Transcript
Speaker: At 21, it can be very difficult to think about, you know, 42, you're going to get this email someday. Future contact and that being anonymous is not really a thing anymore. Becoming an egg donor can feel like a decision you're making for one chapter of your life.
Speaker: But the decision itself doesn't end there because years from now, there will be someone else whose story began in part with yours. So what should you understand before you say yes? They need to know if they're, and again, i would say 95% of our egg donors come in and man, they are so loud and proud, man. They are so prideful. I'm so excited. i already told my boss and my sister and we love that. But do they also know that if they didn't tell their brother or their-
Speaker: mother or whomever that that very yeah well may come from another source. Today, I'm joined by psychotherapist Kristin Maljean and Leslie Murphy to talk about what really happens during an egg donor psychological evaluation and why that conversation goes far beyond whether someone is qualified to donate, but also what it really means to be prepared to become an egg donor.
Speaker: Together, we look at the questions worth asking now and the ones that may not have answers until years from now. Enjoy. I feel like many prospective egg donors, they hear that phrase, psychological evaluation, and immediately become nervous.
Speaker: What do you think people most commonly misunderstand about the purpose of the evaluation for the egg donation process? Yeah, that's such a good question. um i think they automatically think it's a test and that it's a pass-fail. I'm either going pass or I'm going to fail the test. And it's there's obviously so much more to it than that. It's um it's really you know something that we want we're doing to help them as much as we are to ensure that this is a good fit for the clinic. We're also ensuring
Speaker: that this is a good fit for the donor themselves. So really, you know, looking to protect them and and ensure that they are supported as well during the process. So it's more of an evaluation, not a test, and something that we are really looking at to help them through the process. Yeah.
Speaker: For egg donors specifically, what is the evaluation actually designed to accomplish? Another good question. um It's we're looking at ruling out certain things, of course. We're looking at making sure that, you know, they're in the healthiest place possible from a mental health perspective. So there's lots of criteria that we are looking at, you know, from that angle. But we're also wanting to make sure that they are informed and that they're making an informed decision about being a donor. Right. So. Not only you know are they a good fit overall, but is this the right time? Are they comfortable with the risks involved? Do they know about benefits that are there for them as well in this process? What are the future implications? So we understand that a lot of donors nowadays have done a lot of research. and have seen lots of videos on TikTok and YouTube. That's such a common, like, how'd you find out about being a donor? Oh, I saw a video on TikTok. um And they are pretty informed for the most part, but there's, you know, there's nuances that that other people don't know about when you just see something on a video. And so there's real life scenarios too that we can talk about um and share with them, you know, about, you know,
Speaker: Donors that we've gotten to know or donor conceived people that have come forward and we've talked to and so we're able to share with them. What if this happens? What if that happens? And so just really be able to walk alongside them from a more personal perspective about this whole process that they're looking into to doing.
Speaker: Yeah, no, for sure. what Especially because I think obviously with, if if you were to do a compare and contrast with the surrogacy, you know, psychological evaluation, of course, it's about the person and still informed consent. But with the egg donation aspect, it is, you do have to touch on, there's going to, there will be a genetic connection to this, you know person in the world and, you know, just everything about that. Can you dive into that a little bit more?
Speaker: Yeah. And I think that's also a really good like area to focus in on because I'm not sure that, you know, all donors really think about that. um We do have a lot of donors, you know, come across that are they're younger and they're focused on, you know, school and education and establishing themselves in a career. and And they absolutely want to help, you know, other families, you know, build their family, but don't really sit down and sit with what does that mean that there is a genetic connection or a genetic link to, other, you know, potentially other people out there down the road. And so we spend time talking about, you know, you know, are you open to potential contact when, when, you know, the donor conceived people turn 18 or older? um you know, how does that make you feel? How do you feel about, you know, several recipients um potentially using your eggs and um and and, and, and, and explaining that contact doesn't mean
Speaker: kinship or any type of, you know, responsibility, responsibility or relationship or accountability for anything. It just means that, you know, you might get contacted, you know, later. And, and also how do you feel about sharing with your potential future children?
Speaker: You know, if they know that they want to have children later and future partners, if they're not, um you know, partnered or married at this time. So just,
Speaker: Talking about what that means to have have that link biologically and then who do you share that with later, you know, and and be transparent with about that. Well, and also, who are you sharing with now? Yeah.
Speaker: Because I think what you said about ah it's it's helpful. we We see so many egg donors and potential egg donors. And so it's really great that we have this history of that.
Speaker: other experiences that we can share. Not that everyone has the same similar situation, but just a little insight. And so one thing I see with current is if, if we have an egg donor who is shared with her family, her parents, and sometimes the parents, especially her mother may see this as their grandchild, like, wait, you're giving away my grandchild. Yeah.
Speaker: And the donor, of course, doesn't see it like that. She says, these are cells. I'm gifting. I'm helping another person, another family. And so that's been a real interesting, i guess, dialogue for them to be able to either go back and explain, especially if sometimes we have donors who... are, are thinking I may not have children of my own. And so this is why not share my genes? I have great genes. I am healthy. I come from a great family. I'm, you know, all the things, why not, if I'm not going use them, why not let someone else? Right. And so, but sometimes your own family and friends don't always align with that. And so it's, it, it makes, and that's what goes back to what Kristen said about
Speaker: like the whole role of the evaluation is having the dialogue and helping them have the words and the voice, um, to, to how, how to explain that to their families. I mean, no, 100%, because yes, I do it. A lot of it is just a misunderstanding of just egg donation as a whole. And, you know, kind of having a, just not an education, not even thinking anything negatively about egg donation, but just not having an education. education unfamiliar Not knowing. Yeah, exactly. Not knowing, not knowing. Yeah. not knowing yeah
Speaker: Before we like just continue to dive into the details, can you help listeners understand what the ASRM is and why their guidelines matter when it comes to egg donation and the psychological evaluation behind it? And how, I mean...
