Reacción a "Reactions: 20-year study of the psychological well-being of children born through third-party assisted reproduction"

This study, conducted in the UK by researcher Susan Golombok and her team, aimed to establish whether children born through assisted reproduction involving gamete donation experience psychological problems or relationship difficulties with their mothers in early adulthood. It also examined the impact of disclosure of their biological origins and the quality of the mother-child relationship from the age of three. The study included 65 assisted reproduction families when the children reached the age of 20, including 22 uterine surrogacy, 17 egg donation and 26 sperm donation families, compared to 52 non-assisted reproduction families.

The study was conducted in a comprehensive manner, with powerful psychological tools and an appropriate methodology, although its main weakness, as the authors themselves acknowledge, is the low number of cases, especially the number of families who used egg donation.  

The results showed that there were no differences between families formed by egg donation, sperm donation, surrogacy and non-assisted reproduction in maternal anxiety or depression, nor in the quality of the mothers' relationships with their partners. Nor were any differences identified in parenting, mothers' acceptance of their adult children, the quality of family relationships or the openness of family communication.

As for young adults, no differences were found in their perceptions of maternal acceptance, nor in the quality of family relationships, according to family type. With respect to psychological well-being, no differences were identified between family types in psychological adjustment, as assessed by the Strengths and Difficulties Questionnaire, completed separately by mothers and young adults, or by a child psychiatrist's ratings of mothers' interview transcripts. Overall, young adults showed high levels of psychological adjustment comparable to those of the general population for 17-23 year olds.

However, within gamete donation families, egg donation mothers had less positive family relationships than sperm donation mothers in terms of family functioning and maternal acceptance of their adolescent children, suggesting to the authors that the absence of a genetic connection between mothers and children presented a challenge for the mother. However, the study has not taken into account a bias that the authors have already commented on in principle, which is that in this group the age of the mother is older than in the other groups, which may have influenced this relationship difficulty, rather than the genetic link. 

It is also important to point out that, before resorting to gamete donation, a prior psychological assessment of the parents is necessary to avoid subsequent rejection after the birth of the child and even during pregnancy, which occurs more frequently in women who use egg donation. The study did not mention that these patients had made such an assessment.  

The study also found worse family communication in young people conceived by sperm donation than those conceived by egg donation. Although the sample sizes for this comparison were again small, this finding, according to the authors, is in line with parents' greater secrecy about sperm donation than about egg donation, which is sometimes due to fathers' greater reluctance than mothers to disclose to their children that they are not their genetic offspring, and their greater opposition to talking about it once they have disclosed it. This is in line with the study's latest findings that adults who learned of their biological origins before the age of seven had less negative relationships with their mothers, and their mothers showed lower levels of anxiety and depression. These findings are consistent with those of other studies showing that disclosure of origin to children born through assisted reproduction should be made at an early age.  

Associations between parenting and child psychological adjustment did not differ between assisted and non-assisted reproductive families from age three to age 20.

Since the study did not, of course, include young people whose parenting was not disclosed, it is not possible to know whether there is any difference between them and those whose parenting was disclosed.  

In conclusion, the findings suggest that the absence of a biological connection between children and their parents in assisted reproductive families does not interfere with the development of positive mother-child relationships or psychological adjustment in adulthood.