Child Preparedness for Infertility Disclosure: A Diagnostic Tool for Supporting Parent and Child Mental Health

Abstract

Infertility, often perceived as an adult issue, can also manifest in childhood, presenting unique challenges. Improper handling of infertility disclosures can strain parent–child relationships and potentially lead to significant psychological distress, including depression, anxiety, and long-term impacts on self-image. Despite the critical nature of these conversations, parents often report receiving little or no guidance from professionals on how or when to disclose this information to their child. This article introduces the Child Readiness for Infertility Disclosure (CRID) Assessment Tool, designed to empirically guide parents and marriage and family counselors in assessing a child's readiness for receiving information about infertility. The CRID tool integrates the concepts of Tiered Priming and Cognitive Preparedness strategies, providing structured recommendations grounded in Erickson's Stages of Psychosocial Development for age-appropriate and developmentally suitable disclosure along with an applied case study.

Keywords

counseling parents psychological distress childhood infertility disclosure strategies Child Readiness for Infertility Disclosure Assessment

Get full access to this article

View all access options for this article.

References

American Counseling Association. (2014). ACA code of ethics. http://www.counseling.org/docs/ethics/2014-aca-code-of-ethics.pdf?sfvrsn=4

Borelli

J. B.

Bender

B. G.

Puck

M. H.

Salbenblatt

J. A.

Robinson

(1984). The meaning of early knowledge of a child's infertility in families with 47,XXY and 45,X children. Child Psychiatry and Human Development, 14(4), 215–222. https://doi.org/10.1007/BF00706035

Center for Disease Control. (2023). Reproductive health: Frequently asked questions. Retrieved November 7, 2017, from https://www.cdc.gov/reproductivehealth/infertility/index.htm

Chen

Dong

Chen

(2023). Fertility preservation in pediatric healthcare: A review. Frontiers in Endocrinology (Lausanne), 14, Article 1147898. https://doi.org/10.3389/fendo.2023.1147898

Cummings

Mercurio

(2010). Ethics for the paediatrician: Autonomy, beneficence and rights. Pediatrics in Review, 31(6), 252–255. https://doi.org/10.1542/pir.31.6.252

Dennis

Howell

Cordeiro

Tartaglia

(2015). “How should I tell my child?” Disclosing the diagnosis of sex chromosome aneuploidies. Journal of Genetic Counseling, 24(1), 88–103. https://doi.org/10.1007/s10897-014-9741-4

Duff

M. A.

Goedeke

(2024). Parents’ disclosure to their donor-conceived children in the last 10 years and factors affecting disclosure: A narrative review. Human Reproduction Update, 30(4), 488–527. https://doi.org/10.1093/humupd/dmae010

Erikson

E. H.

(1982). The life cycle completed: A review. W. W. Norton & Company.

Faux

Schoch

Eubanks

Hooper

Shashi

(2012). Assessment of parental disclosure of a 22q11.2 deletion syndrome diagnosis and implications for clinicians. Journal of Genetic Counseling, 21(6), 835–844. https://doi.org/10.1007/s10897-012-9535-5

10.

Gallo

Angst

Knafl

K. A.

Hadley

Smith

(2005). Parents sharing information with their children about genetic conditions. Journal of Pediatric Health Care, 19(5), 267–275. https://doi.org/10.1016/j.pedhc.2005.05.008

11.

Gupta

Donen

Sung

Boydell

K. M.

K. C.

Stephens

Pritchard

Portwine

Maloney

A. M.

Lorenzo

A. J.

(2016). Testicular biopsy for fertility preservation in prepubertal boys with cancer: Identifying preferences for procedure and reactions to disclosure practices. Journal of Urology, 196(1), 219–224. https://doi.org/10.1016/j.juro.2016.02.2967

12.

Hunt

Monach

(1997). Beyond the bereavement model: The significance of depression for infertility counselling. Human Reproduction, 12(11), 188–194.

13.

