OK so back to the beginning when the Bambers found themselves infertile:
Infertility is not usually something that "happens". Rather, it is a reality that is forced on a couple over a period of months which then stretch on into years. It includes anxieties about sexual performance and bodily intergrity. It includes medical investigations and the possibility of drugs and of surgical interventions. It includes the allocation of responsbility for the infertility - to the man, to the woman or to both. And it requires mourning.
I use the term "mourning" deliberately, as infertility implies some very significant losses. There is the loss of an image of oneself or of one's partner as biologically intact and capable of conceiving a child. There is the loss of the hoped-for status of biolgocial parent (which includes a fantasy of presenting a grandchild to one's own parents). And there is the loss of the hoped-for biological child, a child who carried both one's own genes and one's own dreams. This last loss, is for many people, an especially painful one. Paradoxically (except within a psychoanalytic framework) it is this loss of which they often are not conscious. Fantasies regarding their imagined biological child often remain hidden until they are exposed by a discrepancy between the real adopted child and the imagined biological child.
Unfortunately the adoptive parents' fantasies regarding their (nonexistent) biological child are not at all inactive. They silently colour many aspects of the relationship between the adoptive parents and their adopted child. And, of course they are not alone in this process; sooner or later the adopted child also develops his own fantasies about his biological parents.
These fantasies whether they reside within an adoptive parent or within the adopted child - are not necessarily pathogenic. However, the clinical literature contains many examples of families in which such fantasies prevented one person from seeing the real person in front of them. (The adopted playwright, Edward Albee, uses an especially powerful example of such fantasies as the focal point for his play, Who's Afraid of Virginia Woolf? In this play the "son" of the two major protagonists, George and Martha, is gradually revealed to be a fantasy - a fantasy who has himself wondered if, perhaps, he was adopted.)
If the adoptive parents are to be able to see their adopted child for whom he is, and if the adopted child is to be able to see his adoptive parents for whom they are, they must mourn the loss of their respective fantasied biological child and fantasied biological parents. The lost (fantasied) relationships must be mourned before the new (real adoptive) relationships can flourish".
The above is from the Psychology of Adoption by psychologist David Brodzinsky.