A study published in the Journal of Reproductive and Infant Psychology found that children conceived using IVF want to know their conception story. So, the question becomes: How can patients explain IVF to their children so they can understand how they were conceived? Here is a guide for reproductive endocrinologists to help support patients through this process.
Toddler and Preschool
If parents want to explain to their child how they were conceived, it's best to start when the child is young. The dialogue should be ongoing but age-appropriate.
Physicians will want to encourage patients to begin by telling their child — early and often — how much they were wanted and assuring them about how much they are loved. It is advisable for the conversation to end there until the parents believe the child is ready for information about reproduction and their conception story.
When the time is right, it's best to explain IVF at this age using simple facts about reproduction and the various ways families are made. Reproductive endocrinologists can offer written, audio and video content — to appeal to different learning styles — to assist in the conversation.
Doctors are likely to have additional materials, such as the Donor Conception Network's Telling and Talking booklets, available for patients who used an egg and/or sperm donor.
When it's time to tell the child their own conception story, physicians can offer the parents encouragement and a willingness to provide additional support if needed.
According to a study published in Human Reproduction, 43 percent of participants disclosed the use of an egg donor to their children and an additional 39 percent intended to disclose. On average, the children were 5.5 years old.
If an egg and/or sperm donor was used, reproductive endocrinologists will suggest patients emphasize their roles as parents, regardless of genetics.
Elementary School
The next phase of the conversation should build upon the foundation the parents established during the toddler and preschool years. First and foremost, doctors will want to reinforce to patients the importance of reassuring the child of unconditional love from both parents.
In this phase, patients will explain the history of IVF in further detail, including how the parents made a mutual decision to have a child. Because the child almost certainly will be asking questions at this age, physicians can assist patients in explaining in more detail the various ways families are made.
Assuming the child was not born using a gestational carrier, patients may decide to reassure the child that they were carried in the mother's uterus and born just like many of their friends were. If a gestational carrier, egg donor and/or sperm donor were used, reproductive endocrinologists can help patients find the words to explain that these are good people who wanted to help others have children.
Doctors will tell parents to prepare for a likely emotional response from the child at this age, especially if another child or adult in their life has made a negative comment about their conception. Toward the end of elementary school, they may receive some sex education, so the topic might come up.
Whatever the child is feeling, physicians should encourage patients to validate those emotions and make themselves available to listen, answer questions and explain IVF.
Junior High and High School
By junior high and high school, children are likely ready to understand infertility as a medical condition and why their parents chose IVF to build their family.
As always, reproductive endocrinologists should drive home the importance of starting every conception conversation with how much the child was wanted and is loved by both parents. Patients can then explain IVF in step-by-step detail, if the child is interested in this information.
At this age, however, normalizing infertility and IVF are arguably the most crucial topics. Doctors are able to provide patients with statistics about their method of conception (i.e., IVF with own eggs, IVF with donor eggs, etc.) to aid in the conversation. Additionally, patients should be encouraged to leave the decision about whether or not to discuss their background publicly to the child.
If a donor was used, the child may express more intense feelings of confusion, sadness and pain than in the past, so physicians should help prepare patients for this possibility. Suggesting a therapist for both the parents and child to help all parties work through their emotions might be appropriate.
Explaining IVF doesn't have to be traumatic, but it's important for reproductive endocrinologists to help guide the conversation as the child matures.
