The assisted reproduction families generally showed high levels of family functioning and children's adjustment from early childhood through to adolescence

Love and Truth: What Really Matters for Children Born Through Third‐Party Assisted Reproduction. Susan Golombok. Child Development Perspectives, May 4 2021. https://doi.org/10.1111/cdep.12406

Abstract: Ever since the birth of the first baby born through in vitro fertilization in 1978, advances in reproductive technologies have raised new concerns about the outcomes for children. In this article, I summarize research on children born through assisted reproduction involving a third party, that is, children born through egg donation, sperm donation, and surrogacy, with particular attention to the findings of a longitudinal study of children born to heterosexual couples in the United Kingdom. The assisted reproduction families generally showed high levels of family functioning and children's adjustment from early childhood through to adolescence, suggesting that biological relatedness is less important than positive parent–child relationships for the well‐being of children conceived by third‐party assisted reproduction. Similarly, studies of families created by third‐party reproduction with two mothers, single mothers, two fathers, and single fathers have shown that these families function well.

Conclusions

Despite concerns to the contrary, in the U.K. Longitudinal Study of Assisted Reproduction Families, the assisted reproduction families generally showed high levels of family functioning and children's adjustment from early childhood through to adolescence. The differences identified did not point to dysfunctional family relationships but instead reflected variation within the expected range. The idea that third‐party assisted reproduction adversely affects parenting and children's adjustment comes, in part, from research showing an increased likelihood of childhood psychological problems in adoptive families (Palacios & Brodzinsky, 2010) and stepfamilies (Dunn, Deater‐Deckard, Pickering, O'Connor, & Golding, 1998), in which children similarly lack a biological link to one or both parents. However, the problems experienced by adopted children and stepchildren often arise from difficult family situations before being adopted, or before or after moving into a stepfamily. Adopted children often have suffered maltreatment before being placed with their adoptive parents, sometimes for years, and many have been moved from one foster family to another before being adopted (Palacios & Brodzinsky, 2010). Children in stepfamilies often have been separated from a parent to whom they were attached and are required to form relationships with new family members. Moreover, stepparents generally do not see stepchildren as their own children (Dunn, Davies, O'Connor, & Sturgess, 2000). In contrast, children born through assisted reproduction are raised from birth by parents who wanted to have them and who consider them to be their own children. Biological relatedness seems to be less important for the well‐being of children conceived by third‐party assisted reproduction than are warm and responsive relationships between parents and their children.

Although the absence of a biological connection between children and their parents does not appear to cause difficulties for children, not telling children about their origins or delaying disclosure beyond the preschool years is associated with less positive outcomes for adolescents' well‐being and family relationships. Moreover, just because adolescents born through donor conception and surrogacy are functioning well does not mean that their donor or surrogate is of no significance to them. Some donor‐conceived adolescents have little interest in finding out about their donor. But others search for information on the Internet. In investigations of motivations, adolescents and young adults who searched for their sperm donor and donor siblings were curious about resemblances in physical and personality characteristics, wanted to learn about their ancestry, and wished for a more complete story of how they were born (Canzi, Accordini, & Facchin, 2019; Jadva, Freeman, Kramer, & Golombok, 2010; Scheib, McCormick, Benward, & Ruby, 2020; Scheib, Ruby, & Benward, 2017). In many cases, these youth were more interested in their donor siblings than in their donors; they wanted information about their donor, and some wanted to meet him, but they usually did not see him as their father, and they were more likely to develop enduring connections with their donor siblings. In a study that explored why some adolescents are more interested in their donor relations than others, secure attachment relationships with mothers were associated with greater acceptance of and curiosity about donor conception (Slutsky et al., 2016).

The U.K. Longitudinal Study of Assisted Reproduction Families collected data from mothers, fathers, children, and teachers using standardized interviews, observational assessments, and standardized questionnaires. Nevertheless, it is the only prospective, comparative study of parent–child relationships and children's psychological adjustment in families formed through sperm donation, egg donation, surrogacy, and unassisted conception and the only in‐depth study of children born through surrogacy. Therefore, replication should be a priority, especially given the increasing numbers of children being born through assisted reproduction worldwide. Because the parents in the study were predominantly White and of medium to high socioeconomic status, the findings may not be relevant to more diverse families, who may struggle financially to afford fertility treatment, or who are from religious or ethnic backgrounds that do not accept third‐party assisted reproduction, requiring parents to keep their children's biological origins secret.

The study also focused on children born to heterosexual couples. More research is being done on lesbian‐mother families formed by sperm donation (Bos & Gartrell, 2020), single heterosexual‐mother families formed by sperm donation (Golombok, Zadeh, Freeman, Lysons, & Foley, 2020; Golombok, Zadeh, Imrie, Smith, & Freeman, 2016), families with gay fathers created through surrogacy and egg donation (Golombok, Blake, et al., 2017; Rubio et al., 2020), and single‐father families with children born through surrogacy and egg donation (Carone, Baiocco, Lingiardi, & Barone, 2020), all with similarly positive outcomes. These findings show that families created by third‐party reproduction with two mothers, single mothers, two fathers, or single fathers function well, irrespective of the number, gender, and sexual orientation of the parents. As with traditional families formed by assisted reproduction, in nontraditional families, the quality of parent–child relationships appears to be more important for children than the way in which the family is constructed.

The overall findings of research on children born through third‐party assisted reproduction are consistent with a relational developmental systems framework (Osher, Cantor, Berg, Steyer, & Rose, 2020; Overton, 2015): Relationships, such as those between parents and children, and context, such as the disclosure or nondisclosure of children's biological origins, interact reciprocally with characteristics of the child to influence development. Newly emerging family forms raise new questions about the psychological consequences for children. Transgender parents who have had children through fertility preservation and lesbian couples that use one partner's egg to create the other partner's pregnancy are just two examples of 21st‐century families made possible through advances in assisted reproduction. Researchers need to study the outcomes of parents and children in these families. However, based on what we know from current studies, warm and supportive relationships between parents and their children, and openness about the children's origins, seem to be what matter most for children born through third‐party assisted reproduction.