In June, I shared my thoughts about four novels featuring donor-conceived characters and two nonfiction reads that explore donor conception, family, and kinship. Spira's Queering Families critically examines how donor conception advocacy centering genetic connection can inadvertently align with bionormative messaging. Hertz & Nelson's Random Families draws on 350+ interviews tracing how donor-conceived people and families transform "genetic strangers" into kinship networks. McKenzie's Skye Falling (Lambda Literary Award winner) follows a Black queer egg donor and the young woman who seeks her out twelve years later. Barclay's Find You First is a thriller with multiple DCP narrators investigating a sperm donor's decision to warn his biological children about a hereditary illness. Clark's The Ones We Choose explores family meaning through multiple perspectives, including the donor, recipient parent, grandparents, and relatives. Jewell's Making of Us traces three UK-conceived adults who connect through a donor sibling registry while their dying donor parallels their stories. Each offers different framings of genetic connection, obligation, belonging, and what family actually means. If you are interested in other creative works that feature donor-conceived characters, check out the Parts of Me DCP Stories Collection.

Research Recap

Groundstroem et al. (2026) surveyed 96 Swedish donor-conceived adolescents (ages 13-16) in the Swedish Study on Gamete Donation about their intentions to request identifying information from identity-release donors. Fifty-eight percent intended to request donor information (28% as soon as possible, 30% sometime in future); 32% were uncertain; 9% had no intention. Family form (lesbian vs. heterosexual) and gender did not significantly predict intention. Adolescents reporting better family functioning were approximately 5 times more likely to report uncertainty than clear intention. Among heterosexual-couple families, those conceived with donor eggs were significantly more likely to intend to request information than those conceived with sperm.

Hobbs & Martin (2026) conducted a market analysis of donor sperm pricing across five major U.S. sperm banks in April 2025 and obtained longitudinal pricing data from two banks spanning 9-10 years (inflation-adjusted to 2025 dollars). Only 2 of 5 banks sampled continued offering non-identified donors in 2025; 3 had discontinued them. Current average pricing across five banks (2025): IUI and ICI vials $1,968 for identity-disclosure donors versus $1,495 for non-identified donors; IVF vials $1,789 (identity-disclosure) versus $1,245 (non-identified); ICSI vials $1,841 (identity-disclosure) versus $1,195 (non-identified). Study documents industry shift toward identity-disclosure donors and significant price increases but cannot establish causation or assess whether pricing reflects disclosure mandate effects, regulatory burden, or limited market competition.

Lavoie & Côté (2023) studied a French-speaking Quebec Facebook group (2,800+ members) dedicated to surrogacy and egg donation from 2015-2021, interviewing 22 participants (6 intended mothers, 12 surrogates, 4 egg donors). Surrogates and egg donors actively selected intended parents based on relationship stability, values alignment, and personal chemistry, reporting greater control and autonomy through online networks compared to agencies. Some participants preferred trust-based agreements; others wanted formal oversight for vetting and financial security. The Facebook group provided information sharing, emotional support, knowledge building, social networking, and cost savings compared to private agencies. The group debated legal protections and whether compensation for surrogacy is ethical or necessary, and whether the work deserves payment.

Montagnini et al. (2025) surveyed 401 Brazilians about disclosure of biological origin in egg and embryo donation: 104 patients, 205 fertility clinic staff, and 92 psychologists. Among parents, 33% intended to disclose, 22% did not, 45% were uncertain. Parents planning to tell the child's grandfather were more likely to tell the child; those planning to tell the grandmother were less likely to tell the child. Among clinic staff, 56% supported disclosure, 10% opposed, 34% undecided. Psychologists showed strongest support: 72% favored disclosure, 2% opposed, 26% undecided.

Imrie et al. (2023) compared 72 egg donation families to 50 IVF families with 5-year-old children. Both groups of children were developing well and showed normal behavior and emotional adjustment. Teachers reported egg donation children had slightly more behavior and emotional challenges compared to IVF children, but both groups were in the normal range. Egg donation parents reported more stress, less support from others, and less confidence than IVF parents, though neither group was at concerning levels. However, when researchers watched parents and children play together, both groups showed warm, responsive interactions with no real differences. Across both groups, children who had more behavior problems had parents with lower support from others and increasing stress over time.

Hall et al. (2026) reviewed 57 studies about donor-conceived people, donors, parents, and donor siblings connecting after donor conception. Most studies had small samples and came from the US, UK, and Australia. Few studies captured children and teens navigating contact in real time. Most donor-conceived people who met their donors reported positive or neutral experiences, though some felt disappointed when reality didn’t match expectations. DCP contact with same-donor siblings was similarly mostly positive; early childhood contact facilitated by parents was associated with smoother integration. Donors generally wanted to share information and were curious about outcomes but often waited for others to reach out first. Parents sought contact for medical information, child identity development, and extended family building. Positive contact was more likely when families were open about donor conception, expectations were realistic, contact happened in childhood, and sibling networks were smaller. Official identity-release registries were often hard to access or had wrong information, so most people connected through informal means like social media and DNA testing sites that don’t always have safety protections.

Adams et al. (2022) surveyed 272 donor sperm-conceived and 877 spontaneously conceived adults (average age ~32-33, mostly female) about mental health. Donor-conceived participants were mainly recruited through donor conception Facebook groups and support organizations. Because the study recruited donor-conceived participants mainly from support groups and advocacy organizations, results likely capture people already engaged with donor conception issues. The study didn't track disclosure/discovery timing, family structure, whether they know their donor, or whether they're searching for donors. The largest difference observed was in identity formation difficulty: 52% of donor sperm-conceived adults reported it vs. 14% of spontaneously conceived adults. This is also the only finding that remained statistically significant when the analysis was restricted to Australian respondents only (54% vs. 14%). The authors did not define what “identity formation difficulty” means, used a single yes/no survey item, and did not distinguish between different dimensions of identity (genealogical, psychological, relational, narrative).

Other Tidbits

• The Trump administration nearly doubled funding for embryo adoption grants and reframed them using "fetal personhood" language, calling frozen embryos "children who already exist and are in need of a family."

• PET reviews the BBC podcast "The Gift," which explores two sperm donors' experiences discovering their donor-conceived offspring through DNA testing.

• Paths to Parenthub published descriptive statistics from their survey of 1,103 recipients and intended parents. The report covers parent comfort levels, support needs, and satisfaction with clinical care across the donor conception journey.

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Geographic Region: Sweden

Research Question: How do Swedish single mothers by choice (SMBC) with young children understand and negotiate family and kinship boundaries in relation to donor-related genetic ties?

Design: Qualitative study using a hermeneutic phenomenological approach, meaning the researcher aimed to understand how participants experience and make meaning of family and kinship in everyday life, rather than to test a specific hypothesis or measure outcomes numerically. Data collection included semi-structured phone interviews, conducted between January and March 2026. All interviews opened with the same question (“Can you describe what your family situation looks like today?”) and then moved through topics including pathways to motherhood, everyday family life, support networks, disclosure, donors, donor siblings, and future expectations. Interviews were transcribed verbatim in Swedish, coded initially in Swedish, and translated into English, with attention to preserving meaning and tone. The analysis drew on three theoretical concepts: temporal discordance (how past, present, and future genetic ties can coexist and create tension), relational authority (who holds the moral right to define, initiate, or limit a relationship), and displaying family (how people actively signal to themselves and others that their relationships count as family).

Sample: 16 women from an earlier cohort of 54 single Swedish women who began pursuing donor-assisted parenthood shortly after Sweden’s 2016 legal reform granted single women access to publicly funded donor insemination. Of the original 54, 5 could not be located, and of the 31 who responded to a follow-up questionnaire (63% response rate), 18 had become mothers through donor conception and met inclusion criteria; 16 ultimately completed interviews. At the time of the interviews, participants were 40–47 years old and had become mothers between ages 34 and 41. Nine had one child, and seven had two. Children were born between 2017 and 2023 (ages 3 to 9 years old). Most children were conceived via sperm donation; one via double donation (egg and sperm). All donors were identity-release donors whose identities were unknown to the families at the time of the study. Mothers treated in Denmark had access to donor numbers and more non-identifying information than those treated in Sweden. No participants had contact with donor siblings in other families. Most had higher education and medium-to-high incomes, though the sample also included mothers with lower incomes and lower educational attainment. Twelve were still single parents at the time of interview; four had entered relationships, with three partners taking on parental roles. Most participants had regular contact with other SMBCs and described this as an important source of practical and emotional support.

Key Findings

Donor and donor-sibling ties were acknowledged but placed outside the family in the present, with their meaning left open for the child’s future.

• Mothers consistently described donors with gratitude but positioned them as facilitators rather than family members or father figures. Most used the word “donor” specifically to avoid implying a parental relationship.

• Several mothers described the donor as capable of becoming suddenly, briefly present in their thinking, even though he was mostly absent from daily consideration.

• All participants supported their child’s future right to learn the donor’s identity and emphasized that it should be the child’s decision.

• Donor siblings (children conceived using the same donor) were harder for mothers to categorize than donors themselves. Some avoided the term “sibling” altogether, using phrases like “genetically similar” instead, because the relationship lacked shared history or daily contact.

• None of the 16 mothers had done DNA testing on their children to identify donor siblings or donor relatives, and several chose not to search registries or social media using donor numbers. Several mothers reflected that choosing not to act (not testing, not searching) was itself a decision with consequences, since it already shapes what the child later finds familiar, thinkable, or normal.

Disclosure was treated as a moral obligation and used to make the family understandable, both to the child and to the outside world

• Fifteen of the sixteen mothers had told their children about their donor conception, typically starting in infancy as a way of making the story feel natural and rehearsed for the mother herself. Two mothers had not followed the typical early-disclosure pattern: one told her daughter at age seven, and the other had not yet told her nearly 8-year-old son by the time of the interview. Both of these mothers had partners who had taken on parental roles.

• Disclosure served a specific practical function in these single-parent families: because the absence of a father was often socially visible, mothers needed a way to explain the family structure without implying the donor was a father.

• Children’s books about donor conception and family diversity were widely used as a low-pressure, repeatable way to introduce and revisit the topic over time.

• Discussion of donor siblings with children was far less developed than discussion of the donor. Most mothers said they planned to address donor siblings later, describing the topic as too abstract or complex for young children, and expressing a wish for more research or guidance on how to approach it.

Limitations: For some, interviews took place years after the transition to motherhood, and accounts of parenting and family life may be shaped by a wish to present oneself favorably. Recruitment through a single original clinic cohort limits generalizability, though participants were geographically dispersed and some had used other clinics for treatment. The study does not report racial or ethnic composition of participants, and the sample is skewed toward higher-education, higher-income women. This limits what the study can say about how race, class, or immigration background shape these disclosure and kinship practices.

Applications: The findings should be read as an in-depth account of common patterns within a fairly narrow slice of the Swedish SMBC population, not a comprehensive picture of it.

Funding Source: Not reported

Lead Author: Marie Ström is a graduate student who completed this work as a Master’s thesis in Sociology at Stockholm University (Spring 2026), under the supervision of Andrea Voyer, with Helena Volgsten (registered midwife and associate professor at Uppsala University’s Department of Women’s and Children’s Health) serving as co-supervisor. The author discloses her positioning as a parent who formed her family through egg donation and adoption.

Regulatory Context

• Sweden was one of the first countries in the world to end anonymous sperm donation, doing so in 1985.

• Only altruistic gamete donation is permitted; donors may be reimbursed for expenses but not paid for gametes themselves, and donation is only legal through authorized fertility clinics. Both sperm and egg donation are permitted, and embryo donation became legal in 2019.

• Access to donor insemination was extended to same-sex female couples in 2005 and to single women in 2016. IVF access for same-sex couples followed in 2016. All donors and recipients must undergo counseling and medical/psychological screening.

• Under Sweden’s identity-release system, donor-conceived individuals have the legal right to obtain identifying information about their donor once they reach “sufficient maturity”, typically interpreted as around age 18, though no specific age is set in law.

• Since a 2019 reform to the Children and Parents Code, parents are legally required to inform donor-conceived children about their conception, though as this thesis notes, most participating mothers were unaware of this specific legal requirement and disclosed anyway, suggesting social norms rather than legal knowledge were the primary driver.

• In Sweden, a donor can contribute to a maximum of six families.

• A national register of donor treatments is maintained by the National Board of Health and Welfare, and contact between donor siblings can be facilitated through medical records once individuals are considered sufficiently mature and all parties consent.

Related Posts

• Adolescent-parent relationships similar across donation and IVF families (Paulin, 2024)

• How family bonds affect donor-conceived teens' identity journey (Groundstroem, 2024)

• Donor-conceived adolescents show varied preferences for donor information (Groundstroem, 2026)

Geographic Region: Hungary

Research Question: What are the reproductive decisions and concept of kinship of single mothers by choice (SMBC) in Hungary who pursued motherhood through assisted reproductive technologies (ART)?

Design: Qualitative study using semi-structured interviews, conducted between February and October 2025. Participants were recruited through social media groups, a nationwide online newspaper announcement, and snowball sampling. All interviews were conducted and analyzed in Hungarian; quotes used in the article were translated into English and checked by all three authors for accuracy of meaning.