Speaker: I think we, when I think, a when I think donation in general, I think a lot of people just think, you know, people walk into a clinic and most of the time they're thinking of sperm donation and it's like, you're in, you're out, you get a hundred bucks and you call it a day, but there's so much more. in yeah dropping it off see you later just Exactly. Exactly. Right. um Yeah. So can you just dive into that a little bit more for me, Kristen?
Speaker: Yeah, of course. So ASRM is American society for reproductive medicine. It is the multidisciplinary organization that seeks to advance reproductive care.
Speaker: So um and also educating about reproductive rights. and um And and really one of the big things that they do is establish standards of care um for all of these procedures, all of the things related to infertility and specifically with their party, you know, wanting to make sure that that Because we know evaluations are both, you know, subjective and objective, right? There's a combination of, you know, but you know gray area and black and white. um They're setting forth ethical standards, you know, and criteria. So there is criteria that they have, but it's not, you know, it is, there's stuff in between that too, if that makes sense. Mm-hmm. Yeah, absolutely.
Speaker: So around just donor psychological evaluations, what are they trying, I guess, what's like that standard of care? What are they trying to protect protect against or ins ensure for donors and families?
Speaker: You want to jump in? Well, I was just going to say, i think like being the standard of care what's What's really cool is we we can go to a conference and meet someone who lives in Mexico City or lives somewhere. And so everyone's practicing the same level of standard or should be right practicing the same level of care. Right. And so, again, i think your question is, what are they preventing or what are they? Yeah. Like, what's what's the goal? Like, what's the motivation behind or the or the reasoning for having and and the evaluation done? And so I think it's mostly to ensure that, and you touched on this, but that every donor, and that's going to be anonymous and or directed donor, right that that they can give informed consent, that they understand what they're agreeing to, that they have the ah the support and resources
Speaker: to kind of guide and help them along the way, whether that's an agency or their family or whoever that might be, that that their motivation is um what we call altruistic, appropriate. They, of course, can receive compensation, but that is kind of an extra. drive their Their main reason should be more from the altruism and that they are at a good physical and mental level of stability. um We look a lot of at the heritability issues, genetics, mental health genetics, and and issues that they're passing along. um
Speaker: yeah And then, of course, what Kristen talked a lot about, which is their their ideas and understanding of future contact and that being anonymous is not really a thing anymore. yeah and so helping them to understand that and know what the risks are to that, what are the benefits, what are their rights. so A lot of it is about their rights. Yeah. And protecting them and supporting them. Yeah. yeah oh interesting. Interesting. Can you dive into that a little more?
Speaker: Yeah, I think, you know, it's it's understanding that they have, you know, the right to make a decision on what kind of disclosure status they want um and what that means. um So, you know, they don't have rights, you know, to the to the children that are conceived. You know, they sign away all those parental rights, but they do have rights in terms of, you know, how how they want to be contacted in the future, if they want to be contacted in the future. And and in what way? are you thinking you of something else? No, yeah it's it's interesting watching ah watching some of the different states and some of the laws that are coming up. Right. So in certain states like Colorado, if you are a if you're going to participate ah as a donor, right you are agreeing
Speaker: that you will be, yeah and the and and the language is tricky because sometimes you hear identity release, you might hear open donor, and so it's misleading sometimes. yeah But I'm just going to use Colorado. um Is that that anyone who donates out of Colorado or through an agency based in Colorado that that donor understands informed consent that she is donating, understanding that she will be an identity release donor. Right. Correct. And they have to agree to that. They don't have to participate if they're uncomfortable with that. But if they're going to donate in those certain states, and I can i can't tell What does that mean about identity release? Right. And then what does that mean? Right. And so, again, there's protectors for for everyone involved. um
Speaker: i don't know if you want to get into all the donor registry and all of that yet, but. No, right. Exactly. Exactly. But I mean, again, right. Just going back to that psychological evaluation and having, i think that education around education, hey, I know it seems like that this is an easy, or I shouldn't say easy, but, you know, a one and done or this moment in time, but this will have residual down the road. You know, like you said, Colorado, this is, at minimum, you are going to be always updating your medical history for that yeah person. And your contact information. And right they have to keep that on file. Yep. But, you know, it's interesting when we talk about, like, our role is also whether we're doing the education or we're making sure the donor has the education. a lot of these are young women who are, who really
Speaker: I mean, I think a lot of us don't, you know, you get out of college, you you really don't know the female body and the role of birth control. You might say, oh, I got on the pill or I did this. But really understanding ovulation and endometriosis and AMA, H and all, I mean, all these things. So a lot of times we see this as a benefit, no matter what happens with the outcome, that they are learning more about their genetics. They're learning about their body. They're learning about are are they at risk for possibly having some kind of premature ovarian failure or do they have fibroids? do they so it's So that's one of those benefits that through the process, no matter what happens, that they're learning. Getting informed about, yeah yeah. And gaining more information about about their own possibility to go through. So I just had an egg donor last week I met with.
Speaker: um And she was, you know, I don't know, mid to late 20s and had had a child and was very healthy and and then learned that um her her, I guess, um follicle count needs to be a certain number or level to move forward with the agency or with the clinic. And hers was just a little bit shy of that. Now, that doesn't mean she's infertile, but it does give her a little information of, okay, I'm 27.
