Fertility Experts share their views: Dr Lauren Magalnick Berman, Ph.D.

Job title: Chair of the Mental Health Professional Group of the American Society for Reproductive Medicine
Organization: Fertility Psychology Center of Atlanta, LLC


Talking to children about their conception is never straightforward. When they’re conceived by egg or sperm donation or surrogacy, there’s an extra layer of complexity. Resources like books and videos are more limited, and they’re less likely to encounter other children who have been brought into the world in the same way.


This month, we spoke to Dr Lauren Magalnick Berman, an expert in reproductive psychology, to ask for her advice on having the Big Conversation.  


Lauren, what’s your connection to donor assisted conception, and what’s your related background?
I was a clinical Psychologist for 32 years, taking a Reproductive Psychology specialty for 15 years. I counsel people who are planning to use sperm, egg and embryo donors and gestational carriers in order to create (or complete) their families.  
I also work as a psychotherapist with individuals and couples who are dealing with the emotional challenges of fertility treatment and reproductive trauma.  I am currently the Chair of the Mental Health Professional Group of the American Society for Reproductive Medicine.


What do you believe are the benefits of telling children their story?  
There are many benefits in talking with children about donor (and/or gestational carrier) conception. The truth is that with modern technology - genomic and artificial intelligence - there is no longer the possibility of secrecy.  Every day, people are discovering genetic relatives, family secrets, and genetic history through direct-to-consumer DNA testing.  These services are very popular in the United States.  It’s estimated that by the end of 2021, there will be 100 million US-based DNA samples in these databanks.  
Adding social media to the information gained from these databanks, most Americans are likely to be discoverable.  In her memoir, Inheritance,  Dani Shapiro describes how, once she discovered that she was donor-conceived through AncestryDNA, she quickly discovered the identity of her donor. 
The main benefit of disclosure to children is that parents remove the perils of secrecy from their family. Secrecy can create shame, distrust, identity confusion, and guardedness.  When parents are open with their children about their conception, there is greater comfort and openness in the family system.


How early do you recommend parents tell their children about their conception? 
The current recommendation is to begin sharing the donor conception story from birth or even prior to birth.  The thinking is that beginning disclosure before or shortly after birth gives parents the opportunity to gain comfort with the story and to work through any issues they, themselves, might have with using a donor.  We do not know when the disclosure story will “click” for the child, so telling them from a very young age helps us bypass the issue of trying to find this moment in time.


What are the most important things to consider when telling your child? 
It is really important for parents to gain comfort with their conception story and fertility history. This may include grieving the loss of passing on their own (and/or their spouse’s) DNA. It’s also important to let their children know that they went through donor conception because they very much wanted to bring children into the world.


Does it make a difference for either parents or children if they are telling about a donor egg or a donor sperm?  
I find that heterosexual couples who use donor gametes sometime struggle more with disclosure than single-parents-by-choice or same-sex couples. 


What’s your preferred way to communicate this kind of information? 
I love children’s books for sharing all kinds of information and family values.  When my children were small, I read to them every night and I remember those times as very special.  We read books about how to be a good friend, how to overcome problems, etc. 


What’s your favourite children’s book on these subjects?
There are different books for different stages of development and I recommend having a variety of books on this topic.  A Tiny, Itsy Bitsy Gift of Life is excellent for young children and The Pea That Was Me and Phoebe’s Family are wonderful for older children.


What are your thoughts on The Magic of You?
What I love about The Magic of You is that it can be personalized for each family.  I have patients of many different races and ethnicities who cannot find books that look like their families and children. The Magic of You solves that problem for them. Likewise, I have patients who use multiple forms of assisted reproductive technology - such as gestational carrier and embryo donation - to create their families.  The Magic of You enables them to have a book that describes their lived experience.


In your experience, how have you found attitudes towards telling donor-conceived children about their story? 
In the fifteen years that I have done this work, I have found that parents have become more and more open to disclosure.  When I first began working with people who are planning to use donors, these patients were much more reluctant and took some convincing.  Now I share stories and resources and most patients are delighted to have the stories and books shared with them.


What is your advice for parents who are nervous about explaining to their children how they were conceived? 
I tell parents that they are the best people to share this story in a positive and loving way.  It is important for family relationships and children’s self-identification that the story comes from parents and not an external source.  Sometimes reluctance to disclose is related to unresolved issues around the complex, family-building journey our patients often take. 


As Lauren mentions, The Magic of You is a wonderful way to tell your child’s story back to them as they grow up, allowing you to add photos of them and the special people involved in the process. Learn how to design yours here


Because every family’s situation is so unique, we always recommend seeking personal advice from professionals if you’re going through this stage and have any doubts or concerns. 


You can read more about Lauren here, and her articles about infertility awareness here and here.