Sample: 21 Hungarian women, aged 35 to 53, who became mothers between the ages of 35 and 51 through ART using donor gametes or embryos. Fifteen participants used sperm donation only; six conceived through double gamete donation (both donor egg and donor sperm) or embryo donation. Eleven participants underwent treatment exclusively in Hungarian clinics, six exclusively abroad, and four in both Hungary and another country (destinations included the Czech Republic, Slovakia, Spain, Portugal, Greece, and the United States). Most had one child; two had two children, and one had three. With one exception, all participants held tertiary degrees, and most described themselves as financially stable. Eligibility required at least one child conceived through ART using donor gametes or embryos, with the youngest child no older than 15; being legally single both at conception and at the time of the study; and living alone with the child(ren).

Key Findings

• When asked about their reasons for pursuing becoming an SMBC, all 21 participants described a strong, longstanding desire to have a child. Most had originally hoped to have children within a partnership, and had either not found a suitable partner or had partners who did not want children. Participants described ART as a fallback plan rather than a first choice, taken up as they approached the end of their reproductive years. Several said they waited “until the last moment” in case a partner appeared. Some participants also described valuing the independence and autonomy of parenting alone, such as avoiding parenting conflicts and making child-rearing decisions on their own.

• When asked why they pursued ART rather than adoption, participants described Hungarian laws that make adoption by single people extremely difficult, alongside the perceived challenges of parenting an older child with a prior care history, as reasons for preferring ART.

• When asked about the role of genetic relatedness, most participants attached strong importance to conceiving with their own eggs, and several attempted this against medical advice, even when clinics recommended a donor egg. Participants who conceived using donor eggs or embryos often emphasized carrying the pregnancy and giving birth themselves as a form of biological connection, and some described choosing donor embryos partly for physical resemblance (e.g., matching eye or hair color) as a way of approximating a genetic tie. Several participants described more difficulty explaining to their child that they were not genetically related (in cases of egg or embryo donation) than explaining that the genetic father was a donor.

• Most participants in Hungary could not choose an identity-release donor because Hungarian law excludes this option entirely. Among those who expressed a preference, most said they would have preferred identity-release donation, reasoning that it would benefit their child’s ability to learn about their origins. Several participants described more difficulty explaining to their child that they were not a genetic parent (in cases of egg or embryo donation) than explaining that they used a sperm donor.

• When asked about the donor and searching for genetic relatives, most participants expressed a neutral or grateful attitude toward the donor. Few had actively tried to identify an anonymous donor; several described this as something they would leave for their child to decide as an adult, or as ethically uncomfortable given the donor’s original choice of anonymity. There was more agreement that searching for donor-conceived half-siblings was worthwhile. Most participants attempted this, and several succeeded, primarily through Facebook groups and international sperm bank sibling registries. Motivations included curiosity, a desire to support their child’s identity development, and a wish to build extended family-like networks.

Limitations: Recruitment through social media groups, an online newspaper announcement, and snowball sampling likely favored women already connected to online communities and already comfortable discussing donor conception. The sample was relatively small and consisted of highly educated, financially stable heterosexual women, which may limit the generalizability of the findings.

Implications: Any research conducted in a constrained-choice environment tells you as much about the environment as it does about the psychology.

Funding Source: University of Pécs (Rectoral Application Grant No. 009_2025_PTE_RK/5, awarded to Adrienn Bognár) and Momentum Programme of the Hungarian Academy of Sciences (Grant LENDULET_2021-78)

Lead Author: Adrienn Bognár is an associate professor of sociology at the University of Pécs, Hungary, where she also earned her PhD in the social sciences. No personal connection to donor conception is disclosed in the article.

Regulatory Context

• Identity-release (identifiable) donation is legally excluded for both sperm and egg donation; only limited non-identifying information (physical characteristics, screening results) may be shared with recipients.

• Since the late 1990s, publicly funded ART, including up to six insemination cycles and five IVF cycles, is available to single women under 45 if natural conception is considered unlikely, generally requiring confirmation from at least two independent medical opinions. Assisted reproduction, including sperm donation, is completely unavailable to same-sex female couples in Hungary.

• Altruistic sperm donation is compensated for expenses. Financial compensation for egg donation is not permitted. Egg donation inside Hungary is limited to altruistic, non-commercial donations from a close female relative under 35 who has already given birth.

• Since 2020 legislative changes, adoption by single people has become extremely difficult: ministerial approval is required, and single applicants may adopt only when no married couple wishes to adopt the child.

• There is no legal requirement for parents to disclose donor conception to children, though the child’s medical records include this information and are accessible to the child as an adult.

Related Posts

• A case study reveals how one young donor-conceived person in Turkey navigates family identity (Özden, 2025)

• Research shows Italian society split on acceptance of donor-conceived families (Fusco, 2025)

• Study reveals how medical practitioners’ conceptual frameworks restrict access to donor treatments (Lindgren, 2025)

Geographic Region: United Kingdom

Research Question: What are the motivations, experiences, and psychological correlates of social disclosure among donor-conceived young adults? Does the minority stress model help explain the relationship between social disclosure, mental wellbeing, and resilience?

Design: A cross-sectional, multi-method (quantitative and qualitative) online survey study, conducted between January and August 2022. This study is part of the Young Adults Study, a UK-based project focused on the lived experiences and wellbeing of donor-conceived young adults (ages 18–32). The survey was developed in consultation with staff and volunteers from the UK’s two largest donor conception community networks (the Donor Conception Network and the Donor Conceived Register Registrants’ Panel, now Donor Conceived UK). The survey was piloted with five donor-conceived people before launch. Recruitment occurred through these community networks’ mailing lists and social media, the research team’s own networks, university mailing lists, and snowball sampling. Participants completed sociodemographic questions; questions about the age and circumstances under which they learned they were donor conceived; closed and open-ended questions about social disclosure (who they had told, how often they discussed it, and their motivations and experiences); and four standardized psychometric measures: the Mental Health Continuum Short Form (wellbeing in the last month), an adapted Disclosure Concerns subscale of the HIV Stigma Scale (stigma concealment), and adapted Pride (pride in being donor conceived) and Community Connectedness (affiliation to a community of others who are donor conceived) subscales of the Gender Minority Stress and Resilience Measure. The latter three scales were originally developed for other stigmatized populations (people living with HIV; transgender and non-binary people) and were reworded by the research team for relevance to donor conception; all three showed good internal consistency in this sample. The authors used a conservative threshold (p < 0.01) to guard against false positives from multiple comparisons.

Sample: 41 donor-conceived young adults, aged 18–30 years (mean = 25.34), drawn from a larger study of 139 participants. Participants were mostly female (73%), straight/heterosexual (61%), and not religious (78%). The sample was entirely white. Most participants were conceived via sperm donation (78%), followed by egg donation (17%) and embryo donation (5%). The majority (76%) had been conceived within a heterosexual two-parent family, 15% within a same-sex female couple family, and nearly 10% by a single mother. Educational attainment was relatively high (61% held an undergraduate or postgraduate degree), and 76% were members of a donor conception organization. No participant was conceived using a known donor, and because the UK’s 2005 shift to donor identifiability was not applied retroactively, none of the participants in this study has the legal right to identifying information about their donor.

Key Findings

• Most participants (71%) were told about their donor conception by a parent. Among those who learned in another way, this occurred through DNA testing (7%), official documentation (7%), or their own inference based on parental age or infertility history (5%).

• Nearly 44% learned in early childhood (before age 8), 27% in middle childhood/adolescence (ages 8–17), and 29% in adulthood (ages 18+).

• All 41 participants (100%) had disclosed being donor conceived to a friend; most had also told a spouse/partner (68%), family members (66%), and other donor-conceived people (63%).

• Frequency of talking about being donor conceived varied: 42% discussed it several times a month, 34% a few times a year.

• Concerning the experience of social disclosure: Half of the participants described mixed experiences of telling others, varying by audience (other donor-conceived people versus not; close friends versus acquaintances) or by life stage (as a child versus as an adult). 24% described predominantly positive experiences, 13% described predominantly negative experiences, and 11% described neutral experiences.

• The most common motivations for disclosure were: it being part of one’s identity or story (9 participants), seeking support (8), and relevance to the conversation at hand (7). The most common reasons for not disclosing were: no perceived reason to tell / not relevant (6 participants) and following a parent’s advice or respecting a parent’s feelings about the topic (5).

• When considering all respondents, stigma concealment was significantly and negatively associated with wellbeing and with pride. In other words, participants who reported concealing their donor conception more also reported less pride and poorer wellbeing. Community connectedness was not significantly correlated with pride, stigma concealment, or wellbeing.

• The authors ran a test to determine if the timing of disclosure (told in early childhood, told in middle childhood/adolescence, or told/found out as adults) related to differences in all four outcomes (stigma concealment, pride, community connectedness, and general wellbeing). This came back significant, meaning that as a group, these four variables did differ depending on when someone was told. When they looked at each variable separately to see which ones were driving that overall effect, only stigma concealment differed significantly across the three age groups. The finding that remained statistically significant was that people told in early childhood reported less stigma concealment than those told in middle childhood/adolescence.

• The authors ran a test to see if stigma concealment, pride, and/or community connectedness predicted wellbeing in donor-conceived people and whether pride or community connectedness might soften the negative effect of stigma concealment on wellbeing. The three factors together predicted wellbeing (this finding was statistically significant). When they looked at each factor individually, only stigma concealment maintained statistical significance. More concealment was linked to worse wellbeing. When they tested to see if pride or community connectedness changed how strongly concealment affects wellbeing, neither appeared to be protective.

Limitations: The sample was small and demographically homogeneous, limiting the ability to examine intersectional experiences or generalize to other donor-conceived populations. The relative homogeneity of family type (mostly heterosexual two-parent families) may explain why community connectedness and pride did not function as protective resources in this sample the way they might in more diverse family contexts, such as LGBTQ+-headed families, where identity affirmation and community socialization have been found to matter more. The adapted psychometric scales have not been independently validated for the donor-conceived population. Every one of the 41 participants had told at least one persion about being donor conceived. The study cannot describe the experiences, motivations, or wellbeing of donor-conceived young adults who have disclosed to no one. The stigma concealment measure was adapted from a tool built to capture people managing a secret they may never disclose. Applied here, the scale is likely picking up selective disclosure (who you tell, how freely) rather than concealment. Future studies should aim for more diversity in "outness" about being donor conceived.

Applications: In general, more concealment was linked to worse wellbeing. Participants told between ages 8–17 reported more stigma concealment than those told earlier or as adults, but wellbeing itself showed no significant difference by disclosure age at all. Researchers could treat this as a hypothesis worth testing further. Given the study’s demographic narrowness, its findings should be considered as illustrative of one slice of the donor-conceived population (predominantly White, heterosexual-family-raised, sperm-donor-conceived) rather than representative of donor-conceived people’s experiences broadly. The qualitative findings normalize the experience of having mixed, evolving feelings about telling others.

Funding Source: UK Economic and Social Research Council (ESRC) New Investigator Award, grant ES/S015426/1.

Lead Author: Sophie Zadeh is a Reader in Family Psychology at the School of Psychology, University of Sussex, and previously an Associate Professor of Social Psychology at the Thomas Coram Research Unit, University College London; she is the Principal Investigator of the Young Adults Study and has published extensively on donor conception, disclosure, and family psychology. The author disclosed that she is not donor conceived.

Regulatory Context

• This study was conducted in the UK, where the Human Fertilisation and Embryology Authority (HFEA) is the independent regulator overseeing fertility treatment and donor conception.

• In 2005, the UK moved from anonymous to identifiable gamete donation; donor-conceived people conceived on or after April 1, 2005, can request identifying information about their donor (and about donor siblings who have also opted into contact) once they turn 18. This change was not retroactive: those conceived before April 2005 have no legal right to their donor’s identity, though a voluntary Donor Conceived Register allows pre-2005 donors and donor-conceived people to register and potentially match.

• Since 2023, the HFEA’s Code of Practice has made it a mandatory requirement for all UK licensed fertility clinics to inform prospective parents using donor gametes about the importance of early disclosure to any resulting child and to provide guidance on suitable methods of doing so.

Related Posts

• Adolescents describe what it's like to request information about their sperm donor (Maas, 2026)

• Do donor-conceived teens want donor information access? (Groundstroem, 2024)

• An exploration of psychological, emotional and social wellbeing among donor conceived young adults in the UK (Ridley-Jones, 2024)

Geographic Region: Global with most respondents coming from Australia, the Netherlands, the United States, the United Kingdom, and Belgium

Research Question: Do donor sperm-conceived adults self-report different mental health outcomes (e.g., formal diagnoses, personal experience measures, and standardized depression/anxiety/stress scores) compared to spontaneously conceived adults?

Design: Cross-sectional online survey fielded between December 2017 and March 2018. The survey covered demographic characteristics, birth and gestational history, general health and lifestyle, diagnosed mental health conditions, self-reported mental health experiences, and the Depression Anxiety Stress Scale-21 (DASS-21), which is a validated instrument measuring current levels of depression, anxiety, and stress over the prior week.

Sample: 1,149 adults (272 donor sperm-conceived and 877 spontaneously conceived). The mean age was approximately 32–33 years in both groups. Over 80% in each group identified as female, and education levels were higher in the donor-conceived group (32% holding postgraduate degrees). Donor-conceived participants were recruited primarily through donor conception Facebook groups and organizations, supplemented by a survey recruitment platform and snowball sampling. Spontaneously conceived participants were recruited through Flinders University advertising, a survey recruitment platform, and snowball sampling. The two groups were matched on mean age, height, sex ratio, alcohol consumption, current smoking status, exercise levels, maternal smoking during pregnancy, and whether participants had received fertility treatment themselves. The study does not report race or ethnicity, socioeconomic status beyond education level, or the age at which participants learned of their donor conception. Donor type (known, anonymous, identity-release), family structure, and disclosure circumstances are also not captured.