Speaker: If I want to have more children, I might want to keep testing this number yeah and looking at that and being being proactive and being prepared. So now she knows that and she wouldn't have known that. She wasn't able to move forward in that moment. but But we always are so appreciative of anyone who just even offers. Is willing to cry. Yeah.
Speaker: Yeah. Yeah. Yeah. Yeah, absolutely. We'll get right back to the show in just a second. But real quick, have you ever thought about doing something truly meaningful for someone else?
Speaker: At Egg Donor and Surrogate Solutions, we've spent the last 18 years helping women like you make a life-changing difference by becoming egg donors, giving hopeful parents one of the most precious gifts possible, the chance to grow their family.
Speaker: If you're healthy between the ages of 21 and 28 and curious about how egg donation works, we'd love to support you. You can download our egg donor journey and compensation guide at createahappyfamily.com.
Speaker: you might be the missing piece in someone's family story. All right, let's get back to the show. Going back to, you know, you said um as part of the evaluation, you're looking and discussing hereditary, you know, things. And of course, we're always thinking about genetics, but, you know, you do get into the mental health aspect and there's, you know, discussion around anxiety and medication use. And, you know, again, all very similar to the surrogacy evaluation, but different because this is, you know, a genetic connection. How do you kind of, how do you distinguish between a concern and a contradiction or maybe just something that needs deeper conversation?
Speaker: Well, question yeah, very good question. and and there's not like a simple answer, but we'll just, we'll, yeah, we'll just walk through, you know, you know, our, some maybe our experience and scenarios, but yeah,
Speaker: Yeah, it's similar to the surrogacy process. You know, we still look at did you know, did this candidate or did this donor have a situational thing? Like I had a donor that um her, she had saved up all her money and bought a car and then it got, you know, totaled in an accident and she was fine. But, you know, was it did put her in a state of anxiety just from losing all of that, you know, but she was, she did, you know, reach out and got help and support and worked through it. So, you know In a situation like that, you know it shows that you know she's proactive, she's going to reach out, she's got some resiliency. So she had situational anxiety triggered by a specific event. or Sometimes we find out we have donors that you know maybe they had a hard time getting um you know used to the college experience and they you know were not as comfortable with that. So there was some anxiety there or test anxiety or
Speaker: You know, launching into adulthood, you know, that kind of thing. Some anxiety there, like, are my finances going to be okay? Like, how do I manage all this stuff? You know, so those types of things, you know, that's different from I've struggled with anxiety since I was, you know, you know, i don't know, 12 or, you know, in the early school age years or. Right. You know, notice that I had this. I didn't really know what it was, you know, but now looking back on childhood, I, you know, my, you know, I had this sense, but my, you know, you know, just didn't know what else to do. So, you know, something like that is we're going to dig in deeper. um i mean, I think you talked about this in the surrogacy, even somebody that has had like postpartum depression, that can also be situational too. If they, if there was nothing else going on, that happened, they got help, you know, they recovered and they were fine. So that's not necessarily like we're going to say, no, it's just, you know, what did you do? How did you get through this time? What were your coping techniques? Who supported you? so it it's, i don't know if that answers your question, but that's kind of the difference between, you know, anxiety. Sorry, go ahead. No, I was just going to say, I think
Speaker: We're using the same assessment exactly for both egg donor and surrogate. However, there are going to be things that are going to be more of a priority for your surrogate, yeah meaning her home life and her level of support and and her yeah ability to be able to have this child and have be able to to release and and and move forward.
Speaker: So I do think the genetics come much more into play with donor the donor, right? Because we're looking at heritable issues. We're looking at, you know, what is their own family history. i mean, some of our donors, they they may come in and say, I don't know.
Speaker: Like, they're on. Like, I don't know. I've not seen my dad since I was young. We've not kept up. I don't know. Or they say, well, my mom didn't have a diagnosis, but she was always very, you know, I could tell there was a lot of anxiety or there was a lot of ups and downs or, oh you know. interesting. Yeah. And there and so there's there's not like...
Speaker: you know, immediate family that has a specific diagnosis, but they're, they're aware that that was there. And that's not necessarily like a deal breaker either. It's just, you know, so or di it's a deeper dive. it It triggers a deeper dive into tell me what it was like and what did you see and anybody else in the family. And, and then obviously looking, you know, through the lens of, you know, does the, is there any concern about that with, you know, the candidate and, or the donor and um yeah, just ah you kind of,
Speaker: kind of peel back the layers a little bit more with that kind of, I also think with the donor, I, i always like to say we're not, I mean, cause we are certainly not here to judge and what we want, what we want to do is give the most information that we can, the most proactive information to the parents. And so when we couch it that way with our donor of share with me anything. Like, like don't, don't put her own attachment or judgment on it. Like just like, or shame or shame. Just share everything because that we all have something, right? or We all something in ourselves, our families. And so share with me, whether that is autism, ADD,
Speaker: um paranoid schizophrenia, whatever that is, share everything you know, and then we'll decide the level of risk. Because that's what we're talking about is risk. It's not, oh, your mom was... you know, had this. right It's more of what is the genetic risk to those parents that they need to know what the risk is to their child. right And so I remember a situation where we had a donor whose aunt had schizophrenia.
