[share-ebook]PSYCHOLOGICAL CONSENT FOR EGG DONATION PARTICIPANTS

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PSYCHOLOGICAL CONSENT FOR EGG DONATION PARTICIPANTS  
 

I/We give____________________________________ permission for all information in the psychological evaluation to be discussed with the physicians and staff at Georgia Reproductive Specialists and for the assessment to become part of my medical file. 
 

PSYCHOLOGICAL EVALUATION 
 

I/We understand that this psychological evaluation may involve psychological testing and will include discussions of my psychosocial history, current mental status, current level of support from significant others, marital satisfaction, family background, and both my and my family’s psychological well-being. I/we understand that the evaluation process and the discussion of life experiences can be emotionally distressing. Psychological responses to the evaluation process may be, but are not limited to: anxiety, depression, frustration/anger, distress, fear of rejection, or disappointment especially if it is decided either by myself/us or by the program that I/we not proceed with the egg donor program as planned. Emotional risks of either participating in the psychological evaluation or in the egg donor program include but are not limited to: stress, interpersonal difficulties, conflicts with loved ones, impairment in daily functioning, sexual dysfunction or distress, anxiety or panic, depression, alteration of emotional well-being or triggering of traumatic memories especially involving physical or sexual abuse/trauma. 
 

PSYCHOLOGICAL IMPACT OF REPRODUCTIVE TECHNOLOGIES  
 

Procedures involving high levels of medical technology, including assisted reproductive technologies can be both physically and psychologically demanding. I/We understand that there are physical, psychological, and social risks involved in participating in IVF and the egg donor program. These may include but are not limited to: 
 

• Psychological stresses of the IVF/egg donor process include the stress of the evaluation, the medical procedures, and future emotional reactions. Stresses of the process include managing the commitments of medical treatment, invasiveness of treatment, and stresses to relationships. Emotional risks of either the psychological evaluation or the IVF process include but are not limited to: stress, interpersonal difficulties, conflicts with loved ones, impairment in daily functioning, sexual dysfunction or distress, anxiety or panic, depression, alteration of emotional well-being or triggering of traumatic memories especially those involving physical or sexual abuse or trauma. In addition, I/we understand that some women experience psychological side effects to the ovulation induction medications.

• I/We have been informed that the IVF/egg donor procedure itself may trigger past emotionally difficult experiences related to pregnancy, fertility, reproduction, sexuality, or family issues.

• If the egg retrieval is cancelled, I/we may respond with any number of emotional reactions including anger, disappointment, anxiety, depression, bitterness, or indignation. I/We also understand that for some women the feelings of sadness and disappointment become overwhelming and unmanageable and that I/we am/are encouraged to return for additional support and assistance should this happen to me/us.

• Depending upon my/our motivation and/or my/our experiences with the IVF/egg donor procedure, I/we may not gain the degree of satisfaction that I/we initially expected. I/We may experience less gratification than I/we anticipated and the process may be less rewarding or more demanding than I/we envisioned.

SOCIAL AND RELATIONSHIP ASPECTS OF REPRODUCTIVE TECHNOLOGIES  
 

• Relationship- risks as a result of the IVF/egg donor procedures include distress in either current or future relationships with my spouse, family and friends as well as strained social, familial, or work relationships. Marital relationships may be impacted by the stresses of intense medical treatment and may result in a variety of problems such as marital conflict or transient sexual problems.

• Social- risks include conflict with religious leaders or religious doctrine or the disapproval of friends, family, or others to assisted reproduction. I/We understand that others may not understand the IVF/egg donor procedures, my/our motivations, or my/our participation in assisted reproduction and I/we may encounter disapproval, criticism, or censure. This may result in psychological distress including embarrassment, anger, resentment, or distress.