Invisible dads

Alana's first birth certificate said Hutcheson-the last name of a man who shared no biological link to her. Her second birth certificate said Stewart-the last name of the man her mother married after divorcing the first. Neither birth certificate mentions her biological father-the man who donated the sperm to create her. Alana changed her name from Stewart to Sveta, a Polish-sounding name she adopted after she learned her donor dad was Polish, and then changed it back to Stewart to re-identify with the only family she knows. But it still gnaws at her that her birth certificate doesn't acknowledge her biological dad, and she'll never know his name.

Stewart's name changes reflect her search for identity and a way to connect to the father she only knows as "Donor." Her experience is echoed in the title of a recent study-"My Daddy's Name is Donor"-that contains troubling findings about the way some donor offspring view their identity and experience family relationships. An estimated 30,000-60,000 children are born each year through sperm donation-the product of a $3.3 billion fertility industry that does not have to keep strict records of births, reveal donor names, or regulate the number of children one sperm donor creates. For Stewart and other donor­conceived children, never knowing their fathers has created a crisis of identity.

The study, released by the Commission on Parenthood's Future, took a representative sample of 485 donor offspring, comparing it with groups of adopted and biological children. It found that donor-conceived children are more likely to express feelings of sadness about their conception and experience family break-up, depression, delinquency, and substance abuse. Forty-five percent of donor-conceived children say that the circumstances of their conception bother them. Sixty-five percent say that their donor is part of who they are. Nearly half feel sad when they see friends with biological parents and more than half say it hurts when others talk about their genealogical background.

The study also found that family breakdown is more common in the families of donor offspring. Overall, 44 percent of donor offspring experience "family transitions" (like divorce) before the age of 16, compared to 22 percent of adopted children and 35 percent of those raised by biological parents.

Stewart said her own experience illustrates the family knots that donor conception can create. She thinks the circumstances of her conception-her mother having a child with another man's sperm-made her mother's first husband see Stewart as "a symbol of what one man could do that he couldn't do." He favored Stewart's adopted sister-the daughter who had a biological link to neither parent-over Stewart, the child who had a biological link to his wife but not to him. When he and Stewart's mom divorced, he only asked for custody of Stewart's sister.

"I don't really consider anyone my father," Stewart said-a situation that she says created insecurity and lack of trust. She excelled at school until early adolescence, when questions of her identity began to beset her. Then she plummeted from the top of her class to the bottom and started a string of destructive relationships. She went through a man-hating phase and says her lack of a secure male father figure has made her wrestle with the idea of a paternal God.

She has spent her adult life searching for a way to connect with her donor dad and learn more of who she is in the process. She says of her donor dad, "I view him as kind of like a ghost and a fantastical figure, like how some people speak of children that they want. . . . A person who doesn't really exist but who is so very important to me." The United States leaves sperm donation largely unregulated, so sperm banks and fertility clinics decide what they will ask donors to reveal. Stewart only knows that her donor dad has blue eyes and blond hair. He lived in L.A. He was a doctor and a scuba instructor. He was 5-foot-9 and played the flute. He was Polish.

When she found he was Polish, she traveled to Poland to connect to that part of her heritage but was disappointed to find that it seemed so foreign: "Nothing echoed to me except for my physical appearance with the people." The little girls had eyes and hair like hers, and the same crook in their noses, she remembered: "Everything else was distant."

Wendy Kramer, co-founder of the Donor Sibling Registry, notes that "My Daddy's Name is Donor" is not peer-reviewed and said some of the findings are not consistent with what she knows from interacting with donor-conceived people each day. She founded the Donor Sibling Registry, a site that connects donor siblings, with her donor-conceived son Ryan when he became curious about his identity. It's true, she says, that donor-conceived offspring wonder where they came from and are curious about their unknown siblings. Ryan would say, "I look in the mirror and I can see where half of me comes from. . . . There's this invisible one-half of me."

But despite that invisible half, he still considers himself a complete person. Kramer was surprised by the revelation that donor-conceived children have higher rates of depression. She said parents should inform their donor-conceived children about their conception early: If a child learns about his donor conception later rather than earlier, it can create feelings of distrust and shame about his origins.

"My Daddy's Name is Donor" seems to confirm this: Forty-four percent of donor-conceived children said that donor conception is fine for children as long as parents tell children the truth early; 36 percent said that learning about donor conception can be hard, but telling the truth early makes it easier. Only 11 percent said that it's hard for children even when parents tell the truth. Kramer said the donor community should listen to those who struggle with their origins, even if they're a minority: "These are voices to be heard, but I don't think they're the only voices."

Stewart, like 61 percent of the donor-conceived children in Marquardt's study, doesn't oppose sperm donation; she just opposes unregulated donation that leaves children with no knowledge of half of their heritage. Donation should be an altruistic act instead of a lucrative one, she says, and parents and donors should develop relationships with each other.

Stewart used to tell people her dad was dead because if she told the truth they made jokes or turned awkward and silent. Now, to help them understand, she is writing a screenplay about her story. She fantasizes that her donor dad will see it, recognize himself in her, find her, and finally tell her his name.

Charting solutions

When Karen Gaul turned 30, she finally had the house and the steady job she wanted before she pursued the next dream-a baby. For the next three years, Gaul visited a fertility clinic, sought out a reproductive endocrinologist, tried an ovulation drug, and injected hormones into her stomach twice a day for a week every month. When doctors said that in vitro fertilization (IVF) was the only option left, Gaul and her husband said they opposed the procedure and left.

One in seven couples seek medical intervention to help them conceive and thousands turn to invasive options like IVF, a treatment that costs on average $12,400 per four-week cycle. IVF doctors create embryos only to destroy the imperfect ones and freeze the leftovers. Gaul said the doctors became offended when she expressed objections: "They honestly believe that they're just working with things, like working with skin or working with bread."

Gaul, a Roman Catholic, was searching her diocese's website for an alternative when another parishioner directed her to the Gianna Center for Women, a New York City--based, Catholic clinic that uses a natural approach to diagnose the cause of infertility-something Gaul said her other doctors never did.

Dr. Anne Mielnik, founder of the Gianna Center, uses NaPro Technology. She shows a chart where women note their body's signs of fertility each day. They use red dots during their period, green dots on other days, and baby stickers on the days when they're fertile. After four months of charting, Mielnik searches the charts for abnormalities, makes a diagnosis, and decides on a treatment plan. A woman with a progesterone or estrogen deficiency might take hormones and another woman might simply take more Vitamin B6. After Gaul's investigation phase, she discovered that she suffered from endometriosis, a sometimes symptomless condition that can cause infertility, and she had surgery.

In 2008, the Journal of the American Board of Family Medicine published a peer-reviewed study that found NaPro Technology produced 52.8 live births per 100 couples, a rate comparable to more invasive treatments like IVF. But treatment can take up to two years, a drawback for women of an age when they are becoming less likely to conceive. Over half of the study's 1,200 couples withdrew after less than two years of treatment.

Gaul, who has been at Gianna since November, said her charts show that her health has improved. It gives her hope that she won't have to choose between following her convictions or having a child. In the rest of the fertility industry, she said, "Women don't feel like they have a choice."