THIRD-PARTY DONATION

At age 20, children conceived from third-party donation enjoy well-adjusted family relationships

Published 15 April 2023

A 20-year qualitative study which has followed 65 families with children born from ART - 22 by surrogacy, 17 by egg donation and 26 by sperm donation – from infancy through to early adulthood has found that at age 20 there was no difference in psychological well-being or quality of family relationships between the children born by ART and those born naturally.(1) However, the study’s findings do suggest that telling children about their biological origins early on – before they start school – can be advantageous for family relationships and healthy adjustment. Specifically, young adults who learned about their biological origins before age 7 had fewer negative relationships with their mothers, and their mothers showed lower levels of anxiety and depression.

This longitudinal study, say the authors, is the first to examine the long-term effects of different types of third-party ART on parenting and child adjustment, as well as the first to investigate prospectively the effect of the age at which children were told that they were conceived by egg donation, sperm donation or surrogacy.

This latest report is from the seventh phase of this study and allowed the researchers, led by Susan Golombok from the Centre for Family Research, University of Cambridge, to examine the quality of parent–child relationships and psychological adjustment of the study children when they reached 20 years. Although findings at age 14 showed that the families formed by reproductive donation to be functioning well, it was not known whether this pattern continued into adulthood. The conclusion from that analysis was positive, despite fears that ‘young adults born through reproductive donation would show higher levels of adjustment problems and difficulties in relationships with their mothers than those born by unassisted conception’.

The results were derived - as in all earlier phases of the study - from standardised interviews and questionnaires with the mothers and children. Notably, the latest analysis showed that young adults who learned about their biological origins before age 7 had fewer negative relationships with their mothers, although generally the associations between parenting and child adjustment did not differ between assisted and unassisted reproduction families from ages 3 to 20. The findings, said the authors, ‘suggest that the absence of a biological connection between children and their parents [in donor conception families] does not interfere with the development of positive mother–child relationships or psychological adjustment in adulthood’. They further suggested that families ‘may benefit’ from parents of children born through third-party ART speaking to them about the circumstances of their birth at an early age, ideally before they start school. For example, only 7% of mothers who had disclosed such details by age 7 reported problems in family relationships, compared with 22% of those who disclosed after age 7.

The results also seem to overturn the widely held belief that children conceived by gamete donation and in the absence of a genetic connection to the mother or father might result in raised levels of child adjustment problems. By way of explanation the authors suggest that gamete donation children are born into the families in which they are raised, and are not relinquished by, or removed from, their biological parents; their parents consider them to be their own children. And of course, in most such families, there is a genetic connection to one parent.

‘Despite people's concerns, families with children born through third-party assisted reproduction – whether that be an egg donor, sperm donor or a surrogate – are doing well right up to adulthood, said Susan Golombok in a press statement.

The one caveat to such conclusions was found in families with children conceived by sperm donation. Young adults conceived by sperm donation reported poorer family communication than those conceived by egg donation. This could be explained, said the authors, by the greater secrecy around sperm donation than egg donation, sometimes driven by greater reluctance of fathers than mothers to disclose to their child that they are not their genetic parent, and a greater reluctance to talk about it once they have disclosed. In fact, the researchers found that only 42% of sperm donor parents disclosed by age 20, compared to 88% of egg donation parents and 100% of surrogate parents.

‘Today there are so many more families created by assisted reproduction that it just seems quite ordinary,’ said Golombok. ‘But twenty years ago, when we started this study, attitudes were very different. What this research means is that having children in different or new ways doesn’t actually interfere with how families function. Really wanting children seems to trump everything – that’s what really matters.’


1. Golombok S, Jones C, Hall P, et al. A longitudinal study of families formed through third-party assisted reproduction: Mother-child relationships and child adjustment from infancy to adulthood. Developmental Psychol 2023. DOI.org/10.1037/dev0001526