Key Findings

• The largest difference observed was in identity formation difficulty: 52% of donor sperm-conceived adults reported it vs. 14% of spontaneously conceived adults. This is also the only finding that remained statistically significant when the analysis was restricted to Australian respondents only (54% vs. 14%). The authors did not define what “identity formation difficulty” means, used a single yes/no survey item, and did not distinguish between different dimensions of identity (genealogical, psychological, relational, narrative).

• Donor sperm-conceived adults were more likely to self-report a diagnosis of attention deficit disorder or ADHD (10% vs. 4%) and an autism or autism spectrum disorder diagnosis (5% vs. 2%). These findings remained statistically significant after correction.

• Donor sperm-conceived adults reported a higher rate of diagnoses falling outside the listed categories (13% vs. 7%); the most common free-text conditions named were borderline personality disorder, OCD, and PTSD, though none of these individual categories reached statistical significance after correction.

• Donor sperm-conceived adults were more likely to report a depression diagnosis (40% vs. 31%), but this difference was not significant after the authors did the statistical correction.

• Donor sperm-conceived adults were more likely to report having had panic attacks (54% vs. 43%), learning difficulties (17% vs. 7%), alcohol or drug dependency (12% vs. 6%), and recurrent nightmares (26% vs. 18%). These findings maintained statistical significance after correction.

• Donor sperm-conceived adults were more likely to have seen a mental health professional at all (70% vs. 50%), including psychologists (47% vs. 33%) and psychiatrists (22% vs. 16%). Whether this reflects greater distress, greater help-seeking, or both cannot be determined from these data. These findings maintained statistical significance after correction.

• On the DASS-21, donor sperm-conceived adults scored significantly higher on the stress subscale over the past week (mean 13.43 vs. 11.65), but both of these scores fall within the "normal" range on the DASS-21 scoring system. Depression and anxiety subscale scores did not differ significantly between groups. The overall DASS-21 total score difference was also not statistically significant.

• The subgroup analyses were underpowered, and no firm conclusions can be drawn from them.

Limitations: The authors stated that recruitment through donor conception Facebook groups and advocacy organizations meant donor-conceived participants were self-selected from among those already engaged with and potentially distressed about their conception. Those who do know their donor conception status and seek out community support are not representative of the broader population. The heavy female skew (over 80% in each group) limits generalizability to men. The study captures no information about disclosure timing or other characteristics. Given the study’s own observation that early disclosure is associated with “better outcomes”, this omission is significant. No race or ethnicity data are reported, and most donor conception research to date is drawn from samples that are disproportionately white and educated. Family structure is not captured, so subpopulations have meaningfully different experiences that are collapsed into a single group. Donor type is unknown, so anonymous, identity-release, and known donor conception are pooled. The study makes no distinction between donor-conceived adults who are actively searching for or in contact with their donor and those who are not. The absence of age-bracket data is itself a limitation that prevents distinguishing whether outcomes are driven by a specific historical secrecy regime or are more broadly distributed across donor-conception practice over time.

Applications: Donor-conceived adults who recognize themselves in these findings, particularly regarding identity difficulties, stress, or having sought mental health support, should know they are not statistically unusual in this study's sample. At the same time, this is not a population-representative study, so it shouldn't be read as "this is what donor conception does to people." Future studies should treat disclosure timing and quality, family structure, donor type, and contact status as primary variables and use theoretically grounded, validated, multi-item measures for identity. Recruitment strategies that reach beyond advocacy and support communities would meaningfully improve the generalizability of findings in this area.

Funding Source: Australian Government Research Training Program Scholarship

Lead Author: Damian Adams is a post-doctoral researcher in the College of Nursing and Health Sciences at Flinders University, South Australia, whose work focuses on physical and mental health outcomes and welfare rights of donor-conceived people, grounded in the Developmental Origins of Health and Disease framework. Adams is donor-conceived, has publicly identified as an advocate for the rights of donor-conceived people, has lobbied for legislative reforms in South Australia and Victoria, has provided expert testimony to Australian state and federal government inquiries and to the United Nations, and has published opinion and advocacy pieces alongside his peer-reviewed research.

Regulatory Context: The study is international in scope, drawing participants primarily from Australia, the Netherlands, the United States, the United Kingdom, and Belgium. Regulatory frameworks differ substantially across these jurisdictions.

Related Posts

• I have to remind myself that everyone's search is different': experiences and outcomes of searching and not searching for donor connections among donor conceived adults (Zadeh, 2024)

• Family dynamics factor in donor identity search process (Widbom, 2024)

• An exploration of psychological, emotional and social wellbeing among donor conceived young adults in the UK (Ridley, 2024)

Geographic Region: United States (29 of 57 articles), United Kingdom (14 articles), Australia (9 articles), the Netherlands (4 articles), Canada (3 articles), New Zealand (3 articles), and Norway (1 article).

Research Question: How do donor-conceived people, donors, parents, and same-donor siblings experience contact with one another following donor conception involving donors who were previously unknown to recipients, and what factors shape those experiences?

Design: Mixed methods systematic review following PRISMA 2020 guidelines. The review was prospectively registered with PROSPERO (CRD42024546154). Searches were conducted across eight databases, covering English-language, peer-reviewed empirical studies published between 2004 and January 2026. Reference lists, Google Scholar’s ‘cited by’ function, and the publication histories of primary authors were also searched (snowball methods). Studies were included if they used empirical methods (quantitative, qualitative, or mixed) and involved participants who had post-birth contact experiences following donation between parties who were previously unknown to one another. Both clinic-recruited donations (anonymous, identity-release) and online-recruited open-identity donations qualified.

Sample: 57 articles, 23 of which were part of five larger collaborative studies: the Donor Sibling Registry (DSR) Study (8 articles), the US National Longitudinal Lesbian Family Study (NLLFS) (4 articles), the Pride Angel – UK based Online Donation Connection Website (2 articles), the Single Mothers by Choice in Australia (SMC) Study (3 articles), and the Fiom KID-DNA Network study (2 articles). Articles were published between 2008 and January 2026, with 42% published since 2020. Of the 57 articles, 53% were qualitative, 40% were mixed-methods, and 7% were quantitative. Interviews were the most common qualitative method; surveys were used in 47% of articles employing quantitative methods. Sample sizes across included studies ranged from 5 to 2,636 participants, with a median of 42; 24 studies had fewer than 40 participants. Family form was reported in 63% of articles. Among those reporting a specific family structure, lesbian-parent families were included in 29 articles, single mothers by choice in 13 articles, and heterosexual parent families in 21 articles. Only one article focused on gay father families. Thirty-seven percent of articles did not report family form at all. Donation type was heavily weighted toward sperm donation (86% of articles; 60% focused exclusively on sperm donation); egg donation appeared in 33% of articles and was the exclusive focus in only 7%. Embryo donation appeared in 14% of articles. Nineteen articles focused on DCP contact with donors or same-donor siblings; 13 focused specifically on DCP contact with donors; 13 focused on donors’ contact with parents and/or DCPs; and 18 explored parents’ contact with donors or same-donor families. Age of DCP participants ranged from 9 to 70 years across studies; donor participants ranged from 18 to 73 years. Race, ethnicity, and socioeconomic status were not reported as variables in the study, and the authors note that participants are largely of European descent.

Key Findings

DCP Contact with Donors

• Across multiple studies, contact between donor-conceived people and their donors was initiated by the DCP themselves, by their parents, or through DNA testing. The degree of parental involvement depended on the DCP’s age, maturity, and the legal context for accessing donor information.

• Across multiple studies, most DCPs described their contact experiences with donors as positive or neutral. Positive experiences were associated with feelings of happiness, validation, and recognition, even when initial encounters felt awkward or uncertain. Contact sometimes led to meaningful shifts in DCPs’ sense of self and family identity. A minority of DCPs across studies reported negative or difficult experiences, often linked to lifestyle disagreements, lack of common ground, unmet expectations, or negative reactions from the donor’s family.

• Across multiple studies, the terms DCPs used for donors ranged widely, from ‘donor’ or ‘stranger’ to ‘extended family member’ or ‘relative.’

DCP Contact with Same-Donor Siblings

• Across multiple studies, most DCPs who connected with same-donor siblings reported positive or neutral experiences, whether contact was one-on-one or in group settings.

• Across multiple studies, initial meetings frequently began with comparing physical features and shared traits, which could foster connection and sometimes prompt identity redefinition.

• Multiple studies found that early contact facilitated by parents during childhood was associated with smoother integration of donor conception into the DCP’s identity.

• Across multiple studies, even limited or online-only contact with same-donor siblings was valued. Some DCPs described a sense of belonging simply from knowing that same-donor siblings existed, without requiring close contact.

• Across multiple studies, large sibling networks introduced challenges: emotional fatigue, complex group dynamics, rivalry, exclusion, and pressure to connect with each newly discovered sibling. Several DCPs disengaged from large networks over time, though many maintained at least occasional contact.

Donors

• Across multiple studies and donation types, donors expressed a sense of responsibility to make themselves available to DCPs, particularly to share personal and medical history, and most were curious about the outcomes of their donations. However, donors commonly remained passive, waiting for DCPs or parents to initiate contact, and suppressed their own needs to avoid being perceived as intrusive.

• Across multiple studies, most donors did not describe feeling a parental bond with DCPs but perceived themselves as relatives or important sources of genetic and medical information. Across gamete types, donors tended to position themselves—or were positioned by recipient families—as extended family members akin to aunts or uncles, which allowed continued interest in DCP lives without threatening parental roles.

• Across multiple studies, donor contact ranged from brief one-off exchanges to ongoing relationships, with positive relationships more likely when contact was gradual and emotionally sensitive.

• Across multiple studies, contact introduced complexity for donors’ own families—navigating partner feelings, explaining to their raised children the existence of donor siblings, and managing relationships across multiple DCP families. Some donors felt overwhelmed by the prospect of maintaining relationships with large numbers of offspring.

Parents

• Across multiple studies, parents sought contact with donors and same-donor families for a range of reasons: obtaining medical information, supporting their children’s identity development, and building an extended family network.

• Across multiple studies, when contact between parents and donors occurred, most parents reported positive experiences even when initial meetings involved anxiety. Parents in embryo donation programs specifically described relief that donors were not seeking to claim the child, a finding that comes primarily from two studies of one US program (Frith et al., 2017; Davis et al., 2020).

• Across multiple studies, some parents—particularly non-biological parents—reported feeling that donor involvement threatened their parental role or autonomy. This concern could create barriers to contact for the child and occasionally generated couple conflict.

• Across multiple studies, parents often preferred contact with same-donor families over direct donor contact, seeing it as a way to build kinship networks for their children while preserving more parental autonomy.

Factors Shaping Contact Experiences

• Expectations of contact: Across multiple studies, romanticized notions of the other party or strong desires to connect could lead to disappointment when reality fell short. Despite this, most participants across studies felt their expectations had been broadly met.

• Age at first contact: Across multiple studies, contact established in childhood tended to produce stronger, more naturally integrated bonds, while contact initiated in adulthood was more emotionally complex. Many who connected later in life expressed regret about missed time.

• Family communication: Across multiple studies, family openness about donor conception was consistently associated with more positive contact outcomes.

• Attitudes from others toward contact: Across multiple studies, parental openness about donor conception was consistently associated with more positive contact experiences. Secrecy or negative parental reactions following DCP-initiated contact—especially from fathers in heterosexual relationships—complicated the process.

• Number of individuals connected: Across multiple studies, large donor networks excited and overwhelmed in equal measure. DCPs, donors, and parents all reported challenges when sibling numbers were high, underscoring the relationship between donation limits, record-keeping, and downstream psychosocial outcomes.

• Mechanisms for contact: Across multiple studies, formal identity-release registries were often inaccessible, time-consuming, or yielded inaccurate information. Most contact was facilitated through informal means (e.g., online platforms, DNA testing services, social media, and voluntary registers). These informal routes offered flexibility and community support but lacked the safety frameworks that formal services provide.

Limitations: Sample sizes across included studies varied widely (5 to 2,636 participants), with a median of 42, making it difficult to integrate findings or draw firm conclusions. Most included studies relied on self-selected participants, which likely biases findings toward people with positive or particularly salient contact experiences. The evidence base is geographically concentrated in the United States and United Kingdom, with participants largely of European descent. Findings may not apply in other cultural settings. Only 4 studies focused exclusively on egg donation and 4 on embryo donation, leaving significant gaps in understanding contact experiences across gamete types. The review is limited to English-language publications, excluding potentially important research from non-Anglophone countries. Contact occurring through informal mechanisms (social media, DNA testing) versus formal services was not systematically compared, leaving gaps in understanding how mechanism shapes outcomes. The experience of gay fathers with egg donors is essentially absent from the evidence base. Race, ethnicity, and socioeconomic status are not analyzed as variables in the review, and the review does not explore how racism, racial matching practices, or racialized access to donor conception shape contact experiences. Only 19 of 57 articles focused on DCP contact experiences, and most DCP participants were adults reflecting retrospectively. The experiences of children and adolescents navigating contact in real time are underrepresented. Whether contact initiated positively in childhood remains positive into adulthood, or whether early contact complicates DCP identity formation in ways not yet captured, cannot be assessed from this evidence base.

