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Family Building Options
Just as there’s not a one-size-fits-all treatment for infertility, you may resolve your infertility in a number of ways. Your family may be built through third-party reproduction, adoption, with the help of a donor or surrogate, or you may decide to live childfree after infertility.
Egg, Sperm & Embryo Donation
The use of donor gametes (eggs or sperm) enables singles or couples to build genetic or biological families. Deciding whether to use donor eggs or donor sperm can raise emotional, practical, and legal concerns, which must first be explored. Donor sperm can be used with in vitro fertilization (IVF), intrauterine insemination (IUI), intracytoplasmic sperm injection (ICSI), and with surrogacy and gestational carriers.
Women who want to experience pregnancy and childbirth, but have poor egg quality or no eggs may turn to egg donation. Egg donation is also used by women with no ovaries but an intact uterus, and women who don’t want to pass genetic factors on to a child.
While embryo donation is gaining attention, it is still not widely practiced. With embryo donation the female is able to experience pregnancy and give birth, but the baby will not be genetically related to her or her partner. Embryo donation is used when infertility is untreatable, when recurrent miscarriage is unrelated to uterine or implantation problems, and when one or both partners has a genetic disorder.
When using donor egg, sperm, or embryos, there are a number of issues to consider from both a practical and emotional standpoint. In addition there are a number of steps to take: finding a donor, whether to use an anonymous or known donor, disclosure to family, friends and your child. In the case of egg donation, there is also the issue of whether to do a shared donor cycle.
Surrogacy and gestational care, in which a woman carries and gives birth to another woman’s baby, is a family building option for those who want a child with genetic ties and have had multiple miscarriages or difficulty conceiving and carrying a pregnancy to term, or women who has no uterus or a congenital anomaly of her uterus but has intact ovaries, gay male couples who want a child with a genetically related to one partner.
While still in its infancy, egg freezing may preserve the fertility of women who have certain cancers or must undergo cancer treatment that may damage their eggs or destroy ovarian function. It may also be an option for women who delay having children because they have not yet found the “right” partner, are focused on their careers, or don’t feel the time or circumstances are right for having children.
Adoption is often the next step following unsuccessful fertility treatment. However, first you must give up the dream of having a biological child, grieve the loss, and explore your feelings regarding adoption. Once you are ready to take the next step, you must research a number of options including domestic or international adoption, and closed or open adoption.
Childfree After Infertility
Choosing to live childfree after infertility might seem like an unlikely choice, but couples do make that decision. It requires much contemplation and introspection, and an honest assessment of your values and goals.