Embryo donation programs and policies in North America: survey results and implications for health and mental health professionals.

OBJECTIVE: To use survey results from Society of Assisted Reproductive Technology to describe program policies regarding embryo donation, report protocols used for the disposition of cryopreserved embryos, and discuss clarification of guidelines governing ethical and psychosocially informed embryo donation. METHOD(S): A 66-item questionnaire was sent to the 312 Society of Assisted Reproductive Technology programs, generating 108 responses. RESULT(S): Seventy-eight (72%) of 108 programs offer embryo donation. Forty (37%) have actually performed donation, with 246 cycles completed and 53 "take-home babies." Disposition agreements for donors address divorce (92%) and death (90%). Only 28% require that potential donors undergo psychologic evaluation. Ninety-five percent of programs do not compensate donors. Seventy-one percent require a complete medical and psychologic history and 10% require genetic karyotyping. Three percent limit the number of donations. Eligible recipients include married couples (100%), unmarried couples (61%), lesbian couples (55%), and single women (59%). Sixty-four percent of programs require psychologic screening. Storage limits range from 2-10 years. Forty-nine percent of programs have unclaimed embryos in storage. CONCLUSION(S): Embryo donation is more often contemplated than performed. Variability in program procedures and policies suggests that guidelines need to be clarified. The complexity of the psychosocial and ethical issues underscores the importance of a routine, comprehensive psychologic assessment.

Families created through ovum donation: a preliminary investigation of obstetrical outcome and psychosocial adjustment.

PURPOSE: This study attempted to obtain preliminary follow-up information regarding obstetrical outcomes and the psychosocial well-being of families created through the ovum donation. There is presently very little known about this population with respect to obstetrical care, health status of offspring, family and marital relationships of recipient couples, or how couples feel about having chosen ovum donation as a family-building option. RESULTS: Fifty-nine couples were initially surveyed and, ultimately, extensive information was obtained for 30 husbands, 31 wives, and 51 offspring. There was a very high percentage of cesarean section deliveries (81.6%), and although a few children experienced health problems at birth, they are all now in good health and developmental milestones are within normal limits. Information was also obtained about breast-feeding experiences, choice of donor (known [sister] or anonymous), reasons for choosing ovum donation over other parenting options, and the impact of this choice on marital and family relationships. Demographic data were also obtained. CONCLUSIONS: For many infertile couples, the long struggle to become parents culminated in a successful birth, and the experience of pregnancy seemed to meet a need to be both biological and psychosocial parents. In general, subjects were extremely cooperative with the investigation and they indicated a desire to learn as much as possible about the psychosocial status of families created through ovum donation. As the assisted reproductive technologies move rapidly into the 21st century, it now seems imperative that health and mental health professionals gain more knowledge about the impact of third party reproduction and the psychosocial adjustment and well-being of families created by this medical technology.