Applications: Contact with donors and same-donor siblings is one avenue among many for identity exploration and connection. Contact is not a necessary step for well-being, and the range of experiences found across studies reflects the diversity of what donor-conceived people actually want and need. Support for those navigating large sibling networks, unexpected DNA discoveries, or donor non-response is a gap. Parental attitudes toward contact likely shape their children's experiences with decision-making. The review identifies a consistent gap between the demand for psychosocial support around donor linking and what is actually available. Professionals supporting donor-conceived people and their families can expect to encounter clients navigating accelerated kinship, large sibling networks, mismatched expectations, and the emotional aftermath of donor non-response or death before contact. Pre-contact expectation management, support during contact, and ongoing aftercare could be beneficial. The failures of formal identity-release systems described across multiple studies (e.g., inaccessibility, inaccurate records, lack of responsiveness) seem to contribute directly to the growth of informal, unsupported contact routes. The field needs longitudinal studies tracking how contact experiences evolve over time; research that includes diverse family structures and value systems; and studies conducted in non-Anglophone and non-Western cultural settings.

Funding Source: No external funding source is identified in the article.

Lead Author: K. Hall is a researcher in the Department of Psychology and Neuroscience at Auckland University of Technology (AUT), New Zealand. No personal connection to donor conception was disclosed. Corresponding author S. Goedeke is an Associate Professor of Psychology and registered clinical psychologist at Auckland University of Technology whose research focuses on the psychosocial and ethical dimensions of infertility treatment, donor conception, and third-party reproduction, including embryo donation, egg donation, and disclosure practices. She has published extensively in this field and several studies included in this review are Goedeke's own published work.

Regulatory Context: This review spans multiple jurisdictions.

Related Posts

• Do Donor-Conceived Kids Need to Know Their Half-Siblings?

• Guest Post by Eli Ramos: Making It Up As We Go - A Queer Parent’s View

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My list of books, podcasts, and documentaries related to donor conception keeps growing. "From the Stacks" is where I will share my thoughts on what I've been reading, watching, and listening to. A quick note: I purchase or borrow everything independently and receive no compensation from authors, publishers, or affiliate links. If you are interested in other creative works that feature donor-conceived characters, check out the Parts of Me DCP Stories Collection.

Queering Families: Reproductive Justice in Precarious Times - Spira (2025)

Official Blurb: Queering Families traces the shifting dominant meanings of queer family from the late twentieth century to today. With this book, Spira highlights the growing embrace of normative family structures by LGBTQ+ movements—calling into question how many queers, once deemed unfit to parent, have become contradictory agents within the US empire’s racial and colonial agendas. Simultaneously, Queering Families celebrates the rich history of queer reproductive justice, from the radical movements of the 1970s through the present, led by Black, decolonial, and queer of color feminist activists. Ultimately, Spira argues that queering reproductive justice impels us to build communities of care to cherish and uphold the lives of those who, defying normativity’s violent stranglehold, are deemed to be unworthy of life. She issues the call to lovingly wager a future for the world’s children, the planet, and all living beings against all odds, and in increasingly perilous times.

For the donor conception community, Chapter 3 is particularly relevant. Using the Donor Sibling Registry and Wendy Kramer’s books as case studies, the author shows how donor conception advice and advocacy (often rooted in genuine care and real testimonies of harm) has organized itself around genetic connection as a core solution. Spira points out that when donor conception spaces position genetic connection as “the best practice” (use a known donor, do DNA testing to find relatives, maintain regular contact with donor siblings and donors), that framing can align with the messages used by pro-family movements to delegitimize non-genetic, non-traditional families (children must be raised by their biological mother and father). The underlying logic is similar: without genetic connection, something is missing/broken. We inherited that logic from a bionormative world that needs genetic connection to mean something very specific—that it's the key to family legitimacy, to wholeness, to identity. Advocacy and advice built from that logic, however well-intentioned, is still operating inside it. Spira demands that we look closer: What social and political movements benefit from those messages?

Random Families: Genetic Strangers, Sperm Donor Siblings, and the Creation of New Kin - Hertz & Nelson (2018)

Based on over 350 interviews with donor-conceived people (ages 10-28), their parents, and donors across the U.S., the book looks at how some people are transforming “genetic strangers” into new possibilities for kinship. The first section of the book looks at the conditions that enable contact among donor siblings, how parents navigate donor selection and the initiation of engagement in “networks of genetic strangers”, and how DCP construct their own understanding of donors and genetic networks. In the second session, the authors describe five specific networks that vary in the era in which conception occurred, the ages of the DCP, the value placed on connections, and interpersonal dynamics. Do note that the demographic similarities of the families included in the book are significant. I appreciate that the book takes seriously how DCP and families choose to engage (or not engage) and resists the assumption that genetic connection automatically creates obligation or belonging.

Skye Falling - McKenzie (2021)

Skye Ellison is 38, Black, queer, and has spent her adult life avoiding anything that might require her to stay in one place. She runs a successful travel company, lives out of a suitcase, and returns to her hometown of West Philly only occasionally to decompress. When she was 26 and broke, a childhood friend named Cynthia asked her to donate eggs to help her have a child. Skye agreed and didn’t think much about it afterward. Twelve years later, at an art opening, a kid named Vicky walks up and introduces herself as “her egg.” Cynthia has died of cancer, and headstrong Vicky wants to know who Skye is. Skye’s first instinct is to flee, but something about Vicky won’t let her. For the first time in years, Skye stays put long enough to reckon with everything she’s been running from. While the book centers Skye’s point of view, Vicky’s thoughts and feelings get decent space. This book also won the 2022 Lambda Literary Award. (I loved this as an audiobook!)

Find You First - Barclay (2021)

Tech millionaire Miles Cookson is diagnosed with a fatal, hereditary condition and realizes that the nine children he fathered as a sperm donor two decades earlier may have inherited it. Determined to warn them, Miles sets out to find them. He connects first with Chloe, an aspiring documentary filmmaker who has already been searching for genetic relatives. As Miles tracks down his donor-conceived children, they begin disappearing. The thriller’s second storyline follows Jeremy Pritkin, a wealthy and powerful man with a predilection for underage girls. As the body count rises, Miles and Chloe race to uncover who is behind the killings before there are no children left to find. Three DCP characters are featured in the multi-narrator format. Content Warnings: Violence and murder (multiple characters killed or injured on-page); sexual exploitation of minors (Pritkin subplot clearly inspired by Jeffrey Epstein).

The Ones We Choose - Clark (2018)

Geneticist Paige Robson has spent her career studying why some fathers choose to stay while others leave, a question rooted in her own father’s abandonment. When she decides to become a mother, she selects an anonymous sperm donor, wanting to build a family without paternal complication. Years later, her 8-year-old son Miles begins asking questions about his biological father. When the donor unexpectedly enters their orbit, a chain of revelations unfolds, forcing Paige to confront what family actually means. I love a book with multiple narrators, and this one spends time on a broad ecosystem of people connected to a donor-conceived person: the recipient parent, grandparents, aunts, cousins, the donor and his relatives. It’s clear the author did her homework observing in SMBC spaces online.

Making of Us - Jewell (2012)

This novel follows three adults who were conceived anonymously via sperm donation in the UK and find each other through a donor sibling registry. Lydia is a wealthy self-made millionaire carrying emotional scars from a traumatic childhood; Dean is a confused 21-year-old single father struggling after his girlfriend’s death; and Robyn is an eighteen-year-old med student concerned that her boyfriend might be her biological sibling. Running parallel is the story of Daniel, their sperm donor, dying of cancer in a hospice. Every DCP’s arc is organized around a father figure — Dean’s absence of one and struggle to embrace the role, Lydia’s emotionally unavailable one, Robyn’s beloved one — reinforcing a traditional ideology in which fathers are central to healthy development.

Have you read any of these? What landed for you? What didn’t? Send your thoughts my way!

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• From the Stacks: Quick Takes on Books, Pods & Docs (July 2025)

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Geographic Region: United Kingdom

Research Question: How do heterosexual couples who used identity-release egg donation to have children differ from couples who conceived using in vitro fertilization with their own gametes in terms of parental psychological well-being, parent-child relationship quality, and children’s psychological adjustment at age 5? What parental factors predict higher levels of behavioral and emotional problems in children in these two family types?

Design: This paper includes data from Phase 2 of the United Kingdom Longitudinal Study of Assisted Reproduction Families conducted under the leadership of Susan Golombok at the Centre for Family Research, University of Cambridge. Researchers compared 72 heterosexual-couple families with children conceived through identity-release egg donation to 50 families who used IVF with their own gametes. Data collection occurred between April 2018 and December 2019, when children were approximately 5 years old. Families had participated in Phase 1 of the study when their children were approximately 1 year old. Parents completed semistructured interviews to assess their representations of the parent-child relationship using the Parent Development Interview, which captures parental affect, reflective functioning, and representations of the child. Parents and their children (aged 5) also participated in structured play tasks (Etch-a-Sketch for mothers and children; Co-Construction Task for fathers and children) that were videotaped and later coded using the Emotional Availability Scales, a measure of parent-child interaction quality grounded in attachment theory. Parents completed questionnaire booklets assessing parenting stress using the Parenting Stress Index, couple relationship quality using the Golombok Rust Inventory of Marital State, and perceived social support using the Multidimensional Scale of Perceived Social Support. Parents were also interviewed about their criticism of their child using a standardized coding scheme. Teachers completed the Strengths and Difficulties Questionnaire to assess children’s behavioral and emotional adjustment. A child psychiatrist, blind to family type, conducted ratings based on maternal interview data to assess the presence and severity of child psychiatric disorder. Statistical analysis used multivariate analysis of variance to compare groups on psychological and relationship measures, with demographic covariates (maternal and paternal education) included when they differed significantly between groups. Latent change score models were used to examine intraindividual change over time in parental measures from Phase 1 (age 1) to Phase 2 (age 5), which allowed researchers to examine how change in parental stress, reflective functioning, social support, and couple relationship quality predicted children’s adjustment at age 5. Moderation analyses tested whether family type (egg donation vs. IVF) changed the strength of these associations. The sample size provided power to detect medium-sized effects.

Sample: 122 mothers (mean age 45 years), 96 fathers (mean age 47 years), and 122 children (56 female, 66 male; mean age 5.6 years). The egg donation group consisted of 72 families, of which 63 had used identity-release donors and 9 had used known donors. The IVF comparison group consisted of 50 families who conceived using the parents’ own gametes. The overall participation rate was 85%. Teachers also participated (66% participation rate). 81% of families participated at both Phases 1 and 2; 79% of fathers participated at Phase 2. The sample predominantly identified as White British (96% of mothers; 90% of fathers). Mothers were significantly older in egg donation families (mean age 48 years) than in IVF families (mean age 42 years), and fathers in egg donation families were also older (mean age 48 years versus 44 years in IVF families). Fewer children in egg donation families had siblings compared to IVF families. Families did not differ significantly on working status, education level, perceived financial difficulties, or prior psychiatric contact. The article does not provide a detailed breakdown of disclosure status, but the researchers note that most parents intended to disclose by age 5.

Key Findings

Child Development Outcomes

• Both egg donation and IVF children were developing well at age 5. Children’s behavioral and emotional scores (measured using the Strengths and Difficulties Questionnaire from teachers and parents and a psychiatric interview) fell within the normal healthy range in both groups.

• Teachers reported slightly more behavior problems (like acting out or hyperactivity) and emotional difficulties (like anxiety or trouble with friendships) in egg donation children compared to IVF children. However, the differences were small to moderate in size and both groups scored in the normal range.

• When a child psychiatrist reviewed mothers’ descriptions of their children, about 11% of all children across both groups had a diagnosable emotional or behavioral problem. There was no difference between egg donation and IVF families. This rate is typical for this age group in the general population.

What Parental Factors Were Associated With Variation in Child Outcomes

• Across both egg donation and IVF families, researchers tracked changes in parental stress (Parenting Stress Index), social support (Multidimensional Scale of Perceived Social Support), and reflective functioning (ability to understand and reflect on the child’s feelings, coded from parent interviews) from age 1 to age 5. Within the normal range of functioning, certain parental characteristics were associated with children having slightly more behavior problems: mothers with lower social support at age 1, whose stress increased significantly between ages 1 and 5, and who expressed more criticism of their child. These factors together explained about 40% of the variation in child behavior. This association does not prove causation; the direction of influence cannot be determined.

• Children with slightly more emotional difficulties were associated with parents whose couple relationship quality (Golombok Rust Inventory of Marital State) was lower at age 1 and whose reflective functioning did not improve over time.

• In egg donation families specifically, increases in parenting stress over time showed a stronger association with children’s behavior problems than in IVF families. This does not mean stress caused problems; rather, the two measures were more closely linked in egg donation families. Whether stress affects children’s behavior, children’s behavior increases parental stress, or both happen together cannot be determined from this data.

Parental Well-Being and Self-Perceptions

• Egg donation parents reported higher parenting stress on the Parenting Stress Index compared to IVF parents. However, both groups scored well below the clinical cutoff (71 and 62 vs. clinical concern at 85+), meaning neither group was in the stressed range.

• Egg donation mothers reported lower social support and less satisfaction with their partnership compared to IVF mothers. Both groups scored in the moderate-to-high support range, not the low support range.