Speaker: And so in talking through the genetics counselor, the genetics counselor came back and said, that the the that the offspring for those parents using that donor, that their child would have the same risk as the general population. And so ah it comes back to being informed yeah and that the parents should always be informed if there is anything at all. But it's really kind of our job with the clinic and the agency to be able to to say, we feel like there's too much risk, whether that's to you or to this donor herself, if she's not in a great place that we're gonna pump her for the surrogate full of hormones and she's struggling herself. sure So that's, what I guess, in ah and in a in a one word risk. kind of Minimizing risk, minimizing risk. I had another scenario like that with ah with a direct donor and there was a history of trauma
Speaker: And that hadn't been, um you know, hadn't hadn't been reprocessed, hadn't been, there hadn't been any, you know, counseling or any help. And so it it was very repressed. And we, and I talked with that donor about that risk of retraumatization. so it was in in that, in that sense, it was more about advocating for the donor um to make sure that she wasn't going to be, you know, further harmed or traumatized through donating. And and then if she does go through right after seeking assistance and support, then, wow, what a great family experience she can have with her brother and his partner and all of that, right? Versus just suck it up and do it right where you may have some kind of feelings that, like you said, were unresolved. Right, right. and And I was thinking when Leslie was talking about some of the benefits, just that when there is a situation like that,
Speaker: it can end up being a huge benefit when that person then and is willing to seek help, which was the case. um And it can be so, you know, restorative for that person and then gets to move on hopefully and, you know, finish out the story that they want to do for their, you know, for the recipients if possible. So yeah, it can sometimes be really nice like that.
Speaker: Yeah. Well, and I mean, again, why Why is it beyond the medical qualifications, what are those things that you're trying to understand about a donor during that psychological evaluation? And maybe why is that important for intended parents? And you shouldn't be in a scenario where it's just, hey, suck it up.
Speaker: Just go do it. It's you know only six weeks zero of of your life sort of situation. Yeah. Yeah. Well, we're we're looking at, you know, are they going to be able to come to appointments? Are they going to show up on time? Are they going to follow directions? You know, are they going to, you know, be late to doctor's appointments? Are they taking this seriously? Or is is this, you know, just kind of a, because, you know, we kind of, we, we, we, Leslie and I will say to each other, like, you know, we feel that the psychological evaluation is a little bit of a job interview because it is, you know, it is something that's, you know, short huge step in that process. So that tells us, you know, how serious they're taking that step, you know, and their, um, you know, our ability to communicate with us. And i don't know if that's answering your question, but that's a small piece of it. That's it. But that's a good one because I, I think for any of your listeners who are ah interested in being or serving as a donor, um, the, this usually is the first main step is to meet with the reproductive counselor. And,
Speaker: you know And we've had a few where they log on and they're in bed with the lights off and we're like, hello, who's there? You know? and You know, so, you know, again, we're not judging, but we are saying, hey, you we you've got to be at the clinic at 720 get in line for blood work. Multiple times a week. Multiple times. And you've got to drive 45 minutes each time. And so it it what you what it says about you when you show up for that first appointment. And most of ours are in person, but if they live in state, you know, five hours away, you know, well we're going to do virtual, but we treat virtual the same. Like you're on time and you've done your paperwork and you answer everything honestly and openly. I mean, so that, that's, i think what you're saying. Well, and I think how, why is that important for the intended parents? It's, you know, you want to feel
Speaker: reassured that the donor that you're matched with, you know, is taking it seriously, is following directions, is taking the medication as instructed, is getting there loud. Cause you know, all of these, most of these intended parents, a lot of them have already gone through a lot of losses or setbacks or disappointments. And so then they come to the place where they're ready. They've grieved and they're ready, you know, to move on to this option.
Speaker: You know, it's just, it's a very, um, sensitive thing. And so, for them to have trust in the donor, i think it's really important that, cause, cause you know, you think about, you know, women that have gone through the retrievals and they don't have control, you know, in this journey and, and you try to control as much as you can when you're going through the IVF yourself. And then when you say, well, I can no longer do it. I'm going to, you know, match with a donor. You, you need to have that trust that that donor is going to follow the directions. It's going to take the medication. It's going to show up for the appointments is, going to do her best to to give you as many healthy eggs as she can. and so I think it's important that, you know, we're assessing that during the whole process. Absolutely.
Speaker: Yeah. Yeah. Yeah. With, with that assessment, you know, especially just first time donors, are there certain topics that consistently surprise donors that you guys discuss?
Speaker: Of course. Ah, ah I mean, I think the number i think the number well the number of appointments sometimes is surprising to them. And usually ours is the longest, right? like yeah They're with us usually for about an hour to an hour and a half for the clinical interview. And then they also take a personality assessment, which is about another hour to an hour and a half. um And so sometimes we'll break that up.
Speaker: But it's so... you know, you kind of, yeah, sometimes they're surprised by, wait, how long is that? Yeah, so this is a long process. and I think Kristen had someone recently who just thought she could drive to the clinic and drop off her eggs. Yeah, pretty much. You know, so.
Speaker: other whoops. So this goes back to informed consent. Yes. And why, you know, why why that's important. um But yeah we do ask, I mean, we ask some personal yeah questions. And yeah um and it you know ah sexual partner history um sexual assault history so we do ask some personal questions and so we always want to be really sensitive to if they haven't processed that or if it's bringing up and even sometimes when we're talking about
Speaker: you know, tell us about where, where'd you grow up and tell us, you know, what was, you know, the best thing about childhood, what was the hardest and what was your biggest stressor and your biggest, ah you know, and so sometimes that can bring up things and they might find themselves like, oh my gosh, i haven't thought about that. You know, it could be their parents' divorce or they moved or they had,
Speaker: some kind of a trauma or experience they thought of. And so it kind of brings up emotion. And so I've had some say, um I'm sorry, I'm getting tearful, which doesn't right mean, oh my gosh, they're depressed. right You know, it just means, wow, they haven't thought about this. And so, so they might be surprised by maybe some, some of that. I do think it's important that they know we do write a report. Um, we don't put every detail like that in there. It's more of a generalized, um, report that goes to the clinic or go and, or goes to the agency. So they do need to know that there is record of that as well. Um,
Speaker: And so I don't know. um That's a little off topic, but just, you know, something to think about for them. No, no, no. I think that is important for for donors to to know and understand. And, you know, again, that's what makes this process, especially if you're doing it ethically,
Speaker: That's what makes things like that you do need to be aware of. And that is that is everyone doing due diligence for the intended parent's sake as well as the donor and having her best. Absolutely. Right. As well as the intended parents. Right. Knowing there's this full bodied, you know, understanding of this person.
