27 February 2025
On February 27, 2025, an event promoting the scientific program „Assisted Reproduction Technologies and the Well-being of the Child” took place in the Council Hall of the Faculty of Educational Studies at Adam Mickiewicz University in Poznań. The program is implemented by the Family Law team of the Central European Professors’ Network and coordinated by the Central European Academy and the Faculty of Law at the University of Miskolc.
The issue of ART is discussed from many points of view; particularly, its medical and legal aspects are emphasized. However, the demographic, sociological, and psychological aspects should not be overlooked either.
At the Center for Research on Family Law, that I am the head of at the Institute of Legal Studies of the Polish Academy of Sciences, we have adopted a methodological assumption to comprehensively approach all legal issues related to family functioning. In line with this approach, in our study, we refer to axiology and social sciences, fields outside the legal perspective, which allows us to delve deeper into the essence of legal problems. In many cases, this broader perspective is more significant than the legal regulations themselves.
When organizing the previous dissemination events, I tended to invite experts from non-legal disciplines to contribute their insights on the topic under discussion. Last year, for example, our guest was Prof. Michał Michalski, a demographer, cultural expert, and economist, who spoke about the impact of law on demography.
This year, our invited expert was Dr. Karolina Appelt, a psychologist from the Department of Developmental Psychology at the Faculty of Psychology and Cognitive Science at AMU. She was asked to prepare a presentation on the psychological aspects of assisted reproduction technologies. Dr. Appelt gave the following title to the lecture:
“The Psychological Costs of Assisted Reproductive Technology We Rarely Talk About.”
From a legal perspective, the significance of this issue is closely tied to the requirement for patient consent before any medical procedures can be performed. According to legal regulations, valid consent can only be given if the individuals undergoing the procedure are fully aware of what they are consenting to. In highly complex matters such as Assisted Reproductive Technologies (ART), this is only possible if the patient has received comprehensive information from medical professionals regarding the potential consequences of both the actions taken and waived during the process.
However, media stories about ART tend to emphasize only the benefits of these procedures, particularly their success rates, which are often measured solely by the number of children born. In public debates, whether in the context of political disputes over the legality of ART or discussions about social issues, the focus is primarily on the advantages of these procedures. When the downsides are discussed, the concerns raised typically revolve around the fate of surplus embryos rather than broader psychological, ethical, or medical implications for patients.
Meanwhile, there are many other aspects—especially medical and psychological—that should be presented to anyone considering undergoing ART, ensuring they make this significant life decision with the highest level of awareness. This was the rationale for entrusting the psychologist Dr. Karolina Appelt with the task of shedding light on a full range of psychological aspects of these procedures.
„Full range” includes the impact on the recipient of the gamete or embryo, her husband or partner, the sperm donor, and ultimately, the child born as a result of this procedure. The goal was also to distinguish these aspects in relation to the period they apply to: before ART, during the early period of parenthood resulting from ART, and throughout the childhood of children conceived in this way.
Dr. Appelt began her presentation by providing fundamental information on the methods of assisted reproductive technology, including the distinction between in vivo and in vitro methods, as well as partner fertilization (using the sperm of the husband or long-term partner) and non-partner fertilization (using sperm from an unrelated male donor). She also addressed surrogacy, the issues of cryopreservation, and other risks to embryo viability.
She pointed out that controversies surrounding in vitro fertilization (IVF) are not limited to the methods of gamete retrieval and the ethical concerns regarding unused embryos—a deeply sensitive issue for those who believe that human life begins at conception. Instead, the controversies also extend to numerous factors related to fetal development and postnatal health outcomes, including higher perinatal mortality rates, an increased risk of complications, and a greater prevalence of genetic disorders.
These significant findings are well-documented in numerous scientific studies and are widely recognized in medical literature. However, while research primarily focuses on the health of children who are born via ART, far less is known about the health outcomes (including potential diseases) of those embryos that do not survive due to miscarriage or implantation failure.
The speaker then delved into the psychological challenges faced by mothers who give birth through IVF. She provided a detailed analysis of the legal and psychological aspects of a child’s right to knowledge about their origins and identity protection. This issue has already been recognized in the context of adopted children, as reflected in Article 20 of the Convention on the Rights of the Child.
For children born through ART, there is often a stronger temptation to withhold from them the information about their genetic origins, as then the likelihood of maintaining secrecy is greater. This issue is acknowledged not only by researchers and judicial systems in some countries but also by non-governmental organizations involved in the promotion of artificial reproductive technologies.
According to the dominant perspective, measures should be taken to ensure that children have the right to know their origins and protect their identity. A liberal-leaning organization, the Association for Infertility Treatment and Adoption Support NASZ BOCIAN, advocated for such rights when the Infertility Treatment Act was proposed in 2014 and subsequently enacted in 2015. However, their efforts to secure effective legal provisions in this regard were ultimately unsuccessful.
The psychological difficulties experienced by mothers undergoing ART are rooted in intensive medical treatments and their emotional investment in the procedure. This often leads to the development of a strong desire to be a perfect mother. These women are typically older and more mature, and they are keenly aware that the child born through ART may be their only opportunity for motherhood. As a result, they tend to deeply appreciate their maternal role and often become exceptionally devoted and caring mothers.
While this can be beneficial for the child, it may also result in overprotective parenting, characterized by excessive concern for every aspect of the child’s life, particularly their health and safety. This, in turn, leads to intense emotional focus on the child, imposing strict limitations to shield them from any risks. For the mother, such an approach can become emotionally exhausting, leading to parental burnout.
Children born via ART may also be at risk of emotional challenges due to their status as a “precious child.” Some studies suggest an increased likelihood of neurological disorders and difficulties in emotional and social functioning among these children.
After the presentation, Dr. Karolina Appelt answered questions and comments raised by the participants of the meeting. The attendees did not hide their surprise at the information presented during the lecture. They could not hide the cognitive dissonance caused by the lecture. This became evident during the discussion, where it was acknowledged that the knowledge shared during the lecture would probably not deter those who see ART as their only chance for parenthood from pursuing the procedure. That was not the goal of the presentation, however. Both those who decide to undergo ART and those who reconsider to forego this possibility should acquire comprehensive knowledge about the issue so that their decision is well-grounded. Adoption, surrogate parenting, and parenthood through ART should not be promoted, as they all are very challenging. The truth related to the topic is the most interesting and important — and it foregrounds that all decisions in such important matters should be made by individuals fully aware of the existing risks both for the adults and the conceived children.