• When interviewed about their feelings and representations of their child (Parent Development Interview), egg donation mothers and fathers reported feeling more anger, less confidence, and less competence compared to IVF parents. Egg donation fathers also expressed more criticism of their children. These parents’ absolute scores remained in the range reflecting good parenting.

Parent-Child Interaction in Real Time

• When researchers watched parents and children in structured play tasks (Etch-a-Sketch for mothers and children; Co-Construction Task for fathers and children) and coded their interactions using the Emotional Availability Scales, they found that both egg donation and IVF families showed warm, responsive, emotionally healthy interactions. There were essentially no meaningful differences between groups. Both scored in the upper range of quality.

• Egg donation fathers provided slightly less guidance and scaffolding during the play task compared to IVF fathers, though this difference was modest and did not reach clinical concern.

• There is a notable contrast between how egg donation parents reported feeling in interviews and questionnaires (stressed, less confident, angry) and what researchers observed when watching them with their children (warm, responsive, engaged). This disconnect suggests that egg donation parents’ internal anxiety and stress did not substantially interfere with their actual parenting behavior.

Limitations: The sample was limited to predominantly White British, highly educated families, and intending to disclose, restricting generalizability to other sociocultural contexts and populations. All families were heterosexual, cisgender, and two-parent, preventing generalization to families using egg donation in other family structures. There was a smaller sample size for fathers, which limited the ability to examine father effects on child adjustment. The comparison to IVF families, while controlling for fertility treatment, still frames genetic relatedness as the baseline, potentially pathologizing egg donation rather than treating it as a neutral alternative family formation. The study relies on parental representations of the child rather than direct reports from the child. The study does not adequately disentangle whether elevated parenting stress, lower social support, and poorer couple relationship quality reflect the experience of being an egg donation parent or other factors, such as parental age (egg donation parents were, on average, 5 years older).

Applications: Within all families, multiple factors (e.g., parental stress, social support, couple relationship quality, and parental reflective functioning) are associated with variation in child behavior. This is true across family types, not specific to egg donation. General attention to family well-being benefits children, regardless of how they were conceived. Future research could examine whether the parental stress and lower confidence reported by egg donation parents in this study reflects egg donation itself, the context of identity-release disclosure, parental age, or other factors.

Funding Source: The Wellcome Trust (Grant 208013/Z/17/Z).

Lead Author: Susan Imrie is a developmental psychologist and researcher at the Centre for Family Research at the University of Cambridge, where she studies family functioning in new family forms, including families created through assisted reproduction and families with trans parents. No personal connection to donor conception was disclosed.

Regulatory Context:

• The Human Fertilisation and Embryology Authority (HFEA) is the independent regulatory body overseeing fertility treatment and embryo research in the UK. In 2005, UK law changed from permitting anonymous egg and sperm donation to requiring identity-release donation, ending donor anonymity. This means that donor-conceived people born on or after April 1, 2005, have the legal right to request identifying information about their donor at age 18 and information about any donor siblings who have also registered interest in contact. Those conceived before 2005 do not have the same legal right to identifying information; donors were guaranteed anonymity at the time of donation. However, a voluntary Donor Conceived Register (DCR) allows pre-2005 donors and donor-conceived people to voluntarily register and potentially match.

• Same-sex female couples gained access to fertility treatment in 2006. Access is available to different-sex couples, same-sex couples, and single individuals. Embryo donation is legal.

• All fertility treatment must be provided by licensed fertility clinics authorized by the HFEA.

• Legal parentage is typically determined by birth (for the birth mother) and consent/intention (for partners).

Related Posts

• Maternal fears about donor contact don't prevent disclosure plans (Lysons, 2023)

• Nearly one-third of UK egg donation parents didn’t understand identity-release laws (Lysons, 2022)

• Beliefs about genetics influence how people respond to unexpected donor connections through DNA testing (Nordqvist, 2025)

Geographic Region: Brazil

Research Question: How do Brazilian couples in oocyte and embryo donation programs approach disclosure of biological origin to children, and what are the perspectives of fertility professionals and psychologists on disclosure practices?

Design: Prospective, multicenter, cross-sectional study conducted from May 2023 to March 2025. The researchers administered three separate anonymous online surveys, each targeting a different population: patients enrolled in oocyte and embryo donation programs, fertility clinic staff members, and psychologists working in reproductive medicine throughout Brazil. The surveys collected information on disclosure intentions and perspectives, emotional factors, demographic characteristics, and professional backgrounds.

Sample: 702 individuals were invited to participate, with 401 completing surveys across the three groups. The patient group included 104 respondents (72% response rate) who were enrolled in oocyte and embryo donation programs at six fertility centers across three Brazilian states. The staff group comprised 205 respondents (57% response rate) employed at these fertility centers in various roles. The psychologist group included 92 respondents (47% response rate) working in reproductive medicine throughout Brazil.

Key Findings

• Among parents, 33% intended to disclose biological origin to their children, 22% did not intend to disclose, and 45% were uncertain.

• Emotions predicted disclosure intentions. Parents who reported feeling joy were less likely to plan disclosure as those who did not report joy. Parents who felt sadness were less likely to disclose as those who did not report sadness. Parents experiencing guilt were less likely to plan to disclose than those without guilt.

• Parents who planned to tell the child's grandfather were more likely to also plan to tell the child. The opposite pattern emerged with the child’s grandmother: parents who planned to tell the grandmother were less likely to tell the child. This suggests grandmothers might serve as confidants. Parents planning to tell extended family or friends were also less likely to tell the child.

• Among fertility clinic staff, 56% supported disclosure, 10% opposed it, and 34% were undecided. Support for disclosure was significantly less common among staff members aged 41–50 years, those who were single, and those with ≥8 years of professional experience.

• Staff members who applied consistent principles across different donor types (e.g., supporting disclosure equally for anonymous and known donors) were more likely to support disclosure overall.

• Psychologists showed the strongest support for disclosure: 72% favored disclosure, 2% opposed, and 26% were undecided.

• Psychologists with a clear understanding of an ideal disclosure age were more likely to support disclosure. Those actively guiding patients toward transparency were significantly more likely to support disclosure.

Limitations: Cross-sectional design captures intentions and attitudes at a single time point, not actual disclosure behavior or longitudinal changes in perspective. Response rates vary substantially across groups, and non-respondents may differ systematically from respondents in their disclosure attitudes. The abstract provides minimal detail on sample characteristics (age, race/ethnicity, socioeconomic status, family structure, prior disclosure experience).

Applications: This study maps the current range of disclosure intentions in a mandatory-anonymity system.

Funding Source: Not reported in abstract.

Lead Author: Helena Maria Loureiro Montagnini is a reproductive psychologist and researcher at Huntington Medicina Reprodutiva (Eugin Group) in São Paulo, Brazil, specializing in psychological aspects of assisted reproduction. No personal connection to donor conception was disclosed.

Regulatory Context

• Brazil maintains mandatory donor anonymity for all forms of gamete and embryo donation. The National Health Surveillance Agency (ANVISA) enforces strict anonymity protocols, prohibiting disclosure of donor identity to recipients and offspring under any circumstances except in life-threatening medical emergencies.

• Brazil’s Children’s Act grants all children the legal right to know their genetic identity by filing a lawsuit. In theory, a donor-conceived individual could pursue legal action to discover donor identity.

• Only altruistic donation is permitted; donors may be reimbursed for reasonable expenses but not paid for gametes.

• Fertility treatments are available to heterosexual married couples and, in practice, some LGBTQ+ individuals and unmarried couples, though access varies by clinic and state.

• The donation information is recorded in medical records, but disclosure remains a private family decision.

Related Posts

• Research shows conservative attitudes toward donor identity in Brazil (Rocha, 2023)

• Prayer frequency emerges as strongest predictor of ART acceptance in Switzerland (Schroedter, 2025)

• Research shows Italian society split on acceptance of donor-conceived families (Fusco, 2025)

Geographic Region: Canada, specifically Quebec

Research Question: How do people involved in surrogacy and egg donation use online communities, specifically Facebook groups, to interact, negotiate agreements, and establish arrangements for third-party reproduction outside formal medical clinics and private agencies?

Design: Qualitative study combined nonparticipant online ethnography and semi-structured individual interviews, conducted from 2015 to 2021. Ethnographic observation of a French-speaking Facebook group (2,800+ members) was conducted continuously with data documented in logbooks and memos. Researchers obtained permission from group administrators and identified themselves transparently as conducting ethical research. Semi-structured interviews were conducted with 47 Canadian women involved in surrogacy or egg donation; 22 of these discussed their Facebook group use during interviews and were included in this analysis. Interviews lasted approximately 2 hours and took place in person, by Skype, by Zoom, or in person. This research is part of the MATRICES study (Maternités assistées par tierces reproductrices), a larger research project documenting experiences of people involved in surrogacy and egg donation in Canada.

Sample: 22 participants (6 intended mothers, 12 surrogates, 4 egg donors). Intended mothers ranged in age 39–58 (M=46), all in relationships with men; five were White, one of Latin American descent; all lived in urban areas; all had pursued surrogacy/egg donation as a last resort after failed fertility treatments and adoption attempts. The 12 surrogates were all White women, ages 23–42 (M=35); 11 heterosexual, one queer; most in relationships approximately 9 years with three or more children; most completed surrogacy once, three multiple times; half experienced gestational surrogacy and half genetic. The four egg donors were ages 30–33; two had no children at first donation; three had university degrees. Recruitment occurred primarily through the Facebook group and snowball sampling.

Key Findings

Ethnographic Findings (from Facebook group observation)

• Intended parents presented carefully written testimonials on Facebook using narrative strategies reminiscent of dating sites, emphasizing relationship stability and describing surrogates/donors as “angels,” “good fairies,” or “rare pearls.”

• The group engaged in extensive debate about legal practices. Members posted questions about filiation procedures, contract enforceability, and whether Ontario births offer better legal protection than Quebec.

• Financial discussions revealed ideological divisions: some members argued that asking for financial compensation commodifies women and children and is ethically wrong; others argued that surrogacy is meaningful work deserving financial recognition and that gift framing minimizes the bodily risk and disruption involved in pregnancy.

• Through these group interactions, members collectively constructed informal norms about what constitutes “right” or “wrong” practice in surrogacy, rather than being governed by agency contractual frameworks.

Interview Findings (from 22 participants: 6 intended mothers, 12 surrogates, 4 egg donors)

• Surrogates and egg donors exercised active criteria-based selection of intended parents, evaluating partner age, relationship length, presence of existing children, and alignment on values about legal and financial arrangements. The relational fit was essential: women reported listening to their “instincts” during initial online conversations and described an “adjustment period” in which they assessed whether chemistry existed. Positive chemistry led to continued negotiation while disagreement or discomfort ended dialogue.

• Surrogates and egg donors report heightened sense of control and autonomy through social networks compared to agency-mediated arrangements. Women recognize themselves as scarce and in high demand, enhancing negotiating power and ability to decide whom they work for and how.

• Some prefer agreements based on mutual trust rather than pre-drafted agency contracts, viewing autonomy as enhancing dignity; however, others prefer formal oversight, citing preference for couple vetting and financial security.

• The Facebook group serves multiple functions: information sharing, emotional support, knowledge construction about surrogacy and egg donation, social networking, and cost savings compared to private agencies charging $60,000–$120,000 CAD.

Limitations: The study is limited to a single French-speaking online community in Quebec whose findings reflect local concerns and may not generalize to other jurisdictions with different regulatory contexts. The interviewees are predominantly White with minimal representation of people of color, solo parents, or LGBTQ+ participants beyond gay men, limiting understanding of how identity shapes surrogacy experiences. Study documents interactions at a point in time but provides minimal information about outcomes of agreements or how families integrated experiences over time. Interview accounts are subject to recall bias, social desirability bias, and post-hoc rationalization of reproductive choices.

Applications: Practitioners could assess whether clients/patients participate in online forums, recognizing these communities as mediators of information and support and deploy education initiatives on digital platforms to reach people where they seek support

Funding Source: Social Sciences and Humanities Research Council of Canada (SSHRC), Réseau québécois en études féministes (RéQEF), and the Faculty of Social Sciences at Université Laval.

Lead Author: Kévin Lavoie is an assistant professor in the School of Social Work and Criminology at Université Laval and scientific director of the Centre de recherche Jeunes, familles et réponses sociales (JEFAR). His research focuses on family diversity, assisted reproduction, and sexual and gender diversity. No personal connection to donor conception was disclosed.

Regulatory Context

• In 2004, Canada passed the Assisted Human Reproduction Act (AHRA), one of the most comprehensive pieces of legislation in the world concerning reproductive technologies and related research. However, in 2010, the Supreme Court of Canada struck down major sections, ruling that they overstepped into provincial constitutional jurisdiction over health care. The Court upheld the right of provinces to regulate health care delivery, including fertility clinics and the use of gametes and embryos in clinical settings. The federal government retained jurisdiction only over criminal prohibitions (e.g., banning payment for surrogacy and gamete donation) and over determining allowable reimbursable expenses for these services. Since 2010, neither Health Canada nor most provinces have enacted comprehensive legislation related to assisted reproduction.

• There is federal legislation ensuring DCP access to identifiable information about donors. Quebec became the first province to recognize the right to know one’s origins when donor anonymity ended in June 2025. Anyone conceived in the province from donated sperm or eggs from June 6, 2025, onward will have the right to know the identity of the donor when they turn 14, or even younger with parental consent.