Speaker: Yeah. Yeah. What, when you are speaking with the donor and we kind of touched on it with, you know, this idea of, you know, hey, donor conceived person and, you know, whether you're doing this, you know, unidentified or direct or, you know, just things like that.
Speaker: What future implications do donors most often not fully consider until they're sitting in the room with you?
Speaker: I love talking about disclosure. So I like to spend a lot of time because I think I mentioned to you that my husband and I use an egg donor for our children. And so I'm always trying to educate people about that process in general, but also just about the importance of disclosure. But to answer your question directly, the thing that I think people pause about the most that they didn't think about was that multiple recipients would, could potentially be involved that they, would have multiple families that use the donor, her eggs. And it's not that they have a bad reaction to that, they just didn't always think about that. They just didn't necessarily, mean, if you're using an egg bank, I guess, you know, three all would be a specific match, but even with a match, you might have repeat to her, right? I think that's probably, and then, you know, just they might, you know, think they kind of will sit and think a little bit and say, well, I'm fine with contact. I just, am I going to have any responsibility? Am I going to have any, know, are they going to have any expectations that I'd be a certain way? And so we talk about that a little bit more, like kind what we mentioned earlier. would say that's kind of the biggest area for just being surprised about disclosure.
Speaker: shirt the sure And I think we've come so full circle where when I first started this, they were encouraging open disclosure, but not that long before it it it was more of a privacy there. They're, you know, why do they need to know that you're raising them as your own child? So of course now, and for, I guess, 20 years or so we've, there's been this push for open and and disclosure. And it's interesting because the word disclosure has been kind of a heated topic about, about
Speaker: Is that the appropriate word to use? right Do we use disclosure? That sounds so formal. I'm disclosing, you know, where it seems kind of sure sounds like a shameful. i have to disclose. Open the secret. Yeah. And so it's interesting, although we've come full circle, we're actually, I'm seeing, I mean, we're seeing more,
Speaker: intended parents and recipients that are saying, well, I'd like to meet my donor. Yeah. I'd like to connect with her. I'd like to, can I have a phone? Can I meet her by, can I zoom with her? And so, and I think we're look there we're looking at the research that comes out that says that open identity, identity release is better for the offspring. And so you're seeing, I had a couple of few weeks ago that said,
Speaker: can Can we meet her? what what are And so so sometimes that's been surprising to a donor. Then it's like, her oh, they want to meet. Yeah. Oh, wait, they want to meet? Oh my gosh. And so then they have to kind of process their own comfort and what that looks like. And are are we still going to use, are but are they using first names? Are they keeping identity? but you know And so that sometimes is a bit of a surprise. And so, and of course,
Speaker: They never have to do that if they don't want to. Right. But we're seeing more of a trend. I've had the privilege of getting to speak to so many donors and recipient intended parents and everyone. There's always one thing that we do is kind of like a letter exchange where So again, whether you're identified or unidentified, there's this letter exchange and every donor that has ever received a letter from their intended parents or every intended parent that has ever received a letter from their donor, they say it is just one of the biggest highlights of the entire shirt experience. I love that. Yeah. Yeah. yeah
Speaker: i but i I love that you brought that up because I've, it A lot of times intended parents want to do something. they want a gift or they want to do something. And so we always say that's that's lovely.
Speaker: you don't have to, but if you'd like to. But I've had the privilege of where they've left a card at the desk and then the donor came back in for whatever reason. And I met with her and went and, oh, why you have this card. And that...
Speaker: man i mean, I've had people bring matching Tiffany something, matching matching paperweights, like really cool things, but that letter, I mean, that...
Speaker: Because the because what what it does, i think, is it makes it personal for that donor. Connection. The donor's already like, going to help someone and this feels good and it helps me help pay for college or helps me for my future and I get to help another family.
Speaker: But when she reads a letter about the impact yeah that she's making, like, man, that's that's powerful. yeah so i and And so I know that y'all do that. I love that.
Speaker: I think that's awesome. It's so, yeah, no, I mean, it really, it was, it was so cute. I was talking to a donor and, um, they found out that the intended parents, um, had a, had a live birth and the donor was talking about how proud her husband was of her and was like telling everyone he knew like, Oh, by the way, guess what my wife did. And and yeah it yeah i so cute. yeah Yes, absolutely. And just having, you know, having some some sort of connection like that. Kristen, would you mind just diving into maybe a little bit of your story, just personally, as far as like disclosure and why that's, you know, important as such an important topic for you?
