Shaping Conversations and Transforming Lives Using the TELL Tool™

In reproductive health conversations, particularly with donor conception, families often face unique challenges with sharing conception information with their children. Thanks to the leading-edge work of Patricia Hershberger, Ph.D., APRN, FNP-BC, FAAN, chair of the University of Michigan School of Nursing Department of Health Behavior and Biological Sciences, there is now a new tool – the TELL Tool™ – that helps families navigate delicate conversations about donor sperm, egg, or embryo origins.

The TELL Tool is the first ever digital decision aid of its kind to support parents in safeguarding the well-being of their children through these conversations.

It started as a prototype a few years ago that was modeled after a longitudinal study conducted by Dr. Hershberger and several other infertility experts across the country. The study revealed that only about 14% of the sampled parents, who were followed for 12 years, told their children about the origins of their conception.

“We discovered those parents had fears of rejection from their child, or they felt that telling them would harm their child in some way,” says Dr. Hershberger. “Many parents also have to come to terms with the grief that comes with infertility. So, they simply needed support to tell their children in a healthy way,” she adds.

"We spent some time trying to understand what affected parents’ ability to tell their children and what  barriers and challenges that they were facing."

The project gained urgency with the introduction of direct-to-consumer genetic testing (i.e., 23AndMe), which Dr. Hershberger says can reveal unanticipated biological relationships that in turn may cause friction within families. To remedy this issue, the TELL Tool generates evidence-based science that supports meaningful and healthy dialogue, ensuring that families from all backgrounds and beliefs can approach this topic with confidence.

“We’ve seen a rise in the use of donor embryos by the LGBTQIA2S+ population so we wanted to make sure the tool incorporates theoretical frameworks used to understand facilitators and barriers and aims to be inclusive across different family structures,” says Dr. Hershberger.

Preliminary results from 2024 showed an encouraging 77% of participants who used the TELL Tool shared donor conception information with their children, representing a major milestone for Dr. Hershberger and her team.

“The tool lets parents know they are not alone. This is one of its most significant attributes,” shares one parent who participated in the study.

“The TELL-Tool is such an informative and instructive resource. It provides parents of donor-conceived children with research-backed strategies to share their family story with their children,” says another parent.

This prototype is just one step toward a viable solution in facilitating challenging family conversations. While it’s not yet accessible to the general public, Dr. Hershberger and her colleagues are targeting a 2025 release date with updated technology and a plan to provide the resource free of charge to families who need this support.