IVF treatment involving donated eggs increases yearly. Numerous technical and commercial transformations have reshaped how eggs are retrieved, stored and managed. A key transformation is vitrification; a 'fast freezing' method that allows efficient preservation of eggs, and therefore more flexibility in use, giving rise to new commercial possibilities. There has been limited focus on egg providers' experiences in the context of vitrification and related commercialisation. We report findings from a study in the UK, Spain and Belgium, where we interviewed 75 egg providers. Comparing experiences within different donation 'regimes' allows an exploration of how varying national practices and policies shape information-giving and women's experiences. In the UK, a system of 'informed gift-giving' was described, where egg providers saw their actions as not-for-profit and felt relatively well informed. In Belgium, the system was presented as 'trusted tissue exchange': with less information-giving than in the UK, but clinics were trusted to act responsibly. In Spain, a 'closed-door, market-driven' system was described, whereby egg providers received little information and expressed concerns about generation of excess profit. Our findings extend understandings of how egg donation is managed at the national level and how donation regimes produce specific experiences, expectations and subjectivities amongst tissue providers.
Abstract To evaluate long-term health outcomes in children born after oocyte donation compared to children born after in vitro fertilization with autologous oocytes and spontaneous conception. Children born after oocyte donation (OD) may have an increased risk of immune diseases and anxiety disorders compared to spontaneous conception (SC). Oocyte donation has advanced considerably since the first pregnancies from oocyte and embryo donation were reported nearly four decades ago. While perinatal outcomes of children born from oocyte donation pregnancies have been studied, findings remain inconsistent. Some studies report higher rates of preterm delivery and low birth weight, compared to standard IVF pregnancies, whereas others find no significant differences. However, the long-term health effects of children born after oocyte donation remain largely unexamined. Study design, size, duration
This study is a retrospective big data cohort study that utilizes electronic data from Maccabi Healthcare Services, a patient integrated care organization, which represents 25% of the pregnant population in the country. The data used in this study was collected from 2000 through 2018. Participants/materials, setting, The cohort consisted of three groups based on the mode of conception: 609 children born after oocyte donation (OD), 12,678 after IVF with autologous oocytes (AO), and 456,786 after spontaneous conception (SC). The groups were compared for basic characteristics, including maternal age at birth, gestational age, weight percentile, first-child status, and gender. Additionally, the prevalence of chronic diseases, as defined by the ICD-9 classification, was analyzed across the groups. Main Mean maternal age was significantly higher in the OD group (40.8 ± 4.3) compared to IVF with autologous oocytes (34.6 ± 4.9, p = 0.001) and SC (31.2 ± 5.3, p = 0.001). Mothers in the OD group also had higher socioeconomic status than those in the AO and SC groups (7.1 ± 1.5 vs. 6.7 ± 2 vs. 6 ± 2, p = 0.001). Preterm labor before 37 weeks was more frequent in the OD group compared to the SC group (24% vs. 5.7%, p = 0.001). Similarly, pregnancy-induced hypertension was more common in the OD group than in both the AO and SC groups (4.1% vs. 1.7% vs. 0.7%, p = 0.001). The proportion of immunological diseases was significantly higher in the OD group compared to the SC group (0.3% vs. 0.1%, p = 0.047), though not significantly different from the AO group (0.3% vs. 0.2%, p = 0.31). No significant differences were found among groups for other chronic diseases including cardiovascular, endocrinology, urology, neurology, rheumatology, neural tube defects, cancer, chromosomal anomalies, or cerebral palsy. Anxiety was more prevalent in children born after OD compared to AO (0.7% vs. 0.2%, p = 0.018) and SC (0.7% vs. 0.2%, p = 0.008). However, no significant differences were observed for other psychiatric conditions, including schizophrenia, depression, and ADHD. Limitations, The study’s retrospective design, reliant on varied physician diagnoses, may have caused under- or over-diagnoses. Missing data on OD/AO indications and male partner characteristics and sperm parameters limited analysis. Mothers using oocyte donation may be reassured in knowing that most long-term health conditions are uncommon in children born through this method. However, there may be a slightly increased risk of immunological and anxiety disorders. Additional population-based studies with extended follow-up are necessary to further validate these findings. No
Abstract
With shifts in legislation, increasing use of direct-to-consumer DNA testing, and growing advocacy around the right to identity more and more donor conceived people are seeking and obtaining information about the genetic origins.
The presentation explores the deeply personal and complex journey of donor conceived (DC) people who seek to find their biological donors.
This presentation explores the nuanced experience of donor conceived people as they are navigating the process of discovering their donor identity. Drawing on recent research, clinical insights and first-hand accounts the presentation explores the motivation of DC people, their hopes and fears, their expectations and experiences of finding and contacting their donors and the diverse outcomes of such processes.
The presentation examines common challenges such as navigating secrecy, boundary setting, impact on family dynamics and different donors’ responses and level of engagement. It also highlights the impact of the interactions between DC individuals and their donors, whether affirming, ambiguous or disappointing, on the individual sense of self and family dynamics.
The presentation will also address the ethical and practical considerations for professionals working in reproductive medicine and / or mental health highlighting the importance and benefits of psychological support, intermediary services and peer support.
Abstract
The general point of view on disclosure of the donor conception to the offspring experienced a major change over the years. From the outset, non-disclosure was imposed by medical professionals. Decades of debates followed, discussing if disclosure or non-disclosure would be in the best interest of the donor-conceived person, before the recommendation to disclose the donor conception to the offspring was integrated in professional guidelines such as those of ASRM (2013) and ESHRE (2024). This change in view was supported by research findings showing that late disclosure (and often discovery) has a negative impact on the wellbeing of donor-conceived people, that early disclosure is not burdensome for donor-conceived children (moreover, it is preferred by donor-conceived people), and that early disclosure is associated with better well-being of donor-conceived people during adolescence. Moreover, societal changes, such as the technological development of direct-to-consumer-genetic testing, have made non-disclosure impossible. Lastly, the framing of disclosure as a question concerning ‘the best interest’ of donor-conceived people has been replaced by a framework that information about one’s origin concerns a fundamental human right.
Not only did the recommendation regarding disclosure/non-disclosure changed, also the knowledge about disclosure increased. While initially disclosure was often approached as a dichotomous act, research findings showed that disclosure occurs much more in layers. Moreover, disclosure is not a one-off activity, but (as preferred by donor-conceived people themselves) an ongoing conversation over the family-life course, that continues when the child grows up. Besides, disclosure is not a unilateral process in which only parents take up an active role, but it is an interactive process in which parent and child co-create their family-story. Lastly, disclosure does not only concern the origins of the child, but it is also a family-building story, in which parents formed their family in a different way they initially imagined.
In relation to the actual disclosure process, studies have shown that parental confidence is generally associated with disclosure and a lack of confidence (including uncertainty around the language to use, the best way and time to disclose, and finding the information difficult to share) is associated with non-disclosure. A recent literature review showed that many participants across studies reported feelings of being unprepared, isolation and anxiety around the disclosure decision and process, and express a desire for support. Parents would like to hear experiences from other parents and to have access to resources, such as storybooks and movies, and networking opportunities for the donor-conceived people as they might enhance feeling comfortable with the disclosure process. However, support and advice were not always provided.
This presentation reviews the latest existing empirical data regarding the disclosure-process (factors that might influence the process, outcomes, experiences of parents and donor-conceived people) and will especially address how, psychosocial as well as medical, professionals can support families in their ongoing conversation about their family-building, pre-, during and post-treatment. Furthermore, challenges and limitations of offering ongoing support will be discussed as well, based on an inquiry conducted in 10 jurisdictions.