Speaker: Yeah, I'd love to. um we My husband and I were trying to conceive for several years. I think i think it had been, um i don't know, two two years, one to two years before we went to the fertility clinic um and did several rounds of IVF with my eggs and never got to the point where I had any embryos that they could even genetically test. Like it was always... And back then it was... We were doing like three to five day transfers. Um, and so, um, that was just, you know, and that, that was all i was getting. So long story short, I had, uh, have diminished ovarian reserve, found that out after the first couple cycles and kept going. And then after the fourth was just like, I can't, you know, do the same thing anymore. And, um, had, you know, discussed it with my husband and, um, you know, been, the doctor had been mentioning, um, donor egg. They kind of, you know, put that
Speaker: put that language out there, um early and you kind of were like, no, I would, rule I would never do that. But I also said I would never do IVF. So, um, you know, all things, you know, everything goes out the window. Yeah, exactly. So, you know, by the time we had, um, gotten to the point of that many cycles, we were, we were okay with it. We did, you know, we did our processing and our grieving and, um, and used a generous solutions. Um, and it was just an awesome experience. Great. great matching process. And, um, and I guess I just, for me, um, the disclosure is important because I think that it's important to not have any shame around, um, third party reproduction and any type of, you know, donation. And so, um, because I've seen, i know my children and I wouldn't want different children, you know, even if it was my own DNA, like I just, they're,
Speaker: unique individuals who I love dearly, of course. And I'm just so grateful. I'm grateful that, that somebody was willing to do that and give me that, fill that desire of my heart that I had had. So, um, I just like to, I like to really, you know, help people to feel empowered by this and not feel, you know, ashamed that they need assistance. Cause it's just one part, you know, it's one part of the story. It's not the whole story. So that is really important to me. Yeah. Yeah.
Speaker: For donors specifically, when it comes to the evaluation and thinking about that test and you know just all of the questions that they're being asked, I know there's some donors that will worry and think that this you know quote unquote test, right, we keep saying that, is to determine whether they're quote good enough to donate. Right.
Speaker: What would you want them to understand about the purpose of the process? um Again, just that we're going into this, the purpose of this is to ins ensure and to to, I should stop to using that word, but to, to really protect them and help them feel like this is a good decision for them as well. Right. That,
Speaker: you know, that their initial interest and motivation in doing this, you know, that prompted them to, you know, reach out and consider being a donor. And, you know, now that they have all the information and now that we've talked about everything and we've looked at their whole history and been open about things that, that they understand that, yeah, this is a good fit for me, right. That this is a good decision. I am, I am, you know, being smart about this. I'm not just, you know,
Speaker: saying, here you go and walking away that they have the full picture of what this means and what it entails. Cause it is a big decision. And I think sometimes it can be minimized a little bit. um just with all, again, with all the videos that are out there now and all the stories. And sure I mean, it's great. The transparency is great, especially when you have influencers that talk about, their personal fertility journeys and stuff. yeah But But our job is to really kind of talk about the nitty gritty with it all too, which you don't get from social media. And so in other places. And so. Yeah. The reality. Yeah. The reality of it. um Yeah. But I think that the good, the good part, right? Like, yeah I think they're the fact that they're even calling right and filling out papers and coming in and inquiring. Like, i already feel like, like that.
Speaker: is a gift, whether it works out or not, or they can't for medical or genetic or, or, or mental health or whatever that, that they leave feeling really prideful that man, I, I tried to do this. I i want to help others. And so we've even sometimes with people that haven't been able to What are other ways that they can yeah help people? And we've had a lot of egg donors go into surrogacy, right? We've had donors who gifted eggs and yeah had great experiences and then took a break, got married, had a baby, and then they're like...
Speaker: Hey, wait, i can sound i I can still help people in a different way. and then you also sick right And then you also have egg donors who are like, I could never give my baby up. you know and then And then surrogates who say, I could never give. And so it's just really great that there's all kinds of ways you know to help.
Speaker: Kristen, for you specifically, just speaking from, you know, your personal experience, what was important to you as an intended parent when your donor was going through this process, particularly the psychological evaluation? That's a question. That's a good question. i'll And I have to confess that I wasn't as educated then because I totally fair.
Speaker: i'm ah I'm a social worker by training, but I was working with the elderly population at the time and so didn't really have the deep dive, but i did rely on the agency to really educate me. And um I mean, I did some of my own research too, but um i if I were to... There's more. There's more stuff out there. Yeah. More opportunities. Yeah. and And I think i probably, I knew that there was a psychological evaluation and i knew because of the the clinic I was working with and the recommendation of the agency that whatever was being done was going to be reputable and ethical. And and so i I felt peace, I guess, knowing that that that if I was, you know, that went fine, that everything, yeah you know, was there weren't going to be any concerns or risk factors, um you know, for us that I needed to be worried about. I didn't at all. And I met and i didn't ask to see it or anything. I didn't ask for
Speaker: any feedback on it, which I don't know, I guess I could, I don't know. I don't know why I would, if they even, if we do that, but I think what you said about the and we talked about this in the, in the gestational carrier session,
Speaker: It's so much a blind faith. Yeah. It is so much trust. You're trusting your clinic that recommended this agency or your friend who also used this doctor or this agency. And so there's just this trust of, hey, if you say you're going to, you know, do the screening of genetics and medical and mental health, and then you come back and you say, hey, everything went well, this is what you need to know, right then that, what we hope is then that's enough, that that brings yeah comfort and and confidence, right, for every couple. correct
Speaker: But I do think couples or families, parents, intended parents can ask questions. yeah And they'll say, can I see her evaluation? No, because there's, you know, there's confidential information in there. But a general idea, because I think a lot of parents come in and we ask that question all the time. What's important to you in your search? Yeah. And so we talk a lot about nature versus nurture. What are you know, what is this donor going to bring to you and to your child? What,
Speaker: What traits, genetics are important to you? Like when you talk about what are you getting from the the nature, right? And that's usually going to be, I want someone who parents yeah who resembles me or with the husband a lot. I want someone who represents and looks like my wife. Like that's, you know, and whether that is skin color, whether that is hair color, height, body type. So they usually, we usually start with that. Um, and then we build on, okay, well, what, you know, what, what else comes from that piece of genes and what comes from the nurture. Right. And you know, if, if, if parents talk about, well, I want someone who has done well in school or who's academically inclined or is, is, is intelligent.
