Providing implications counselling to South African anonymous oocyte donors donating to Australian recipients raising Australian DCC in an open-donor-identity context

Cross-border fertility treatment reveals gap in donor identity counseling

Volks, C., Hammarberg, K., & Whittaker, A. (2024). Providing implications counselling to SA anonymous oocyte donors donating to Australian recipients raising Australian DCC in an open-donor-identity context? Human Reproduction, 39(Supplement_1), deae108.833. https://doi.org/10.1093/humrep/deae108.833

Geographic Region: Australia and South Africa

Research Question: How do counselors manage mismatched expectations of stakeholders involved in cross-border oocyte donation between Australia and South Africa when they have different socio-legal frameworks regarding donor anonymity?

Research Methods: Qualitative study using semi-structured in-depth interviews conducted in 2022-2023.

Sample: 9 South African infertility counselors, 16 South African oocyte donors, and 12 Australian recipients

Analysis Methods: Thematic analysis of interview transcripts using NVivo software

Key Findings:

• Australian recipients strongly believed their donor-conceived children had a right to know both who their donor was and if they had any donor siblings. Some were already actively trying to find out their donor's identity, rather than waiting. They also expected that their children might want to use DNA testing in the future to learn about their genetic origins.

• South African donors went into the process expecting to remain anonymous forever, though some said they might be open to contact if South African laws changed to allow it.

• The counselors in South Africa weren't aware that Australian recipients often try to find out who their donors are, so they weren't warning donors about this possibility. They also weren't telling donors that DNA testing and online searching might reveal their identity in the future.

Limitations: Small sample size may not represent all stakeholders. Views may not be representative of all cross-border donation cases between these countries.

Applications: When egg donation happens between countries with different rules about anonymity, everyone involved needs better counseling about what might happen in the future, especially given modern DNA testing and online searching capabilities. This is particularly important as more people travel internationally for fertility treatment.

Funding Source: Not specified

Lead Author: Cal Volks is a Health, Families Relationships & Sexuality Sociology researcher investigating how reproductive technologies affect personal relationships and families / the social and legal implications of using ART. She is currently a research fellow at the School of Human Geography Anthropology & Development Studies (Monash University) and completing an Australian Research Council-funded PhD at La Trobe University Law School.

Regulatory Context:

Australia

• The National Health and Medical Research Council (NHMRC) provides ethical guidelines for assisted reproductive technology (ART), including donor conception. Each state and territory has its own laws governing donor conception, which can lead to some variation across the country.

• Since the early 2000s, most states have moved away from anonymous donation. Donor-conceived individuals generally have the right to access identifying information about their donors once they reach a certain age (usually 18).

• Many states limit the number of families a single donor can contribute to, to reduce the risk of inadvertent consanguineous relationships.

• Most jurisdictions require counseling for donors and recipients before proceeding with donor conception.

• Several states maintain central registries with information about donors and donor-conceived individuals.

• It's illegal to pay donors for their gametes (eggs or sperm) beyond reasonable expenses.

South Africa

• Local donors can be compensated.

• The identity of both the donor (if local) and the recipient/s is kept anonymous. South Africa does import Open ID gametes from other countries.

• According to the National Health Act (Act No. 61 of 2003), a donor may legally not have more than twelve live births.