The provision of oocytes plays an important role in human fertility treatments. Spain alone performs half of oocyte provision cycles in the European Union whilst all other European countries face an oocyte shortage. How do Spanish fertility clinics manage to match the increasing domestic and foreign demand for female oocytes? Adopting a weak performativity approach and drawing insights from interviews carried out with 20 fertility clinic representatives, this study suggests that Spanish clinics are successful thanks to an egg provision system designed as a (quasi) social market. In the absence of traditional market mechanisms based on price fluctuations, the combination of fixed monetary compensation for providers and altruistic framing of oocyte provision as an act of donation, are used to mobilize relatively high numbers of women. Fertility clinics optimize this supply through a set of supplementary strategies to ensure oocyte supply always meets oocyte demand. Though successful, this market design reinforces gender stereotypes and relies on manipulative notions of altruism. A clear but unacknowledged appropriation of women's bodies and reproductive labour are also operated, which reinforces and reproduces racial and social stratifications. Therefore, we ask whether alternative mechanisms to promote female solidarity across different generations, to raise awareness of the risks of advanced maternal age, and to explore alternative market designs should be considered.
Donated sperm, eggs, and embryos are an increasing feature of assisted reproduction; people conceived in this way have different genetic and social histories. Although most offspring of donor-assisted conception are ignorant of their genetic history, recipient parents must negotiate increasing demand for full disclosure to offspring. This paper illustrates some of the reasons parents give for not telling their children, underlines the experience of many parents of being uncertain of how to go about telling, presents information from some parents who have endeavoured to be open with their children about conception from very early childhood, and discusses implications for the narrative identity of offspring of donor-assisted conception. Recipient parents (n=55) and offspring (12) from Australia; Canada, US, England, and Argentina were interviewed and subsequently consulted about the development of their narrative accounts and the way in which these have been interpreted. Parental narratives were found to be located along a continuum, broadly encompassing: (1). Parents who intend to exclude donor-assisted conception from the narratives they construct for their children, (2). parents who are uncertain about what they want to do, or confused about the best way to disclose and discuss donor conception with their children and (3). those have incorporated the donor in their children's narratives from the beginning. From interviews with offspring and on the basis of human rights issues and the increasing salience of genetic knowledge, it is concluded that disclosure to offspring before adolescence should be encouraged.
Chavez-Badiola A et al., 2025·Journal of assisted reproduction and genetics·
Open Access
The economics of IVF operations remain opaque despite growing prevalence and substantial investment in fertility services. Traditional accounting methods often fall short by failing to capture the complex relationship between biological inputs (number of eggs and embryos processed), skilled labor, and equipment utilization, creating a distorted view across different procedures and patient characteristics. This paper presents Activity-Based Costing (ABC) as a methodological framework for understanding true IVF laboratory costs. We demonstrate a use case with an analysis of data from five IVF laboratories (600-2200 annual egg retrieval cycles) across different US regions including time studies of 500 + procedures at each site, with theoretical projections to 4000 annual egg retrieval cycles based on queuing theory. We identify significant cost elasticity with biological inputs; costs increase by 55% for egg freezing when the number of eggs per patient triples, and by 30% for complex IVF procedures (such as those requiring embryo biopsy) when egg count per patient doubles. We also describe substantial scale effects, with marginal lab costs 40% higher in centers performing 500 yearly egg retrieval cycles versus 2000-cycle centers, and 4000-cycle centers estimated to achieve 13-40% lower costs per procedure than operations performing 500 retrieval cycles annually. Finally, we show labor efficiency increases by 30% between centers performing 500 and 2000 annual egg retrieval cycles, an observation supported by a queuing rule of thumb (QROT) analysis, with capital utilization also improving dramatically. ABC enables evidence-based pricing, capacity planning, technology assessment, and consolidation strategizing. ABC is intended to inform operational efficiency, not clinical treatment, ensuring that quality of care and patient outcomes remain the primary considerations in fertility services.
Population and Global Health · Fertility Rates and Demographics
Gallup poll of 1,002 US adults, conducted July 7-21, 2025, released September 4, 2025. Americans continue to say that the ideal family size includes an average of 2.7 children. Distribution: none 2%, one child 4%, two children 40%, three children 27%, four children 11%, five or more 4%. Preferences for one or two children (44%) are statistically tied with preferences for three or more (42%). The mean ideal has held at 2.7 across the past three readings, in 2018, 2023 and 2025.
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.