• There is no limit on the number of families per donor. Industry guidelines suggest a limit of 25 people per population of 800,000.

• Health Canada adopted a revised directive removing restrictions on gay and bisexual sperm donors, effective May 2024.

• Commercial payment to donors is prohibited. Donations must be altruistic; donors may receive reimbursement for legitimate expenses, but not payment for gametes themselves.

• Single people, same-sex couples, and heterosexual couples all have equal legal rights to access assisted reproduction treatments.

• More than 90 percent of the sperm used in Canadian inseminations is imported, mostly from the United States and Europe.

Related Posts

• Canadian finds participants more satisfied with directed embryo donation than anonymous programs (Fuchs Weizman, 2023)

• "Queer tax" creates extra fertility barriers for 2SLGBTQ+ BIPOC families in Canada (Tam, 2025)

• Online sperm donation creates new family-building pathways while presenting unique challenges (Cote, 2025)

Geographic Region: United States.

Research Question: How have donor sperm prices changed over the past decade in the United States, and what is the current pricing landscape across U.S. sperm banks stratified by vial type and donor identity status?

Design: Cross-sectional market analysis with longitudinal price trend data. The authors collected donor sperm pricing information from the publicly listed websites of five of the largest U.S. sperm banks in April 2025. They obtained prices for vials prepared for four insemination methods: intrauterine insemination (IUI), intracervical insemination (ICI), in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI). Prices were stratified by donor identity status to assess financial implications of the industry shift toward identity-disclosure donors (who agree to share identifying information with offspring at age 18) versus non-identified donors (who remain anonymous to recipients and offspring). Two sperm banks provided longitudinal pricing data spanning 9–10 years. Historical prices were inflation-adjusted to 2025 U.S. dollars using the Consumer Price Index and standard inflation adjustment formulas.

Sample: Five large U.S. sperm banks. Non-identified donor options were available at only 2 of the 5 banks sampled in 2025; the other 3 had already discontinued non-identified donations. Longitudinal pricing data spanning 9–10 years came from only two of these banks. The summary cannot assess whether these five banks represent the market, are skewed toward particular regions or pricing strategies, or whether their pricing patterns generalize beyond them.

Key Findings

• Price differences across vial types reflect differences in total motile sperm counts and preparation techniques.

• 2025 average pricing: In April 2025, across five major U.S. sperm banks, IUI and ICI vials averaged $1,968 for identity-disclosure donors and $1,495 for non-identified donors. IVF vial average costs were $1,789 for identity-disclosure donors and $1,245 for non-identified donors. ICSI vials were the least expensive, averaging $1,841 for identity-disclosure donors and $1,195 for non-identified donors.

• Inflation-adjusted price trends (2016–2025): One sperm bank reported non-identified donor pricing from 2016–2024, showing inflation-adjusted increases of 23% (IUI) and 78% (IVF). Two sperm banks reported identity-disclosure pricing from 2016–2025, showing increases of 58% (IUI) and 99% (IVF).

• Absolute dollar increases (2016–2025, inflation-adjusted): At one bank, inflation-adjusted prices increased by $216 for non-identified IUI vials and $449 for non-identified IVF vials. For identity-disclosure donors, mean prices across two banks increased by $574 for IUI vials and $717 for IVF vials over the 10-year period.

Limitations: The authors do not report selection criteria for the ‘five largest’ banks or their geographic distribution, market position, or patient demographics. Only 2 of 5 banks offered non-identified donors in 2025. Longitudinal data come from only 2 banks with different donor type coverage. The research cannot assess whether these banks represent the market broadly or are skewed toward particular regions, pricing strategies, or patient populations. No analysis of the relationship between Colorado Senate Bill 22-224 (which mandated identity disclosure for all gamete donors used by patients in Colorado and went into effect in 2025) and the timing or magnitude of price increases.

Applications: This research documents commercial sperm bank pricing, but is not designed to explain why prices increased, whether disclosure mandates drove the shift, or who is excluded from commercial banking. More work is needed to understand the effects of regulations on access to third-party reproduction. Building legal infrastructure for known-donor arrangements could expand choices by clarifying parentage status and protecting known donors and recipients.

Funding Source: No funding was reported for this project.

Lead Author: Cassie Hobbs is a reproductive endocrinologist at the Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania. The author did not disclose a personal connection to donor conception.

Regulatory Context

• The U.S. lacks comprehensive federal regulation of gamete donation and donor conception. The fertility industry is largely self-regulated.

• The Food and Drug Administration oversees infectious disease screening and testing of donors but does not regulate pricing or donor identity practices.

• The American Society for Reproductive Medicine provides ethical guidelines and recommendations on donation practices, but these are not legally binding.

• There are no federal legal limits on donor compensation. A 2011 court ruling (Kamakahi v. ASRM) determined that price caps violate antitrust laws.

• The U.S. does not have federal laws prohibiting anonymous donation; practice varies by bank and state.

• In 2022, Colorado became the first state to mandate identity disclosure for all gamete donors (Senate Bill 22-224).

• Some states have enacted laws regarding assisted reproduction and parentage, but these vary widely; there is no national donor registry and no uniform access-to-information law for donor-conceived people.

Related Posts

• Analysis of 30 studies shows online sperm donation attracts older donors, marginalized recipients, and creates power dynamics favoring donors (Taylor-Phillips, 2025)

• Increase in open-identity sperm donation in the United States since 1996 (Valido, 2024)

• Recent studies exploring diversity in the U.S. donor pool

Geographic Region: Sweden

Research Questions: Do donor-conceived adolescents in lesbian-couple and heterosexual-couple families intend to request identifying or non-identifying information about their identity-release oocyte or sperm donor? What factors--including family type, donation type, family functioning, and perceived parent-child relationships--are associated with adolescents’ interest in seeking donor information?

Design: A cross-sectional survey study conducted during the fifth wave of data collection (2022 to 2023) from the Swedish Study on Gamete Donation (SSGD), a longitudinal multicenter cohort study that began recruiting heterosexual and lesbian couples undergoing identity-release gamete donation in 2005 to 2008. The survey assessed adolescent awareness of and feelings about donor conception, interest in requesting donor information, motivations for seeking information, types of donor information desired (background/non-identifying versus identity and contact), desire for contact with the donor and same-donor peers, and parent-child relationships. Family functioning was measured using the FAD GF6+, a validated six-item instrument assessing communication, problem-solving, emotional climate, and closeness among family members. Emotional closeness to each parent and perceived resemblance (physical and non-physical characteristics) were assessed with single-item measures rated on four-point Likert scales.

Sample: 96 donor-conceived adolescents (ages 13 to 16, mean 14.7 years) whose parents had disclosed their donor conception status: 47 from lesbian-couple sperm donation families (49%), 27 from heterosexual-couple sperm donation families (28%), and 22 from heterosexual-couple oocyte donation families (23%). Gender distribution was approximately even (49% girls, 51% boys). About 60% had married or cohabiting parents, though adolescents from lesbian-couple families were more likely to have separated parents (57% vs. 15% of hetero-sperm and 32% of hetero-egg). A majority (58%) had donor-conceived siblings in their homes; hetero-egg families were significantly less likely to have siblings than other families. Most adolescents (68%) learned about donor conception before age 8, with highest rates in lesbian-couple families (79%). Regarding knowledge outside the family, 92% of adolescents from lesbian-couple families reported that both family members and others knew, compared to 52% of hetero-sperm and 50% of hetero-egg families. Of 128 adolescents approached, 100 completed surveys (78% response rate). Of the 42 families not providing contact, 9 had not disclosed donor conception to the child, and 22 had not discussed information access.

Key Findings

• 58% of adolescents intended to request donor information (28% ‘as soon as possible’; 30% ‘sometime in the future’). 32% were uncertain. 9% had no intention to request information. Adolescents who reported better family functioning were about 5 times more likely to report uncertainty than clear intention. This finding was statistically significant.

• Among heterosexual-couple families, those conceived with donor eggs were significantly more likely to intend to request information than those conceived with sperm. Sperm-donation adolescents from heterosexual-couple families were about 6 times more likely to be uncertain rather than clearly intending to request information. The authors proposed that sperm-donation adolescents may worry that searching for the donor could negatively impact their relationship with their non-genetic father. For oocyte-donation families, they cite research showing oocyte-donation mothers pursue active strategies to cope with their feelings about the donation, which helps them feel secure as mothers, contributing to a mother-child bond less likely to be threatened by the DCP's interest in the donor They also note that in sperm-donation heterosexual families, mothers tend to be more open about donor issues than fathers, perhaps due to the stigma associated with male infertility.

• Family form (lesbian vs. heterosexual-couple) did not significantly predict intention to request donor information. Gender also did not significantly predict intention, contrary to earlier studies showing girls were more interested than boys.

• Among the 87 adolescents indicating some interest (including those who selected uncertain)

  • Motivations for seeking information included: Determine physical resemblance to donor (71%), Learn about heritage (64%), Explore resemblance of non-physical characteristics (53%), Obtain medical/genetic history (45%), Relevance to own identity (24%), To contact the donor (22%). There were no significant differences between donation groups.

  • Types of information desired included: Background information (78%), Donor’s name and identity number (61%), Donor’s openness to contact (52%), Donor contact information (36%). There were no significant differences between donation groups.

  • 73% of adolescents from lesbian couples discussed seeking information with both parents, compared to 50% of hetero-sperm and 37% of hetero-egg families. Among hetero-egg families, one-third discussed with mother only, suggesting more open maternal communication about donor issues.

• Among all respondents, 31% expressed interest in contact with same-donor peers, 44% were uncertain, and 25% were not interested. There were no significant differences between groups or between adolescents with and without donor-conceived siblings in their families.

Limitations: Longitudinal attrition bias likely selected for stable families. Small subgroup sizes (especially n=9 ‘no intention’ group) limit the ability of some analyses to detect differences. Selection bias from requiring disclosure for participation means non-disclosed adolescents are entirely absent. Lack of demographic disaggregation by race, ethnicity, SES, or immigration status. The FAD GF6+ measures family functioning but not openness about sensitive topics.

Applications: The wide variation in what adolescents want (some want only background, others want identity, some want contact information) suggests that flexible, tailored approaches to ID disclosure may be warranted.

Funding Source: Swedish Research Council (grant 2021-03174) and Umea University.

Lead Author: Henrik Groundstroem is a licensed psychologist and doctoral student in clinical psychology at the Department of Psychology, Umea University, Sweden, whose research focuses on long-term psychosocial outcomes and identity integration among families with identity-release donor-conceived children. No personal connection to donor conception was disclosed.

Regulatory Context:

• Sweden was one of the first countries to implement identity-release donation, passing legislation in 1984 that went into effect in 1985. 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. Donor information is recorded in medical records that the child can access as an adult.

• Only altruistic gamete donation is allowed. Donors can receive compensation for expenses and inconvenience, but not payment for the gametes themselves. Donors must be 18 years or older.

• Legislation allowed donor insemination through the public healthcare system for heterosexual couples in 1985, and IVF treatment with donor eggs or sperm were also permitted to heterosexual couples in 2003. Sperm donation treatment became accessible to lesbian couples in 2005. In 2016, legislation was passed to allow access to assisted reproductive treatments, including procedures with donor eggs and donor sperm, for single women and lesbian couples. A separate change occurred in 2019, allowing both private and public clinics to perform treatments with donated eggs, and a double donation (using both a donated egg and donated sperm) became legal.

• In Sweden, a donor can contribute to a maximum of six families. A central register of all donor treatments is maintained by the National Board of Health and Welfare. This register helps to connect donor-conceived individuals, donors, and their relatives.

Related Posts

• Swedish study examines what donor-conceived adolescents actually want (Groundstroem, 2024)

• Family dynamics factor in donor identity search process (Widbom, 2024)

• Adolescents describe what it's like to request information about their sperm donor (Maas, 2026)

I’m looking for a few people willing to occasionally review DCJC summaries and other content before publication and provide feedback on plain-language clarity, interpretation of articles, and overall framing. I’m particularly interested in hearing from people at the intersection of multiple relevant identities and experiences and from subject-matter experts in areas like mental health, child development, research methods, reproductive justice, family systems, policy, and ethics. I’m also looking for folks who can read critically for racism, ableism, cis/het/bio-normativity, and biological essentialism. If you’re interested, email me with a sentence or two about who you are and what perspective you’d bring. Thank you.

Research Recap

Golombok et al. (2023) examined whether young adults born through donor conception or surrogacy have greater psychological problems or poorer relationships with their mothers compared to those conceived without medical help, and whether disclosure age affects outcomes. Following 117 families (22 surrogacy, 17 egg donation, 26 sperm donation, 52 unassisted) for 20 years (infancy to age 20), they found young adults born through donor conception showed similar psychological wellbeing and family relationships compared to those conceived without third party reproduction. Key finding: Mothers who told their children about donor conception before age 7 were significantly less anxious and depressed at the age-20 follow-up than mothers who disclosed later. Families who disclosed earlier also showed less parental conflict and more open communication. Seventeen families (mostly sperm donation) had still not told their 20-year-old children by the study's end.

