The desire to have a child has very deep roots. It is not based only on instinctual or biological aspects, but also on social, cultural and relational aspects.
Many women plan the right time to have a child, postponing it to wait for emotional and economic stability. However, when they decide to take this step, they may face difficulties in achieving pregnancy.
Having overcome the profound disturbance that derives from the awareness of being infertile and having even postponed the pregnancy, the need arises to make decisions, to assume a new vision of the problem and to evaluate the different alternatives to deal with it. In this way, hope is reborn in the couple.
Usually, women or couples who go to a center specialized in medically assisted reproduction are eager to proceed immediately with the recommended treatment.
In situations such as premature menopause, advanced age or failure of previous infertility treatments, homologous assisted reproduction procedures are not conclusive and in vitro fertilization by egg donation is proposed .
In egg donation, the donor undergoes monitored ovarian stimulation and egg retrieval while the patient is prescribed hormone therapy to prepare the endometrium to receive the embryos that are fertilized in vitro and then transferred.
Egg donation represents for many women the possibility of realizing the dream of becoming a mother but in some cases, receiving eggs from a donor is a difficult and painful choice.
The feeling of grief, consequent to the diagnosis of infertility, is aggravated by the impossibility of passing on the genetic heritage to one’s children. Fears may arise about the psychic development of the child, about the mother / child bond, about the couple relationship and about the attitude of family members and the concern of not perceiving oneself as the child’s true mother may arise.
The intervention of a donor alters the normality of the procreation process within the couple, and can generate strongly ambivalent feelings. The gratitude and gratitude towards her alternate with fantasies that see her as powerful, young and fertile, extraneous to the bereavement faced by the infertile patient. The woman may feel a sense of inequality towards the partner, considering him the only genetic parent.
In fact, recent studies have found that the relationship between mother and embryo is able to affect the genetic heritage of the unborn child, even when there are no biological links between the future mother and the fertilized egg.
This discovery was documented in the study conducted by the IVI Foundation entitled “Hsa-miR-30-d, secreted by the human endometrium, is taken up by the pre-implantation embryo and might modify its transcriptome”. The research was published in the scientific journal Development of the English association of biologists and geneticists which demonstrated how communication between mother and embryo can modify the genetic information of the newborn even in the case of egg donation.
Some particular conditions in which women may be found are able to modify their cells, even those of the endometrium. This determines such a change that in its secretion the genetic information of the mother is released and then absorbed by the embryo.
This communication can cause specific functions to be expressed or inhibited in the embryo, thus giving rise to the aforementioned changes. This discovery confirms the long hypothesized existence of an exchange of information between endometrium and embryo.
In the presence of certain pathological conditions, in fact, as in the case of obesity, diabetes, but also of smoking, the endometrial cells modify the activity of their genes, thus influencing embryonic development. This would explain the process of transmission, between the mother and the child, of some physical characteristics as well as some childhood diseases such as diabetes and obesity.
This discovery will allow us in the future to avoid the transmission of some diseases when their cause is epigenetic, i.e. those diseases that occur as a result of changes in the expression, and therefore in the activity, of one or more genes without being modified. structure.
A further study published by “Nature genetics” would show that the patient who receives the egg, due to an epigenetic phenomenon, is able to modify the original imprinting, transmitting part of its characteristics to the child.
The mother-to-be is able to modify her child’s genome even if the egg is from another woman . In any case, the gestation period of that embryo, although the female component has been donated, creates a very deep physical and psycho-emotional bond with the mother. And it is certainly not to be overlooked that she will give birth and breastfeed him: all essential aspects for which that child, even if conceived from a donated egg, is perceived and loved as one’s own in all respects.
Mothers who accept an egg donation, therefore, would transmit something of themselves to the baby conceived from another woman’s egg and should not be considered simple passive incubators.
Egg donation is experienced by each patient in a different way according to the singularity of their psychic structure. Not all patients or couples take the time to process the feeling of loss that comes from knowing they can’t have children.
When they learn about the diagnosis of infertility, they often make hasty decisions by undergoing multiple treatments, driven by the worry of wasting precious time. They rarely take the time to delve into the emotional implications that assisted reproduction techniques entail.
Facing an artificial fertilization treatment arouses feelings of impatience, trust, hope, optimism, disappointment. There is a constant sense of frustration for one’s inability to procreate, which is intensified by the need to have recourse to a donor.
An appropriate psychological intervention can facilitate the expression of one’s own emotional experiences, personal, couple and interpersonal difficulties, helping to prevent anxious states and to examine the emotions involved in the reproductive path, ranging from denial to acceptance of the problem .
In this context, the relationship with relatives, friends and acquaintances plays an important role, who often ask the couple when they will have children. Patients should be helped to decide freely whether to share this experience with other people, weighing pros and cons.
Socio-family pressure can lead patients to isolate themselves, even from other couples who have had children, and who unconsciously point out their inability to have them. By avoiding social contacts, the only support is sought within the couple itself, generating more tension in a situation where both need support.
It is important that patients be able to use external support to achieve adequate emotional balance, which is useful for dealing with infertility problems and interacting with the surrounding environment. Counseling should intensify in the waiting period for the pregnancy test result, just when patients experience alternating feelings of fear, hope and happiness. At this stage it is also necessary to speak openly about the possibility of a possible negative outcome at the end of the treatment.
Failure to become pregnant represents one of the most difficult moments of the whole process, in which one perceives the absence of a reward for the efforts made. By relying on assisted reproduction techniques, the feeling of loss related to infertility can reappear if pregnancy is not achieved and with it pain, frustration, fear and failure resurface.
It is important to evaluate the possible alternatives to procreation, such as adoption or living without children, deepening one’s own experiences of acceptance or rejection regarding non-parenting.
It can be of great help to try to value what you already have (friends, relationship, projects, interests), trying not to center your life on what you don’t have.
Undertaking the path of assisted reproduction treatments, and egg donation in particular, can be very tiring from an emotional, personal and relational point of view. Adequate psychological support, aimed at containing doubts, sufferings and fears, can be of considerable help in facing this process with due serenity.
