Ways to Strengthen Your Relationship When Using a Donor or Surrogate

“Mommy, where do babies come from?”

In recent years, advances in reproductive medicine have put a whole new twist on the answer to this age-old question. In the emerging world of baby-making, there’s a new player, formally called a “third party,” who can facilitate ways to conceive, or carry a pregnancy and give birth.

But as much as these avenues help make parents out of couples who thought that door had been slammed shut, these new possibilities also carry new challenges. And one of these challenges for couples is how to handle the fact that an “outsider”—an egg donor, sperm donor, or surrogate—has become part of what used to be a very private and personal process. Another challenge may be to redefine ingrained ideas of how families are created, and what it means to be a family.

Making the Connection

Just about everyone has heard of “sperm banks,” which provide semen—sometimes from anonymous donors, sometimes not—for reproductive purposes. Sperm banks have been around for decades, but recently the rise of new medical options for men with fertility problems has lowered the need for donor sperm. Egg donation, on the other hand, is becoming more common as more women wait longer to start their families. And gestational carriers—a type of surrogacy in which a woman carries the pregnancy for a couple using their egg and sperm, or embryos created with donor egg or sperm—are also an increasingly popular option, since unlike a traditional surrogate, a gestational carrier has no biological tie to the child she carries.

Couples who decide to use donor egg or sperm have to face the fact that only one of them will be a biological parent. This sticky issue may be a bit easier for women to deal with, especially if she is able to use a donor egg to carry the pregnancy herself, or use her own egg but have the pregnancy carried by a surrogate. In either of these cases the woman still has a physical connection to the pregnancy. But when a couple uses donor sperm, the husband’s lack of a biological or physical link can cause tension in the marriage, and sometimes even make it difficult for a new father to bond with his child. The “genetic inequality” can be difficult.

That’s what happened to Lily, an attractive 35 year old, who recently spoke of her distress and feelings of being an “outsider” in the birth of her child. Her husband, a man 12 years older, desperately wanted a biological child. But Lily had undergone fertility treatments only to discover that she would not be able to conceive or carry a child, and the couple decided to use both a gestational carrier and a donor egg. As Lily sat in my office awaiting the results of the carrier’s pregnancy test, she said she felt as if she were waiting to see if she was about to become the babysitter for her husband’s child.

Another woman, Caroline, was consumed with jealousy for the gestational carrier who was bearing her child. Caroline’s biological connection with the baby—the embryo was created with her egg and her husband’s sperm—couldn’t silence her intense envy every time she accompanied the pregnant carrier to the doctor’s appointments and watched her own husband and the medical staff shower the carrier with attention.

And Louis, a man who desperately wanted a family, resisted the idea of a sperm donor, believing this would mean that another man could give his wife the baby he could not.

Handling the emotions that arise with third party reproduction is challenging, but not insurmountable. Follow these suggestions to emotionally prepare yourself, and to help your relationship grow along with your family.