Fertility Counselling

Pride Angel provides a fabulous resource for people wishing to donate and for anyone seeking a known donor or co-parent; many choosing this route because they do not wish to have treatment at a clinic.

This can often mean people trying to conceive at home can miss out on the support and information shared during implications counselling which is routine in clinics for both donors and recipients.

It is acknowledged that people considering donating or conceiving with donor assistance have often thought about it for a long time; counselling isn’t there to change anyone’s mind or to provide in-depth analysis of your decision making process.

In cases of known donation there are usually three implications counselling sessions; each one may be with the same or different counsellors. Individual sessions are facilitated for the donor and their partner if they have one and recipient/s and then a joint session; with additional support available as required before, during or following any treatment.

Counselling is recommended not just because of what’s going on consciously; but because we understand how fertility, conception and anything baby or family related can impact on your unconscious, heightened by the lack of control of reproductive organs as you try to conceive. Fertility Counselling can help you to feel grounded, realistic, un-blinkered and hopefully optimistic about the decisions made going forward – whether deciding to try to conceive or to donate…or not.

If a donor and recipient are having treatment at a clinic, they will hopefully have a counsellor they can refer you to (this is compulsory in the UK), counselling is often free of charge, but do check. You are also able to see a private specialist counsellor, which can take place in person or sometimes by telephone or skype.

Donating and conceiving with your donor may be a one off event, with one person or sometimes more. But its impact whether successful or not lasts a lifetime, counselling explores how you feel about donating or conceiving with donor assistance and how that may change over time.

If you decide not to proceed or sadly conception does not occur then specialist fertility counselling can help to explore thoughts and feelings at that time and instead think about and embrace a different direction in life.

Find a specialist counsellor UK: www.bica.net

Contemplating becoming a gamete donor suggests that there’s a belief that you are fertile, a recognition of good levels of health and fitness, surety in your sexual health, able to think creatively and have an altruistic element to your personality. Not bad for starters! 

The first steps if donating through a clinic would be to have an initial discussion about donating and then basic screening tests; for women hoping to donate eggs this can mean a blood test and internal scan and for men hoping to donate sperm an initial semen analysis and freeze/thaw test. In my experience less than 10% get beyond this point as clinic donors have to have above average fertility in order to optimise the chance of successful treatment for recipients. This does not always mean that a donor’s fertility isn’t good enough to achieve a pregnancy, but this rejection can still be incredibly disappointing to hear. Counselling at this point can provide reassurance and help as you process factual information and make plans for the future. 

If a donor is able to and decides to progress as a donor, counselling explores the implications of those decisions now and in the future, for both the donor and anyone they are in close relationships with – partners, children, family, friends. This will include how the donor having genetic offspring might impact more widely and how that in turn may affect the donor. 

It is now well recognised that transparency and openness works best for children born through donor conception and counselling looks at how to utilise the resources available for donors who have children to share information with them, gaining understanding around why it is important, acknowledging that the power of the unconscious applies to children just as much as adults, at all ages and stages. 

If treatment takes place in a clinic it will include legal aspects such as ownership rights of eggs, sperm and embryos, parentage, hopes, expectations, responsibilities and options, not just now but in the future too. For example if there are frozen embryos stored, is the donor able to ask for them for their own use in the future if they are surplus to the recipients’ requirements? 

If treatment is successful counselling provides a neutral ground to explore contact, not just with a donor and any offspring, but also for the wider family. Will the donor’s parents want a grandparent role in any way? It’s also important to acknowledge the importance of terminology, not just on the donor and recipient, but more importantly for any offspring, equally not just in a conscious way, but how the words we use impact on our unconscious. Words used to identify a donor with a parental term can contribute to an unconscious archetypal or stereotypical expectation. So being identified as a donor dad, or biological father, egg Mum or genetic mother, can bring an appropriate sense of loss or abandonment to a child whose donor is recognised as a parent and is not living up to our unconscious expectations. 