Speaker: And so it's hard to ah for us to just to say, oh, sure, you know, this is what we look at. We know that there's not a true genetic link for that, but we do look at what are, you know, what can we look at from her resume and her history and and how she, what she writes in her essays. But we also look at what, if that's their value, that they're going to reinforce that and help that along, no matter what the gene's Versus the nurture, right? So great that's a big part.
Speaker: I think something that is so consistent and that I love so much about the psychological evaluation for both surrogacy and egg donation for intended parents, for you know all participants you're looking at the whole person and there is no black and white.
Speaker: Exactly. so from, from your perspective, what does a quote unquote successful evaluation ah look like?
Speaker: That is such a complicated answer. I feel like, but I guess number one, yeah. but Be yourself. Yeah. Yeah. That's true. When we talk about being successful...
Speaker: Be yourself. Don't try to present something else. Don't yeah try to fill shoes or look good. That look good you said earlier. Like, and we use that language of we're not looking for someone to look good. Right. Or a certain way. We want them to be themselves. Yeah. Right. And I always tell them when we're, when we're sitting down to have the, you know, the interview, this is, I understand this is an evaluation, but this is just going to be a casual conversation. We're just going to talk about, you know, yourself and your history. So, I know that's a little off topic, but yeah. So being yourself, I think, you know, being comfortable yeah with, with, with us or with the pro for them to trust, like we're talking about them tend to parents trusting, but we also really want the donor to trust, right. That, that her agency or her clinic, that everyone is, that we're going to do right by her, meaning, yeah educate her and, and make sure again, like, like you said, this, and we're protecting her, but all that she's, she's engaged in that. We're not going to do anything to traumatize her. So even though we're asking intrusive, sometimes feeling intrusive, personal questions, it is part of this process. And so that's what kind of makes them brave to show up. I mean, it's, it takes bravery. So, I mean, so so I guess what the success is be yourself and,
Speaker: um I was thinking as you were talking, just being forthcoming with information, right? And just a good a good evaluation of ah session is like, wow, that person was you know forthcoming with information, communicated with me, was open. you know um And sometimes if they're not, it's not their fault. It's just you know maybe the way they were raised or you know there's and they're uncomfortable with talking about certain things. But yeah,
Speaker: those are the kind of the high points and then feeling like we were able to have open dialogue. It wasn't just a, let me sit here and take all these notes, you know, we're obviously assessing, but we're also conversational. Yeah. conversational yeah And that they are in this donors in a stable place, right? She's not living on her aunt's couch.
Speaker: Like she, she has, she has intention. She is in school. She's working. she's a stay-at-home mom. She's whatever, but she's stable. yeah um Her financial situation is stable.
Speaker: ah She does not have to be making a lot of yeah money, but she has to be financially independent. um The compensation is often a gift to a lot of these young women. And it helps their, for them, for their families, their future. Um, but it can't be the only reason it goes back to the altruism. Um, so that looks successful. If she is financially independent, she is emotionally stable.
Speaker: Um, she doesn't have to have the full, like she doesn't have to have told everybody and have the full support of everybody, but she has to have some support, whatever that looks like. Um,
Speaker: she can't It can't be a secret if she's living with her partner or with her parents or family, and it is a secret. Like that is um a risk. Red flag, risk to her, risk to disrupting the cycle. It also looks like if she has had struggles, that she's talked openly about what's helped her. So we want to see her resiliency, her resources. Um, uh, so I think that looks successful if she can talk through that. Someone that comes in and says, everything's fine. yeah Nothing's ever happened to me. You know, like, okay. I had a normal childhood. Yeah. I mean, so okay. So then we used to say, well, what's the hardest thing? What'd you do about that? I'm going peel back yeah and layer i'm talking a little, because again, we, we want the whole, the whole picture. Yeah.
Speaker: Um, and then I guess successful, she understands what she's, you know, she's, I mean, we you know, we'll have teachers who want to do this, but they have this tiny window. Yeah. And so I, they can only do it in the summer and they can do it at Christmas. And it's like, well, do they know that the clinics are closed for 10 days at Christmas? Like, so, so, so it's just more about it, it helping to make sure it works for them and, and what's happening with them.
Speaker: Yeah. Well, again, right? Like it's that it's, it's all encompassing. Not only is it, you know understanding the donor, it's making sure that they understand the process and the details. And, you know, cause I i know not every donor is going to go through the education that we offer and, you know, all of those things. And so it's not only making sure that you have it from that aspect of things, but then like you said, right? Like understanding,
Speaker: the future and the implications that come from that. And, you know, just, just all of it, it's all encompassing and making sure that they are fully involved. And we want, we want them to ask questions and be curious too. And like Kristen said, like they're motivated by, you know, I can remember like one tree hill had whatever, you know, I mean, so they hear it. It's right. It's I know so many videos, but it's so many videos and social media, but you know, there's some personal questions like, yeah can I still be sexually active? Or what if I've never been sexually active? yeah So those are the kind of things that we we want them to feel comfortable to just to, again, those conversations that, that we can either reassure, you know, we can't always promise a female physician for everything, but we can kind of talk through what that might be like.
Speaker: And again, that's why we look at trauma and risk. So, Some of those things. So that, I guess, with as far as success, you know, they're mentally healthy, obviously. um And they've thought through the long term implications and what that looks like for their own offspring or if they don't have offspring or right all of those things.
Speaker: Right, right. And I know you mentioned, you know, having discussions with them about language, giving them language to explain to their partners or friends or family or, yes, future children and just the implications that come with that. And right, like you said, there are, I mean, we love the social media aspect of everybody talking about it, but those are the highlights. And yeah there's so much more to it than that.