In a separate study, Golombok et al. (2023) compared whether shared biological motherhood (one partner provides egg, other carries pregnancy using donor sperm) results in stronger mother-child relationships than donor IVF (only one mother has biological connection). They interviewed 120 mothers from 60 UK lesbian couples (30 shared biological motherhood families, 30 donor IVF families, children ages infancy-8 years) using a tool that measures parental warmth, confidence, and emotional engagement. Mothers in both family types showed similar high levels of warmth, joy, and confidence with no differences in how they felt about their children or reflected on relationships. Within shared biological motherhood families, genetic mothers and gestational mothers showed no differences on any measure. Majority of children in both groups were reported as equally close to both mothers, with no significant differences between family types. Most mothers in both groups reported no jealousy toward their partner regarding the child.

Thirup et al. (2025) interviewed 19 Danish men rejected as sperm donors by Cryos International to examine how they experience rejection and cope with new health or genetic information. Rejection reasons included reduced sperm quality, physical illness, genetic predisposition to disease, mental illness, or lack of family medical history. Most cited altruism as motivation; 9 also identified genetic legacy as significant. For 5 men, new health information discovered during screening was most distressing. For 14, the rejection itself was hardest. Many had begun identifying as donors and described feeling a blow to masculinity and sense of defeat. Emotional impact faded within weeks for most.

Tutić Grokša et al. (2025) surveyed 1,097 students across Croatia, Italy, and Greece in medicine, law, philosophy, and theology about attitudes toward medically assisted reproduction. Overall, 77% agreed children have the right to know donor information; 51% agreed MAR should be available to single people and same-sex couples; few supported banning embryo creation (25%), embryo donation (21%), or gamete donation (18%). Field of study was the strongest predictor of attitudes (explaining 46% of variance): theology students showed dramatically higher disapproval compared to philosophy, medicine, and law students. Women had significantly lower disapproval than men. Believers had significantly higher disapproval than non-believers (large effect size). Right-oriented participants had highest disapproval.

Bornstein et al. (2026) interviewed 24 queer adults (ages 18-35, mostly from the United States, half transgender) about how queer identity shapes family-building decisions. Most preferred at-home insemination with a known sperm donor, framing it as consistent with queer values around chosen family. Many wanted biologically related children and found reciprocal IVF appealing, yet expressed discomfort with genetic relatedness as tension with queer values. Participants defined "invasiveness" broadly, including medical procedures and institutional discrimination exposure. At-home insemination was least invasive; adoption/fostering more invasive due to state scrutiny. Anticipated discrimination shaped every pathway. Nearly all raised ethical concerns: DIY insemination more ethical than IVF (eugenics concerns), surrogacy complicated by compensation, adoption/fostering complex due to transracial adoption concerns.

Navarro-Marshall (2026) analyzed 17 Chilean families' recorded origin-story conversations with 19 donor-conceived children (ages 3-8): 5 heterosexual couples, 6 female same-sex couples, 6 single mothers by choice. Conversations averaged 6 minutes 25 seconds with 96 total turns. Parents and children took similar numbers of turns (38 vs. 36 average) but parents used four times more words per turn (15.7 vs. 3.5). All conversations began with a mother's first turn, never a father or child. Approximately 55% of turns were factual; elaborative turns (inviting reflection/feelings) comprised 28% overall (parents 44%, children 28%); narrative turns made up 8%, almost entirely by parents. Forty-one percent of families used a book or story during conversations. Average first disclosure age was 3.8 years. All families reported retelling the story multiple times, typically every four months or more.

Zeghiche et al. (2026) interviewed 40 Canadian parents (ages 28-61, predominantly middle-to-upper-middle-class, 2 non-white) about sperm donor selection for children conceived 2001-2008, using negotiated order theory to examine how institutional, interpersonal, and material constraints shape decisions. Health was a near-universal priority with examination of extended medical histories. Physical resemblance was dominant but varied by family type: heterosexual fathers sought resemblance for paternal legitimacy; lesbian couples for non-biological mother affirmation; single mothers for racial congruence to shield from social scrutiny. Some viewed open-identity donors as essential rights; others framed closed-identity as protecting family boundaries. Clinics narrowed selection through curated lists and restrictions; some offered only closed-identity donors. Extended treatment timelines eroded donor availability. Families used different donors for subsequent children as supplies exhausted. Time pressure intensified and families abandoned initially non-negotiable preferences. Intracouple conflict and unequal participation shaped selection. Some parents expressed regret about donor choices, experiencing tension between decisions made to solve fertility problems versus children's potential future needs.

Other Tidbits

• A new piece in New Lines Magazine examines how postmortem sperm retrieval is becoming state policy in Israel and Ukraine, raising questions about consent, autonomy, genetic legacy, and who gets to decide whether a child is brought into the world.

• The Progress Educational Trust is hosting an event on Donor 7069 (the Danish sperm donor whose undetected TP53 mutation has been linked to cancer diagnoses and deaths among donor-conceived children across Europe) exploring what went wrong and what needs to change. Join them on Wednesday, June 24, 5:30–7:30pm BST. Register here.

• There’s a new Progress Educational Trust podcast episode exploring egg donation across six stakeholder perspectives: donors, recipients, donor-conceived people, fertility professionals, regulators, and policymakers.

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Geographic Region: Canada (primarily Québec)

Research Question: How do intended parents in Canada navigate the process of sperm donor selection under institutional, interpersonal, and material constraints?

Design: Qualitative study drawing on semi-structured interviews with parents of adolescents conceived through donor insemination in Canada. Data were collected in the winter of 2019 and spring of 2020 as part of the STORIES project, which examined how families integrate narratives of donor conception and how parents and their donor-conceived adolescents perceive kinship and parentage. Each parent participated in an individual interview lasting between 1.5 and 2 hours. In two-parent families, partners were interviewed separately to allow candid discussion of potentially divergent perspectives. Interviews covered four themes: infertility experiences, the use of donor insemination, narratives of conception and disclosure, and representations of the donor. This article draws only on findings from the donor insemination theme. The theoretical framework is Strauss’s negotiated order theory, which treats institutional order as provisional, contested, and produced through ongoing interaction among actors with unequal power. Fertility clinics, sperm banks, and policy frameworks are understood as distinct ‘worlds’ converging in the broader ‘arena’ of assisted reproduction. This lens allows the authors to conceptualize donor selection as a negotiated, iterative practice rather than a one-time autonomous choice.

Sample: 40 parents ages from 28 to 61 years (mean age = 46 years) whose donor-conceived children were born between approximately 2001 and 2008. Marital status varied: 18 were married, 7 were single, 9 were separated, 5 were in common-law relationships, and 1 did not specify. Only 2 of the 40 participants identified as racialized individuals. Thirty participants held a university degree. The sample was predominantly middle- to upper-middle-class. Recruitment was conducted primarily through social media communities focused on infertility, sperm donation, single parenting, and lesbian parenting.

Key Findings

• Health was a near-universal selection priority across all family types. Parents examined donors’ extended medical histories seeking to minimize hereditary risk.

• Physical resemblance was a dominant preference, but for different reasons depending on family type. Heterosexual fathers sought resemblance to affirm paternal legitimacy. Lesbian couples often sought resemblance to the non-biological mother to affirm her parental bond. Single mothers sought racial congruence to shield their children from social scrutiny.

• Some parents viewed open-identity donors as essential for their children’s future access to information, framing it as a right rather than a threat. Among parents who chose closed-identity donors for their children, some described their reasoning in terms of family boundaries and the perceived intrusion of a 'third party.' Some parents felt they were not adequately informed about the long-term implications of closed-identity donation before they conceived.

• Parents reported that clinics narrowed and structured the selection process through curated lists, trait limits, and bank restrictions. Some parents experienced this as a denial of agency; others found it a relief from an emotionally overwhelming process.

• Some clinics offered only closed-identity donors, removing open-identity donation as an option entirely. Parents who wanted open-identity donors either had to switch clinics or accept a closed-identity donor. One participant reported that her provincial public program covered only closed-identity donors, and several participants described the additional costs of open-identity donation as prohibitive, making financial constraints a real factor in identity-status decisions for at least some families.

• The donor information provided to parents before conception varied. Canadian clinics tended to provide basic physical descriptors only. One family discovered only after their children were born that the donor’s extended profile included information that conflicted with what the clinic shared with them.

• Extended treatment timelines eroded donor availability. When conception did not occur on the first attempt, the initially chosen donor was often no longer available. Some families used sperm from different donors for subsequent children because their first donor’s supply was exhausted.

• As treatment extended, pressure to conceive intensified and willingness to wait for a preferred donor diminished. Preferences once considered non-negotiable (e.g., open-identity status, physical traits, or ethnic background) were often abandoned under time pressure.

• In two-parent families, donor selection was often shaped by intracouple conflict or unequal participation. One father left all decisions to his partner; she found his disengagement distressing. Other couples disagreed on identity status, ethnicity, or religion and had to negotiate a compromise.

• Some parents who chose anonymous donors expressed some form of regret or retrospective reconsideration. The nature of the regret varied. The authors note a recurring tension: decisions made by prospective parents to solve a fertility problem may feel very different when viewed later through the lens of their child’s needs.

Limitations: The study is limited to the Canadian context and may not generalize to other regulatory and cultural environments. Social-media recruitment substantially limits representativeness. All data are retrospective. Parents were recalling donor-selection decisions made 10–18 years earlier. The socioeconomic profile of the sample is unusually affluent. The bionormativity analysis is primarily descriptive rather than critical.

Applications: The negotiated order framework introduced in the study could be genuinely useful because it allows researchers to examine how institutional power, not just individual preferences, shapes reproductive decisions over time. This study also suggests that tracking how preferences change over time, and why, would be more illuminating than snapshot studies of what parents say they wanted.

Funding Source: Social Sciences and Humanities Research Council of Canada (SSHRC), as part of the Self, Transmission, Origins, Representations, and Identity (STORIES) project (Grant #435-2018-0707)

Lead Author: Sabrina Zeghiche is a postdoctoral researcher in the Department of Social Work at the Université du Québec en Outaouais, where she studies family ties in the context of sperm donation and leads the DRIFTS project on overuse and substitution of sperm donations. The lead author did not disclose a personal connection to donor conception.

Regulatory context

• The Assisted Human Reproduction Act (2004) governs gamete donation nationally and mandates altruism and anonymity in all gamete donations. Health Canada sets safety standards including quarantine requirements for donor sperm.

• Provincial health systems determine access and reimbursement. Québec provides limited public reimbursement for insemination and IVF. Ontario covers one IVF cycle and intrauterine insemination but excludes medication, genetic testing, and storage.

• Most clinics import sperm from the United States, but this increases cost and is often not covered by provincial plans.

• Donor diversity is limited: white donors dominate both Canadian and international databases, creating particular hardship for racialized intended parents.

• There is no national registry to track donor births or protect donor-conceived people’s right to identity information at the federal level.

• Industry guidelines suggest a limit of 25 births per donor per 800,000 population, but this is not legally mandated.

• In 2024, Quebec became the first province to pass legislation to establish a provincial donor registry allowing donor-conceived people over 14 to access certain donor information.

• Commercial payment to donors is prohibited; altruistic donation is required. Single people, same-sex couples, and heterosexual couples have legal access to assisted reproduction.

• In 2024, Canada removed restrictions on gay and bisexual sperm donors.

Related Posts

• Financial barriers and desire for personal autonomy drive decisions to choose known donor (Fyfe, 2025)

• LGBTQ couples experience conflict when deciding between known and unknown sperm donors (McCormick, 2025)

• Donation as a lifelong commitment rather than a one-time event (Martin, 2025)

Geographic Region: Chile

Research Question: How do families with donor-conceived children talk about their origins with them?

Design: Descriptive exploratory qualitative study using a naturalistic approach. The researcher asked families to record origin-story conversations with their children in their own homes, without the researcher present, at a time of the family’s choosing. Parents then conducted brief semi-structured interviews with their children immediately after the origin conversation, asking five questions about the child’s emotional experience and favorite/least favorite parts of the story. The researcher next conducted semi-structured interviews with parents exploring context (who tells, when, frequency, terminology), their emotional experience of telling the story, and reflection on the recorded conversation through audio feedback. Data collection occurred between late 2024 and early 2025. Each recorded conversation was transcribed using the Jefferson system, a transcription method from conversation analysis designed to capture intonations, pauses, overlaps, and turn-taking dynamics—not just the words spoken. One conversation per family was selected and coded for primary analysis (the one with the most turns). The researchers looked at the basic structure: who spoke, who started topics, how family members took turns talking, and whether turns were mainly about expanding ideas (elaborative), stating facts (factual), or telling the story (narrative).

Sample: 45 individuals from 17 families participated, including 19 donor-conceived children (11 female; 8 male) ranging in age from 3 to 8 years (mean age 4.9 years). Caregiver mean age was 41.4 years. Family structures included 5 heterosexual couples, 6 female same-sex couples, and 6 single mothers by choice. Most families (12) used sperm donation, 3 used egg donation, and 2 used double donation through fertility clinics with cryobanks located in the USA, Spain, or Chile. Younger parents and children tended to be in lesbian families; older children were in heterosexual families; older parents were single mothers by choice. All parents held college degrees. All participants were living in Chile at the time of the study and self-identified as Latino/a. All families had already disclosed donor conception or were certain they intended to do so. Donor type varied: some families used identity-release donors (contact information available to the child at age 18), some used anonymous donors (no identifying information ever available), and one family used an informal sperm donor contacted through social media. Recruitment used three channels: social media advertisements, community organizations serving single mothers by choice and lesbian families, and fertility clinic counselors.

