From Loss Comes Hope

From Loss Comes Hope

The emotional impact of egg donation by Britta Dinsmore

Britta Dinsmore, Ph.D., psychological consultant at Oregon Reproductive Medicine helps explain the psychological impact on women when they hear from their doctor that it’s time consider egg donation.

When a woman’s doctor tells her that it is unlikely she will be able to use her own eggs to conceive a child and that it is time to consider egg donation, the emotional impact on her can be profound.  The need to consider egg donation means something different to each woman, and the stage she is at on her fertility journey can play an important role in shaping her emotional response and well-being to this news.

A woman who seeks a consultation knowing or suspecting ahead of time that she may have difficulty conceiving (due to age or existing medial conditions) may experience a sense of gratefulness that there is a recommended treatment option with high success rates.  Women who have experienced multiple treatment failures, miscarriages, or ectopic pregnancies may experience a sense of relief at being presented with a treatment option that will significantly reduce the chances of having to experience another such painful and discouraging outcome.

However, for most women hearing this diagnosis, loss is a frequently expressed theme at this time and the sense of loss can be intense.  There can be many different losses involved, and some may be more painful than others for any given woman.


A sense of loss

Loss of a sense of youthfulness.
Fertility is often associated with youthfulness and vitality.  When a woman is told that her eggs are no longer viable, this may significantly impact how she sees herself in terms of age.  Though fertility challenges can be experienced by women of any age, as a woman grows older, the more likely she is to have difficulty conceiving.  Because menopause marks the end of one’s fertile years, a woman may see the need to use donor eggs as evidence that she is “old.”

Loss of a sense of “wholeness” and health.
Women facing egg donation may feel “broken” or defective.  If a woman has historically been relatively free of health problems, she may also feel shocked and angry at her body for “letting her down” by not being able to conceive.

Loss of feminine identity.
Traditionally, femininity has been defined, in part, by a woman’s fertility—her capacity for giving and nurturing life.  Conceiving a child is supposed to be natural, something every woman can do.  Not being able to do so without the assistance of egg donation may lead a woman to feel that she does not fully embody what it means to be a woman.

Loss of being able to conceive a child that is a product of one’s own and one’s partner’s genes.
For some women, part of the dream of starting a family is conceiving through an intimate expression of love with their partner.  The stark contrast of such a scientific and medicalized process may be a painful reality to accept.  In addition, women in a heterosexual relationship may have looked forward with great anticipation to seeing the mix of their own and their partner’s physical and personality traits passed on to their child.  Feelings of guilt may also be part of the picture—guilt about keeping her partner from realizing their dream of becoming a parent.

Loss of being able to pass on one’s personal and family lineage.
Women considering egg donation may grieve that they won’t see family resemblance mirrored in their future child or that they won’t be able to pass on valued family heritage or ethnic background.

Loss of control over one’s reproductive life.
If a woman has been relatively successful in accomplishing her goals thus far in her life through commitment and hard work, she may find it difficult to accept that no matter how much effort or energy is put forth, the reality of her fertility challenges will not change.  This leaves many women feeling powerless and out-of-control over one of the most important priorities in her life.

Feared loss of security in one’s role as a mother.
A woman conceiving through egg donation may question whether the resulting child will truly feel like her “own” child?  She may wonder if she will be able to bond with the child just as she otherwise would or whether the child will feel like an “outsider” in her own family.


From grief to acceptance

Grieving the loss of one’s fertility is not unlike grieving other losses, such as the loss of a loved one, often involving many of the same feelings and reactions.  Initial reactions may include shock, disbelief, and/or resistance to accepting the information.  This is not surprising given common misconceptions about the impact of age on fertility and the age at which fertility begins to decline.  These misperceptions are perpetuated by media images of pregnant celebrities sharing later in life “success stories” without mention of the reproductive assistance often involved.  In addition, people tend to live “younger” and more physically active lifestyles at older ages than in previous generations.  When a woman is in good health and leads a healthy and active lifestyle, it may be hard for her to accept that her eggs are no longer viable, no matter how old she is.  And certainly, the need to consider egg donation may be even more devastating to a woman if she is still at an age when most women can conceive relatively easily without assistance.

Other common reactions include feelings of anger and guilt.  A woman who has “followed the rules” by waiting to have children until she has achieved stability and financial security may feel extremely angry if she is unable to conceive when there are so many examples of unplanned or unwanted pregnancies.  If a woman was ready to start a family much earlier than her partner was, she may feel angry and resentful toward her partner for delaying their family building efforts.  A woman who postponed having children due to her own lack of readiness at an earlier age may feel guilty, believing rightly or wrongly that her past choices have “cost” her the ability to conceive with her own eggs.

More often than not, acceptance of the need to use egg donation and overcoming the sense of loss doesn’t happen all at once but, is a process that evolves over time.

It may take time for a woman to sort through her own complex mix of feelings and reactions before she feels ready to move forward.  More often than not, acceptance of the need to use egg donation and overcoming the sense of loss doesn’t happen all at once but, is a process that evolves over time.  Recognizing and acknowledging the losses that feel most poignant can be an important part of this process.  Some women do this through self-reflection, journaling, or time alone whereas others find it more helpful to seek support, and share their thoughts and feelings with close friends or loved ones.

Accepting egg donation often begins with a woman’s recognition and acknowledgement that if she wants to have a child, egg donation is the most likely way this is going to happen.  When a woman steps back to consider the many reasons she has for wanting to become a mother, it may quickly become clear that many of the hopes and dreams she has associated with having a child are still very much possible.  Watching baby take that first step, hearing the words “I love you mommy,” outings to the zoo, family trips, making cookies, dance classes, soccer practice, classroom field trips, family holiday celebrations—these are all things that are not at all dependent on a shared genetic link with one’s child.   For some women, coming to recognise the important role she will still play in giving her child life and nurturing him or her through pregnancy and beyond is incredibly powerful.  For other women, it is transformative to learn about infant-parent attachment and hear that establishing a healthy, close, and loving bond with one’s child has nothing to do with shared genetics.

Becoming informed about what to expect can be important in facilitating readiness to move forward.  It is often reassuring for women to learn how egg donors are screened by fertility clinics, what type of information about the donor candidates will be available, and criteria recipients typically consider when choosing an egg donor.

Sometimes future concerns are more prominent, particularly those related to sharing the information about egg donation with the resulting child.  There is often uncertainty about whether, how, and when to share this information and about what impact this is likely to have.

Some women worry that the information may cause the child to question her legitimacy as his or her “real mother” or that the child will feel upset or confused about his or her sense of belonging in the family.  Other women have concerns about whether their own families will welcome and accept the child as they do other children in the extended family or whether the child will struggle with feeling different or with being judged by peers.

It can be immensely relieving to receive resources and guidance about the topic of disclosure and reassuring information about these common worries.


The emergence of hope

Over time sadness, anger, guilt, and fear may gradually give way to growing feelings of hope, optimism, and excitement. As long-hoped-for milestones are reached, there may tend to be more “good days” than bad and feelings of grief and loss may surface with far less frequency and intensity than before.   Successfully establishing a pregnancy, hearing that first heartbeat, feeling the baby move, seeing ones’ body changing and growing to nurture and give life to one’s child can be incredibly healing for women pregnant through egg donation.

After baby is born and mother gets to meet her long-awaited child, she may be surprised to find how quickly it no longer matters to her how this little one came to be and how certain she comes to feel that this is the baby she was meant to have.  Though she may wish the process hadn’t been so painful, she almost certainly would say that if egg donation is what it took to have this particular child, then this was the path she was meant to take.

More information can be found on the Oregon Reproductive Medicine website

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