Where Infertility Arises from a Prior Health Condition – Fit to Adopt?

Although the majority of UK adoptive parents have fertility difficulties, there is no national data about how many were aware of them ahead of trying to conceive. It is likely that most will have presumed themselves fertile until found otherwise. For some, though, knowledge of fertility impairment – or its probability – will have come much earlier. Some cancer survivors, for example, are advised that the treatment is likely to have damaged their chances of ever becoming a biological parent. Other medical treatments, including some for rheumatoid conditions, can carry a similar legacy. And then there are health conditions which themselves can lead to impaired fertility such as Turner’s syndrome (TS) for females or cystic fibrosis (CF) for males. As medical treatments improve, so will the numbers of survivors who look to adoption as their route to parenthood. Adoption agencies need to ensure that they do not discriminate against such applicants either through the use of blanket ‘one size fits all’ policies or through disablist attitudes such as seeing disabled applicants as ‘only fit’ to adopt disabled children.

This chapter considers issues unique to this group, drawing on the limited evidence base and focusing in particular on cancer survivors (acquired health condition) and those living with CF and TS (congenital health conditions) alongside discussing the experiences of disabled parents. In the case of cancer survivors, findings will also be drawn on from a study led by one of the authors (Crawshaw and Sloper 2006, hereafter called the 2006 study) into the experiences of 38 male and female teenage cancer survivors aged 16 to 30 growing up with possible fertility impairment.

To avoid clumsy terminology, ‘health condition’ will be used to denote both health conditions and physical impairments unless specified otherwise.