A systematic review of qualitative studies investigating motives and experiences of recipients of anonymous gamete donation
Five reasons why recipient parents pick anonymous sperm and egg donors
Bauer, T. (2022). A systematic review of qualitative studies investigating motives and experiences of recipients of anonymous gamete donation. Frontiers in Sociology, 7, Article 746847. https://doi.org/10.3389/fsoc.2022.746847
Geographic Region: Primary focus on Western European and North American countries, including studies from: United States, United Kingdom, Belgium, Canada, France, Germany, Israel, Sweden, Netherlands
Research Question: What motives and experiences of recipients choosing anonymous gamete donation (vs ID Disclosure or Known Donors) are reported in relevant qualitative research?
Methods: Systematic search of 7 databases: Web of Science, SCOPUS, MedLine, PubMed, CINAHL, PsycINFO, ProQuest. Theory-guided synthesis using qualitative content analysis. Coding and categorization of motives and experiences. Quality assessment using adapted CASP criteria.
Sample: 53 studies published between 1988-2019 (42 focused on sperm donation, 11 on oocyte donation). Mix of heterosexual couples, lesbian couples, and single mothers. Sample sizes in original studies ranged from single-participant case studies to 200+ participants. Studies conducted before, during, and after treatment.
Key Findings: The analysis revealed five main categories of motives for choosing anonymous donation. The study also found that people's feelings about anonymous donation often change over time. While some remain satisfied with their choice years later, others wish they had chosen differently as their children grow older.
Intention to keep oneself ignorant of donor identity: Many recipients choose anonymous donation to protect their own emotional well-being. They find it easier to feel like "regular" parents when they don't have to think about the donor as a real person. This anonymity helps them avoid complicated feelings of obligation or gratitude, and allows them to focus on building their family without the emotional complexity of knowing the donor. For many couples, this choice helps them feel more secure in their roles as parents and in their relationship with each other.
Intention to keep the child ignorant of donor identity: Parents believed anonymous donation helps avoid potential awkwardness or complications with known donors, particularly if the donor is a family member or friend. Non-biological parents often feel more secure in their parenting role when there isn't a known donor in the picture. The privacy that comes with anonymous donation also helps families maintain clearer boundaries and keep their reproductive choices private.
Intention to keep the donor ignorant of the child's identity: Many parents believe anonymous donation creates a more stable situation for their children. They worry that knowing the donor's identity might lead to disappointment or rejection if the child tries to make contact later in life. Some parents feel children should form their own positive image of the donor rather than dealing with the reality of a specific person. They also believe anonymity makes it easier to be honest with children about their conception since there's no hidden information to manage.
Intention to keep family's social environment ignorant of donor identity: This was especially important for families considering a family member as a donor. Recipients feared that knowing the donor's identity could lead to strained family relationships, questions about the legitimacy of their relationship as parents, or confusion about family roles (like how relatives should view and treat the donor). By choosing an anonymous donor, recipients could better control their family narrative, maintain clear boundaries with relatives, and avoid complicated social dynamics that might arise if family members knew the donor's identity.
Pragmatic reasons: Many recipients choose anonymous donation simply because it's their only option due to legal requirements or medical availability in their area. Others find it offers advantages like faster treatment times, more thorough medical screening, or lower costs. The research shows that these practical factors often interact with emotional and family considerations to influence the final decision.
Limitations
The studies included in the review were heavily concentrated in Western countries, particularly North America and Europe, leaving a gap in understanding how different cultures and societies approach anonymous donation.
The majority of studies only captured participants' views at a single point in time, with very few longitudinal studies tracking how attitudes and experiences change as families grow and children develop.
There's a notable absence of non-biological parents' perspectives, as most research focused primarily on the recipient's viewpoint rather than their partner's experiences.
The studies were conducted across different legal and regulatory environments, making it difficult to compare experiences when some participants had no choice about donor anonymity while others did.
Research quality varied considerably, with some studies providing deep, detailed analysis while others offered more surface-level insights.
The research spans a long period (1988-2019), during which attitudes, technologies, and legal frameworks have significantly changed.
Applications: For professionals, these findings provide a framework for understanding recipient motivations and can improve guidance for pre-treatment counseling.
Funding Source: JSPS KAKENHI Grant Number 19H01186
Lead Author: Tobias Bauer is Faculty of Humanities and Social Sciences at Kumamoto University in Japan.
Regulatory Context: Studies conducted in various regulatory environments:
Countries with mandatory donor anonymity (e.g., Spain, Czech Republic)
Countries with mandatory donor identification (e.g., Sweden, UK)
Countries with mixed systems allowing choice (e.g., US)