is advantageous to be open with children about their origins when they are young.

In addition, in the final phase of this two-decade study, mothers who had revealed their children's origins before the age of seven scored slightly more positively on the questionnaire questions on quality of family relationships, parental acceptance (mother's feelings toward the young adult), and family communication. For example, only 7% of mothers who had disclosed their child's origin before age 7 reported some problems in family relationships, compared with 22% of those who had done so after the child had turned 7.

As for young adults, also those who knew their origins before that age scored more positively on the questionnaire of parental acceptance (perception of the mother's feelings towards them), communication (to what extent they feel heard, know what is happening in their family and receive honest answers to questions), and psychological well-being. They were less likely to report problems about family relationships (12.5%); while 50% of young adults who were told after age 7 did report such problems. "There seems to be a positive effect on being open with children when they are young, before they go to school, about their conception. It's something that studies of adoptive families have also shown," says Golmobok.

How they feel

The young generally showed no concern about their biological origins. One of these young men, born through surrogacy noted, "It doesn't really baffle me; People are born in different ways and if I was born a little differently, that's fine, I understand."

Another, born through sperm donation, said: "My dad is my dad and my mom is my mom. I've never really thought about how things are different, so it's hard to say, I really don't care." Even for some his method of conception made them feel special: "I think it was incredible; Everything is absolutely amazing. I have nothing negative to say about it at all."

The team also found that young adults conceived by sperm donation reported poorer family communication than those conceived by egg donation. This could be explained, the study suggests, by the greater secrecy surrounding sperm donation than egg donation, sometimes driven by a greater reluctance of fathers than mothers to disclose to their children that they are not their genetic fathers, and a greater reluctance to talk about it once they have revealed it.

"Today there are so many more families created by assisted reproduction that it seems quite common," Golombok said. "But 20 years ago, when we started this study, attitudes were very different. It was thought that having a genetic link was very important and without one, relationships would not work well.

"What this research means is that havingchildren in different or new ways doesn't really interfere with the functioning of families. Really wanting to have children seems to triumph above all, that's what really matters," Golombok concludes.

Genetic link

For Rita Vassena, co-founder and CEO of Fecundis, a company that develops assisted reproduction treatments, and former scientific director of the Eugin Group, "the study is of good quality and represents the seventh and final stage of a 20-year longitudinal study in dozens of families that have had children through assisted reproduction with non-own gametes, whether it's donated sperm, donated eggs or surrogacy," he told Science Media Centre (SMC) Spain. In his opinion, the results of the work "are very encouraging, since these children, now young adults, have a very positive situation in relation to themselves, their mothers and their families." Vassena acknowledges that "it was feared, and sometimes still is feared, that children born by assisted reproduction techniques who do not have a genetic link with their parents may have psychological maladjustments similar to those known in adopted children. This study, and the others in the same series, tell us that this fear has no basis in the real data and that, despite sharing with adopted children the lack of genetic connection with parents, their adjustment is positive and similar to those of family children who are conceived without resorting to assisted reproduction treatments. "

Rocío Núñez Calonge, embryologist, scientific director of the UR International Group and professor in the Master of Reproduction of the Complutense University and the Spanish Fertility Society, agrees that the study led by Golombok "is carried out exhaustively, with powerful psychological tools and an adequate methodology, although its main weakness, as the authors themselves recognize, is the low number of cases, especially the number of families who have used egg donation," he tells SMC.

Núñez Calonge recalls that the study shows that "within gamete donation families, egg donation mothers presented less positive family relationships than sperm donation mothers in terms of family functioning and acceptance of their adolescent children," which suggests by the authors, he says, "That the absence of a genetic connection between mothers and children represented a challenge for the mother. However, the study has not taken into account a bias that the authors have already commented on in principle, and that is that in this group, the age of the mother is older than in the rest of the groups, which may have influenced this difficulty of relationship, more than the genetic link. "

For this embryologist "it is important to point out that, before resorting to gamete donation, a prior psychological evaluation of the parents is necessary to avoid subsequent rejections after the birth of the child and even during pregnancy, which occurs more frequently in women who use egg donation. In the work it has not been commented that these patients have made this assessment".

  • Gynaecology
  • Surrogacy
  • Motherhood

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