Egg donors' evolving views on anonymity and contact
Long-Term Follow-Up of Oocyte Donors: Thoughts and Feelings about Donation and Future Contact with Children From the Donation (Holley, 2024)
Holley, S. R., Morris, J. R., Jaswa, E., Ryan, I. P., Kao, L., Forsberg, K., Castaneda, D., Orlin, P. J., Huddleston, H. G., Cedars, M. I., & Pasch, L. (2024). Long-Term Follow-Up of Oocyte Donors: Thoughts and Feelings about Donation and Future Contact with Children From the Donation. Fertility and Sterility, 122(4), e1. https://doi.org/10.1016/j.fertnstert.2024.07.072
Geographic Region: United States
Research Question: What are oocyte donors' long-term feelings about donation, health concerns, and attitudes toward future contact with donor-conceived offspring?
Design: 12-item survey administered to non-directed egg donors who had completed at least one donation cycle at two participating fertility clinics in the San Francisco Bay Area between 2009-2021.
Sample: 249 non-directed egg donors (63.2% response rate) ages 24-47 years. Donors had completed an average of 2.8 cycles (range 1-8 cycles). The average time since the last donation was 7.9 years. Survey response analysis with descriptive statistics.
Findings:
Most donors (about 88%) still felt good about their decision to donate eggs, feeling proud and happy about helping others create families.
About one in four donors had some concerns about how donating might have affected their health or ability to have children in the future.
Most donors (about 74%) were naturally curious about the children born from their donation, but they don't spend a lot of time thinking about it - only about 10% said they think about it often.
About half of the donors would like to meet these children someday, and even more (about two-thirds) said they would be willing to meet if asked.
Even though these donors originally agreed to be anonymous, about 62% said they would be willing to let their identity be shared with donor-conceived adults who ask, with only 16% firmly against the idea.
Limitations: Regional sample from San Francisco Bay Area only. Self-selected response group.
Applications
Clinics and healthcare providers should provide better long-term health information to donors and consider offering ongoing health monitoring for donors who have concerns.
Clinics and banks should consider updating their policies about donor anonymity, given that many donors are open to future contact.
Mental health professionals should help donors think through various future scenarios regarding contact with offspring.
Funding Source: UCSF Department of Obstetrics, Gynecology, and Reproductive Sciences Research Fund
Lead Author: Sarah R. Holley is affiliated with the University of California, San Francisco, specializing in reproductive health research.
Regulatory Context
There are no comprehensive federal laws regulating gamete donation or donor conception in the U.S. The process is largely self-regulated by the fertility industry.
The Food and Drug Administration (FDA) does have some oversight, primarily related to screening and testing of donors for infectious diseases.
The American Society for Reproductive Medicine (ASRM) provides ethical guidelines and recommendations for donation practices. However, these are not legally binding.
There are no legal limits on compensation for donors. A 2011 court ruling (Kamakahi v. ASRM) determined that price caps on donor compensation violate antitrust laws.
ASRM recommends a minimum age of 21 for gamete donors, but this is not legally mandated.
The U.S. does not have laws prohibiting anonymous donation.
Some states have enacted their own laws regarding aspects of assisted reproduction, and parentage, but these vary widely.