Assisted reproductive technology with donor gametes: the need for patient preparation

There are certainly no definitive answers to the questions raised by the use of donor gametes in reproduction, as there are no definitive answers to any of life's most difficult questions. The loss of fertility is usually an unexpected, invisible, deeply painful wound for those couples who are considering the use of donor gametes. As they address the psychological issues of these techniques, they must also heal the wounds created by infertility. This type of grieving and examination of feelings takes time and information. The medical community needs to encourage each couple to resolve the issues around infertility and to use available personal, professional, and written resources to address the dilemmas raised by the use of donor gametes prior to embarking on this type of treatment. In so doing, the couple will reduce the likelihood that the means of conceiving their children will become a source of major conflict in their family. In 1932 Aldous Huxley prophesied the destructive consequences of scientific accomplishment without social involvement and psychological guidance. He said: "The sciences of matter can be applied in such a way that they will destroy life or make the living of it impossibly complex and uncomfortable...unless used as instruments by biologists and psychologists." It is our concern that the procedures for enabling infertile couples to become parents may, if not accompanied by acknowledgment of the unique challenges which they create for all participants in the process, make the living of life "impossibly complex and uncomfortable" for the very families we are trying to help.