Counselling needs of patients receiving treatment with gamete donation

Couples experiencing infertility may be offered treatment with gamete donation where other methods of treatment have failed or are inappropriate. This paper examines a range of concerns related to gamete donation. The paper does not attempt to present a comprehensive and critical review of the literature but concentrates on selecting from the literature, in addition to clinical material, issues which have been identified as contributing to an understanding of patients' experience of treatment with donated gametes. The concerns include feelings and attitudes towards the donor, the role the donor plays in the couple's relationship, feelings about not being the genetic parent and whether to disclose the donation to the potential child and others. These concerns form a basis for counselling couples about the implications of gamete donation for themselves and any children born as a result. The difficulties faced by some people are illustrated by consideration of a single case where the experience of donation linked up with unique aspects of that individual. Therapeutic counselling offers couples faced with such difficulties the opportunity to explore in a more extensive way the underlying dynamics of their concerns, enabling them to think about and make sense of their experience. (C) 1998 John Wiley & Sons, Ltd.