Speaker: Absolutely. Yeah. Well, and like we talked earlier, like your little book behind you, the heart's match. Like we have all kinds of books that we use as prompts and, and there's always new things coming. Like, and so I think just. look at that Okay. So wait, hold on. For, for our listeners who are not watching, but seeing Lisa's holding up a couple of books. Tell us what you got.
Speaker: Okay, this first one is Daddy Was Mommy's Tummy Big. This one, too, is kind is called A Tiny Itsy Bitsy Gift of Life. But what the books, what I like about these two books is that they talk about the the egg or the sperm being the gift, yeah right? And so that's the story. And like Kristen said, you know, that she used an egg donor is not the story. It's part of the story, right? So, but there, we like these books for donors too. And for, of course, for surrogates, right? That they can use those books as tools just to get a conversation going. and And some of them will have, like intended parents will have nieces and nephews. and maybe they're wanting to explain. And so they, we, you know, they can use that even before they have their kiddos. And so anyway, so that's just another nice, a nice way to kind of help both, both the donor and intended parents. Yeah. Tell their story. No, I think it's similar to what makes it successful evaluation. i think what have we learned that, you know, that tells us that this is a, you know, a good donor is just, again, they've, they've,
Speaker: They have thought about their decision, they're informed, they're ready, they're motivated in the right ways. um And they have the stability in this, you know, different areas of life and are truly passionate about, you know, um wanting to help others build their family that um that really feel that that is, you know, the the the true motivation. It's really cool how many hundreds of women we've met with who are so different,
Speaker: Right. I mean, they come from every walk of life, every ethnicity. um And so i I and we live in Houston. So the women we're seeing are so which is amazing. Yes. It's so many across.
Speaker: It's so diverse across. And so what is so cool then is we're meeting, we're sitting across from so many of the parents, potential parents who might, may have matched or may match, right, with some of these women. And sure and just have the same thing with these couples, like they're You know, I had an astrophysicist last week and I was like, like you know, I mean, and and they were both so brilliant and um and so intellectual and but so grounded and so excited. And it's just I know I know that's not really your question, but I was just thinking as you were talking at and about the donors, like they're all so different.
Speaker: yeah And we want that. And that gives different selection. And I think when they write out their essays and they write out their hobbies and interests and, and, you know, and we always say sometimes when they write that out at 22, that's going to look different at 42, right? When this donor offspring is possibly out there looking or connecting. But I think it's just really great that all of that information helps with the matching, right? It helps with those intended parents say, oh my gosh, she, she also did dance or she also has three brothers or she, whatever it is. And so, you know, we talked earlier about, about matching and, and looking for, you know, nature versus nurture, but sometimes it's
Speaker: it's none of it it's just like I connect with this person yeah exactly like yeah even if you don't know them and it's not going to be identified there's still a reassurance with like this feels like someone I would connect with if I met them you know um yeah i as you were talking I was thinking really i really love um hearing all the donors stories, even when it's difficult, you know, for them to reflect on things. But I like, I love to watch a lot of times with, when we're talking there's, you can just see the reflection that's happening.
Speaker: as they're talking and sharing with us. and And it's almost like they're having a little bit of a growth experience too. love that And I love getting to see them. I hadn't really thought about that. Like Leslie said in a long time or that way, but maybe that is why dah, dah, dah, you know? And so it's, it it's another slight benefit is, you know, a lot of, a lot of donors that maybe had never had the opportunity to think about their life, you know, with somebody who's not going to judge them and just, and you know, have the, floor to talk about stuff. And I i like that. I like, you know, and in addition to assessing it, I like seeing them have that experience and, and just hearing their story. Well, and it goes beyond, right. The, the, the process itself. And it's just, like you said, it's just, it's support for them a human, not support exactly as an egg donor.
Speaker: Exactly. exactly that's that That is the best way to sum it up. And it's really cool too because obviously I see Kristen and her beautiful children. But we were talking last time about the surrogacy and how with a lot of times... I mean, I feel like one of the benefits of our job is we get ongoing continuity with a lot of our our women that we see, and they will come back in for life, lifestyle, their kids, their husbands, their work. you know and And it's so cool because they're usually not coming in and saying, well, I don't feel connected to my kid or I don't. They're just saying just, well, you know, the drama at the baseball field, you know, I mean, it's like, it's so I think that's the reassuring part. And you can talk more about that. But yeah, to these intended parents of you, this is your kid. This is your child. You, you,
Speaker: And, and so just that reassurance to them that, yeah, that is going to happen. Yeah. And you're going to, it's still important. There's an important part of the story, but it's not the whole story you move, you know, and to tell the donors that too, like they're, you know, not going to lose sight, you know, of the gift, but they, you know, they're, you know, obviously doing this for a purpose to get to that, you know, experience of getting to be at the sports games and,
Speaker: extracurriculars and all that kind of stuff. So the in-laws, the in-laws, all the grandparents, that brings you in counseling, right? Sure. Yes, exactly. Exactly. The life stuff, the life stuff.
Speaker: And with that, I had to let Kristen and Leslie go because they both had clients waiting for them, but i couldn't end this episode without thanking them again for taking the time to have this conversation with me.
Speaker: I think one of the biggest takeaways from what we have heard from them is that a psychological evaluation isn't about passing or failing. It's about making sure someone understands the decision they're making.
Speaker: feel supported in making it and has had the opportunity to think beyond the immediate process to what egg donation may mean for them, the attended parents and a donor conceived person in the future.
Speaker: Thank you again to Kristen and Leslie for bringing both their professional expertise and personal experiences to this conversation. And as always, thank you for listening and for being part of the create a happy family community.
