Do directed and non-directed oocyte donors differ regarding their motives, ambivalence, satisfaction, and openness about the donation?
Directed and non-directed egg donors report similar long-term satisfaction and openness about donation, despite different initial motivations.
Thorup, E., Sydsjö, G., Skoog Svanberg, A., & Lampic, C. (2024). Do directed and non-directed oocyte donors differ regarding their motives, ambivalence, satisfaction, and openness about the donation? Reproductive BioMedicine Online. Advance online publication. https://doi.org/10.1016/j.rbmo.2024.104455
Geographic Region: Sweden
Research Methods: Part of longitudinal survey study (Swedish Study on Gamete Donation (SSGD)) comparing directed oocyte donors (who donated to family/friends) to non-directed identity-release oocyte donors. Survey data collected at 5 time points, from acceptance as donor to 14-17 years post-donation.
Sample: 16 directed oocyte donors and 123 non-directed oocyte donors recruited from 7 Swedish fertility clinics between 2005-2008
Analysis Methods: Statistical group comparisons and analyses of survey data on motivation, ambivalence, satisfaction, and openness. Qualitative analysis of free-text comments.
Key Findings:
Motivation: Directed donors were primarily motivated by empathy for specific recipients, while non-directed donors reported general altruism as the main motivation.
Ambivalence: No differences between groups in pre-donation ambivalence.
Satisfaction: No differences between groups in post-donation satisfaction. Most donors in both groups were satisfied with donating up to 17 years later.
Openness: No differences between groups in post-donation openness. Both directed and non-directed donors were generally open about having donated. Around 90% of donors in both groups had told their partner, member(s) of their original family, and people outside the family about the donation. Just over half of donors with biological children had told their children about having donated oocytes. Some directed donors perceived their opportunities for openness as restricted by the wishes of recipients. Two directed donors and nine non-directed donors who had completed successful donations had not told their own children about the donation at T5.
Limitations: Small sample of directed donors limits generalizability. Unable to compare outcomes between successful vs unsuccessful donations due to small sample. Survey format limited in-depth exploration of experiences.
Applications:
Confirms directed oocyte donation as valid option that can work well for some
Highlights need for pre- and post-donation counseling to address challenges specific to directed donation, like negotiating disclosure and relationships
Recommends future research on factors affecting post-donation relationships
Funding Source: Swedish Research Council, Swedish Research Council for Health, Working Life and Welfare, ALF Grants Region Östergötland
Regulatory Context:
Sweden was one of the first countries to implement identity-release donation, passing legislation in 1984 that went into effect in 1985.
Only altruistic gamete donation is allowed. Donors can receive compensation for expenses and inconvenience, but not payment for the gametes themselves.
Both sperm and egg donation are permitted. Embryo donation became legal in 2019.
Same-sex female couples have had access to donor insemination since 2005 and IVF since 2016. Single women gained access in 2016.
Donation is only allowed at authorized fertility clinics. Private arrangements are not legal.
All prospective donors and recipients must undergo counseling and medical/psychological screening.
Donors must be 18 years or older.
Anonymous donation is prohibited. All donors must agree to be identifiable to offspring.
Donor-conceived individuals have the legal right to obtain identifying information about their donor when they reach "sufficient maturity," typically interpreted as age 18, though no specific age is mandated by law.
Parents are encouraged, but not legally required, to tell children about their donor conception. However, the information is recorded in medical records that the child can access as an adult.
There are restrictions on how many children/families can be created from one donor's gametes, but the exact number can vary between clinics.
A central register of all donor treatments is maintained by the National Board of Health and Welfare.
Donors do not have any legal or financial obligations to offspring. They are not considered the legal parents.
Lead Author: Emilia Thorup conducts research in two areas. One concerns the early development associated with autism spectrum disorders. Specifically, she is interested in whether early differences in gaze behaviors, such as eye contact and different looking patterns, may be used as indicators of later diagnostic status. Her second research focus is family building through the use of donated eggs and sperm. She is interested in the psychosocial aspects of gamete donation from the perspectives of donors, recipient parents, and donor-conceived people.