In the UK, current regulation permits clinics to work with donors to help to create up to ten families; this limit was set for a variety of different reasons including genetic attraction, the views of donor conceived children, their parents and wider families and the donors too. If a sperm donor is hoping to create more than ten families and/or not sharing information with recipients about other recipients, then counselling can help to explore the thinking around those decisions. 

Donors who donate and a pregnancy is not achieved can access counselling for support; it can be immensely challenging, sometimes overwhelming when trying to help and it’s not working. Often donors forget the gift is in giving, enabling someone the opportunity to try to conceive is fantastic in itself. When it doesn’t work it can be incredibly disappointing, especially if trying home inseminations month after month. Support isn’t available just for those trying to conceive… 

Counselling helps to explore, acknowledge and to gain understanding of the implications of conceiving with the help of a donor or co-parent, not just now but in the future too and not just for the recipient but their family and wider networks. 

Part of acknowledging the implications means recognising loss; for single women, lesbian couples, heterosexual couples experiencing infertility, gay couples – in fact for most people trying to conceive with assistance there is often a loss of fantasy around not conceiving through even mediocre sex with a soul mate or failing that, self-insemination. 

Planning conception, thinking about it for some time, or a long time, can give false reassurances by suggesting that everything has been thought of, so therefore everything will feel absolutely fine. It can then feel confusing if a recipient has any sort of emotional wobble. Anxiety, fear and panic along with the more positive feelings of extreme hope, excitement and optimism means an emotional rollercoaster is wholly appropriate at any stage of your pathway to parenthood. 

The British Infertility Counselling Association produces Best Practice Guidance on the themes that need to be included in a clinic based Implications Counselling Session, but clients are always welcome to discuss anything that comes up for them in their session. 

Treatment in clinics would mean three sessions of counselling, a recipient’s individual session should be attended with a partner if conceiving in a relationship, providing an opportunity to acknowledge the implications around only one being a genetic parent. Where a lesbian couple is having intra-partner treatment, as both Mums are involved in growing their baby, the feelings around not making a baby with a genetic part of both of you can seem less important at conception stage, but can become a bigger issue later on, as it was not acknowledged and/or accepted sooner. 

Counselling can provide strategies to help manage the high levels of stress associated with trying to conceive with assistance; a huge study confirmed that stress does not impact on fertility, but what we do when we are stressed can and sometimes does have an impact – managing stress well so we don’t turn to unhelpful coping strategies such as alcohol, nicotine and caffeine can sometimes be a boost to your fertility. 

Counselling before any attempt to conceive is made can also help you to shift the focus from getting pregnant to thinking about a child. For many people the possibility of a real baby is kept a safe distance away, a coping strategy to try to stop us getting our hopes up, often incorrectly thinking we’ll therefore be less upset if it doesn’t work out as planned. 

Gaining an understanding in your counselling around how a child processes the loss of fantasy associated with donor conception can help to explain why openness from an early age is recommended. A child who grows up knowing, not remembering when they were told about their conception has the opportunity to make sense of what being donor conceived means to them, age appropriately, within the loving, trusting, open relationship they have with their parent/s.

Counselling can also help to explore your thoughts and feelings around the importance of how your donor is identified. How we think on a conscious level can often be in conflict with how our unconscious is processing. For example having a donor dad, biological father, genetic mother or egg Mum, for a child can give a sense of another parent who if not behaving as an archetypal or stereotypical view of parents, can promote an appropriate sense of loss, disappointment or abandonment. If a donor is known as a known donor, our unconscious understanding of a donor is someone generous, donating, giving and a relationship with such a person can be based on how it is, not how our unconscious perceives it should be. 

Contact arrangements can often be organised with great clarity prior to a child being conceived, often a little person can change everyone’s feelings around contact, not just with the donor but their wider family too. For recipients it is important to be able to explore not only how a donor feels but the views of their family also, for example are the donor’s parents hoping for a grandparent role in any way. 
Counselling provides an opportunity to explore… 

Find a specialist counsellor UK: www.bica.net/counsellorbypostcode 

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