Kikendall

K. A.

(1994). Self-discrepancy as an important factor in addressing women's emotional reactions to infertility. Professional Psychology: Research And Practice, 25(3), 214–220. https://doi.org/10.1037/0735-7028.25.3.214

14.

Kitchener

K. S.

(1984). Intuition, critical evaluation, and ethical principles: The foundation for ethical decisions in counseling psychology. The Counseling Psychologist, 12(3), 43–55. https://doi.org/10.1177/0011000084123005

15.

Jayasinghe

Kemertzis

M. A.

Moore

Peate

(2024). Fertility preservation in pediatric and adolescent oncology patients: The decision-making process of parents. Journal of Adolescent and Young Adult Oncology, 6(2), 213–222. https://doi.org/10.1089/jayao.2016.0061

16.

Mac Dougall

Becker

Scheib

J. E.

Nachtigall

R. D.

(2007). Strategies for disclosure: How parents approach telling their children that they were conceived with donor gametes. Fertility and Sterility, 87(3), 524–533. https://doi.org/10.1016/j.fertnstert.2006.07.1514

17.

Mayo Clinic. (2023). Infertility. Retrieved September 7, 2017, from http://www.mayoclinic.org/diseases-conditions/infertility/symptoms-causes/dxc-20228738

18.

McConkie-Rosell

Heise

Spiridigliozzi

(2009). Genetic risk communication: Experiences of adolescent girls and young women from families with fragile X syndrome. Journal of Genetic Counseling, 18(4), 313–325. https://doi.org/10.1007/s10897-009-9215-2

19.

Metcalfe

Plumridge

Coad

Shanks

Gill

(2011). Parents’ and children's communication about genetic risk: A qualitative study, learning from families’ experiences. European Journal of Human Genetics, 19(6), 640–646. https://doi.org/10.1038/ejhg.2010.258

20.

Mosalanejad

Koolee

(2013). Looking at infertility treatment through the lens of the meaning of life: The effect of group logotherapy on psychological distress in infertile women. International Journal of Fertility & Sterility, 6(4), 224–231.

21.

National Institute of Health. (2023). Childhood diseases: What parents need to know. Retrieved September 7, 2023, from https://medlineplus.gov/magazine/issues/spring08/articles/spring08pg5-6.html

22.

Peate

Meiser

Friedlander

Zorbas

Rovelli

Sansom-Daly

Sangster

Hadzi-Pavlovic

Hickey

(2011). It’s now or never: Fertility-related knowledge, decision-making preferences, and treatment intentions in young women with breast cancer: An Australian Fertility Decision Aid Collaborative Group Study. Journal of Clinical Oncology, 29(13), 1670–1677. https://doi.org/10.1200/JCO.2010.31.2462

23.

Romao

R. P.

Lorenzo

A. J.

(2024). Fertility preservation options for children and adolescents with cancer. Canadian Urological Association Journal, 11(1-2S), S97–S102. https://doi.org/10.5489/cuaj.4410

24.

Sutton

E. J.

Young

McInerney-Leo

Bondy

C. A.

Gollust

S. E.

Biesecker

B. B.

(2006). Truth-telling and Turner Syndrome: The importance of diagnostic disclosure. The Journal of Pediatrics, 148(1), 102–107. https://doi.org/10.1016/j.jpeds.2005.08.022

25.

Tremblay

Van Vliet

Gonthier

Janvier

(2016). Partnering with parents to disclose Klinefelter syndrome to their child. Acta Paediatrica (Oslo, Norway: 1992), 105(5), 456–461. https://doi.org/10.1111/apa.13301

26.

Wischmann

(2005). Psychosocial aspects of fertility disorders. Der Urologe, Ausgabe A, 44(2), 185–194. https://doi.org/10.1007/s00120-005-0779-7

27.

World Health Organization. (2021). National, regional, and global trends in infertility: A systematic analysis of 277 health surveys. http://www.who.int/reproductivehealth/publications/infertility/277surveys/en/index.html