Key Findings

• Conversations were brief. The average conversation lasted 6 minutes and 25 seconds and included an average of 96 total turns.

• Conversations were co-constructed but asymmetric. Parents and children took a similar number of turns (38 for caregivers, 36 for children on average), but caregivers used more than four times as many words per turn (15.7 words vs. 3.5 for children). Caregivers made new conversational proposals (initiations plus react-initiations) in approximately 70% of their turns; children did so in about 30% of theirs.

• Conversations were mother-led. In all 17 families, the first turn of the conversation was taken by a mother, never by a father or a child. This was consistent across all family structures.

• All conversations took place at home, most frequently in the evening, at bedtime, or while reading a story.

• The most common type of turn was factual (approximately 55% of all turns on average), meaning turns that conveyed factual information.

• Elaborative turns (those that invited reflection, feelings, or expanded meaning) made up about 28% of all turns. Parents were more elaborative than children: caregiver elaborativity (including narrative-elaborative turns) was 44% of their turns; children’s was 28%.

• Narrative turns (the actual storytelling) made up about 8% of total turns, and narrative plus narrative-elaborative turns combined reached 17%. Parents accounted for virtually all narrative turns (12% of parent turns vs. 3% of children’s).

• Questions were prominent throughout. One-third of all conversational turns (33%) were questions. Of all questions asked, 64% were elaborative questions. Both parents and children asked elaborative questions at similar rates.

• Seven of 17 families (41%) used a story or book as part of the conversation: four created their own written or illustrated tale, one used a repeated oral bedtime story, and two used published children’s books about donor conception.

• Seventy percent of families reported planning how they would approach the conversation.

• The average age at first disclosure conversation was 3.8 years.

• All participating families reported that the story was retold multiple times after the first conversation, with the least frequent family reporting a new conversation at least once every four months.

Conversation Example

Olivia is a 46-year-old single mother by choice. Her daughter Amelia is 5 and was conceived through sperm donation. The conversation analyzed for the study (selected because it had the most conversational turns) started because Amelia had told her friend that her father had died. When Olivia pointed out that this wasn’t true, Amelia explained that she hadn’t wanted to get into ‘the long story.’ Rather than correcting her or pressing her to be more accurate, Olivia followed her daughter’s reasoning. Together, they worked out what had actually happened. Amelia had imagined her friend would see her as someone to feel sorry for and that image made her feel deeply uncomfortable. She eventually named that feeling as embarrassment. This opened a conversation about what it feels like to not have a father. The mother’s questions were almost entirely about emotions (how did you feel) and Amelia described her feelings rather than defending her actions. At one point, Amelia pushed back on her mother’s interpretation, offering her own read of the situation.

Limitations: The study does not distinguish between early and later disclosure conversations. A first disclosure conversation likely differs substantially in structure and tone from a tenth retelling, but the study cannot account for this. The wide age range of children (3–8 years) introduces developmental variability in comprehension and narrative ability that was not fully controlled for. Older children took more turns but were not necessarily more elaborative. Only one conversation per family was analyzed (the one with the most turns), which may not represent the family’s typical conversational style and necessarily excludes briefer or less structured conversations. The study’s findings about fathers are limited. Fathers participated in only a minority of conversations.

Applications: Rather than coaching parents to tell a complete, coherent story, mental health practitioners can consider helping parents ask open-ended, emotionally exploratory questions that invite children to participate in meaning-making.

Funding Source: Agencia Nacional de Investigación y Desarrollo (ANID), Chile, via a doctoral scholarship (Scholarship 21190081).

Lead Author: Javiera Navarro-Marshall is a Chilean psychologist and academic at the Facultad de Psicología, Universidad Alberto Hurtado in Santiago, Chile. Her research focuses on parent-child communication, autobiographical memory, and donor-conceived family storytelling. She is a mother through donor conception.

Regulatory Context:

• Chile has no comprehensive legislation governing assisted reproductive technology or donor conception. ART practices are regulated by the ethics committees of individual medical centers, not by national law. Most clinics voluntarily adhere to standards set by the Latin American Network of Assisted Reproduction (REDLARA).

• The only relevant national legal provision is an article of Chile’s Civil Code stipulating that the father and mother are presumed to be the persons who voluntarily used ART, meaning legal parentage follows intent, not genetics. In the absence of marriage, paternity must be voluntarily acknowledged.

Related Posts

• Study reveals how donor-conceived families feel about discussing origin stories (Navarro, 2024)

• Study uncovers three conversational styles when discussing donor conception with children (Navarro, 2025)

• Parent and child experiences talking about donor conception (Navarro, 2025)

Geographic Region: United States

Research Question: How do queer people form preferences and make decisions about becoming parents, and how does queer identity shape those decisions?

Design: A qualitative interview study guided by the queer reproductive justice framework. The researchers conducted 24 in-depth, one-hour interviews on Zoom. The interview guide included prompts about family of origin, defining family, defining fertility, and family building desires, the process of having children and parenting, how they considered building their families (e.g., fertility treatment, adoption, informal parenting roles), and challenges that they faced or anticipated they might face. They monitored for thematic saturation (i.e., no longer hearing any new themes) separately within cisgender and trans/nonbinary subgroups.

Sample: 24 sexual and gender minority adults assigned female at birth, ranging in age from 18 to 35 years (mean age 28.5). About half identified as transgender (n=11). Just under a third identified with more than one gender (n=7), and about half identified with more than one sexual orientation (n=11). Sexual orientations represented included lesbian, gay, bisexual, pansexual, asexual, and queer; gender identities included woman, nonbinary, genderqueer/gender fluid, two-spirit, agender, demiboy, and man. Most participants were not yet parents but either wanted to be or were unsure (n=18); a few were already parents (n=3) or certain they did not want children (n=3). Participants were recruited via Facebook ads in July–August 2023. Participants received a $40 gift card. No information is provided about race, ethnicity, or socioeconomic status.

Key Findings

Theme 1: Aligning Preferences and Decisions with Values

• Most participants preferred at-home insemination with a known sperm donor as their first-choice pathway to parenthood, framing this as consistent with queer values around chosen family and community.

• Using a known donor was seen as a way to expand the child’s family network, giving the child a connection to the donor as a kind of uncle, family friend, or chosen family member.

• Some participants described how informal parenting roles (stepping into care for children in their community who needed support) also aligned with queer values, even for those who did not actively want to pursue parenthood.

• Many participants, even those who would not choose assisted reproductive technologies (ART) themselves, framed access to ART as part of a broader vision of reproductive and bodily autonomy for queer people.

Theme 2: Desire for and Discomfort With the Pursuit of Biological Relatedness

• Many participants wanted biologically related children, and some described reciprocal IVF (where one partner provides eggs and the other carries the pregnancy) as an appealing option for giving two partners a “biological” connection.

• At the same time, many participants expressed discomfort with this desire, feeling that wanting a biologically related child was in tension with queer values around chosen and non-biological family.

• Several participants articulated that cultural fixation on biological relatedness seemed inconsistent with queerness, and questioned why genetics should matter so much.

Theme 3: Managing Invasiveness (or the level of vulnerability to third parties and systems)

• Participants defined “invasiveness” broadly, including medical procedures and exposure to scrutiny, surveillance, and potential discrimination by third parties, including healthcare providers, adoption agencies, and state child welfare systems.

• Many participants viewed at-home insemination as the least invasive option because it minimized medical intervention and avoided engagement with institutions that might discriminate against them.

• Fostering and adoption were experienced as more invasive than ART by many participants, primarily because of anticipated scrutiny of their family structure, gender identity, or relationship configuration by state actors.

• Several participants, particularly those with transgender or nonbinary partners, described specific concerns that their family would be scrutinized or that their partner would be outed during adoption or fostering processes.

Cross-cutting Themes: Discrimination and Ethics

• Anticipated and experienced discrimination shaped every family-building option participants considered, with no pathway free from concern. Adoption agencies, especially those affiliated with religious institutions, were seen as particularly unwelcoming. Some participants chose ART over adoption specifically because they perceived it as exposing them to less discrimination risk, even if they had ethical reservations about ART.

• Nearly all participants raised ethical concerns about some or all pathways to parenthood. DIY/at-home insemination was generally seen as more ethical than IVF; IVF was associated with concerns about eugenics and a “designer baby” industry. Surrogacy was seen as ethically complicated due to questions about whether it’s possible to ethically compensate someone for carrying a pregnancy. Adoption and fostering were seen as ethically complex for reasons including the potential trauma adoption involves, the predatory dynamics some participants perceived in the adoption system, and specific concerns about transracial and international adoption. Participants with minoritized racial identities were more attuned to these ethical issues.

Limitations: Participants did not always make precise distinctions between different types of adoption (open vs. closed) or between adoption and fostering, and interviewers did not uniformly probe for these distinctions. Many participants inaccurately named the fertility interventions they described (e.g., calling at-home insemination “IVF”), though interviewers deliberately did not correct them to avoid undermining participant expertise on their own experience. Cost was discussed but not deeply explored. The sample has no reported race, ethnicity, or socioeconomic data, which raises a question of if the study can adequately represent queer reproductive justice concerns (the theory is rooted in Black feminist thought). The sample is limited to people assigned female at birth, which influences what the study can and cannot say about trans reproductive experience.

Applications: Family-building counseling could support queer clients in clarifying their values rather than steering them toward any particular pathway. Clinics could audit their environments, intake procedures, and staff training for hetero- and cis-normative assumptions. Gamete banks, clinics, and matching programs could consider how to better support known donor arrangements, with the caveat that informal arrangements often lack reliable legal frameworks in many jurisdictions. The perspectives of people who become parents using known donors are underrepresented in donor conception research, as are the experiences of people born to sexual and gender minority parents via known donation. Future research could follow up with children conceived through known donor arrangements to learn more about their relationship to genetic identity, the durability of informal agreements, and how their experiences align with parental intentions.

Funding Source: NICHD K99/R00 grant

Lead Author: Marta Bornstein is an assistant professor of Health Promotion, Education, and Behavior at the Arnold School of Public Health, University of South Carolina, where her research focuses on sexual and reproductive health, including fertility, infertility, and reproductive decision-making among LGBTQ+ individuals. No personal connection to donor conception was disclosed.

Regulatory Context

• There is no comprehensive federal regulatory framework governing gamete donation or donor conception.

• The FDA provides limited oversight related to infectious disease screening of donors.

• ASRM guidelines are voluntary and not legally binding.

• Compensation for donors is unrestricted.

• Insurance coverage for fertility treatment varies by state and often excludes people who do not meet medical infertility criteria, a barrier disproportionately affecting queer people experiencing social infertility.

Related Posts

• LGBTQ couples experience conflict when deciding between known and unknown sperm donors (McCormick, 2025)

• Financial barriers and desire for personal autonomy drive decisions to choose known donor (Fyfe, 2025)

• "Queer tax" creates extra fertility barriers for 2SLGBTQ+ BIPOC families (Tam, 2025)

Geographic Region: Croatia, Italy, and Greece

Research Question: Do students from Croatia, Italy, and Greece differ in their attitudes toward medically assisted reproduction (MAR), and how do field of study, gender, religiosity, political orientation, financial status, and community size predict those attitudes?

Design: Cross-sectional, quantitative survey study conducted between December 2022 and June 2023 as part of the larger EuroBioMed project (”From diversity of traditions to a common Euro-Mediterranean bioethical platform”). Students completed a paper-based questionnaire in class at five universities across three countries. The primary measure was a 14-item medically assisted reproduction (MAR) instrument, adapted from an earlier Croatian sociological scale (Cifrić, 2005) and expanded to include contemporary bioethical topics. Principal Component Analysis was used to reduce the scale. Five items were removed due to weak correlations with the remaining items: children’s right to know their donor, legal regulation, economic motivation, doctors’ rights over gametes, and the use of embryos in research. The final 9-item scale had good reliability and explained 51% of the variance, labeled “Disapproval of MAR” (higher scores = more disapproval).

Sample: 1,097 students (mean age 24, range 19–74 years) from five universities across three countries: Croatia (60%, n=656), Italy (23%, n=254), and Greece (17%, n=187). Students came from four academic disciplines: law (37%), medicine (30%), philosophy (20%), and theology (13%). Women made up 60% of the sample. Most participants (61%) identified as believers. Regarding political orientation, 29% identified as left, 26% as center, 19% as right, and 25% as not interested in politics. Financial status was self-reported, with approximately half (50%) rating themselves as average. Participants were recruited via convenience sampling in class settings with instructor permission. Participants were not asked about personal or family experience with assisted reproduction, donor conception, or infertility.

Key Findings

• The individual items with the highest levels of agreement across the full sample were: children’s right to know their biological origins/donor information (77% agreement) and the need for legal regulation of MAR (70% agreement).

• Just over half of participants (51%) agreed that MAR should be available to single people or people in same-sex partnerships.

• Very few participants supported banning the creation of surplus embryos (25%), banning the donation of surplus embryos (21%), or banning gamete donation altogether (18%). These were the least endorsed restrictions.

• There was a statistically significant difference in overall MAR disapproval score between countries, but the effect size was very small. The country of origin explained less than 1% of the variance in attitudes.

• The only statistically significant difference was between Italy and Greece. Italian students showed slightly more disapproval of MAR; Greek students showed slightly less. Croatian students fell in between. The authors attribute the Italy-Greece difference partly to Italy’s restrictive ART law and Greece’s comparatively permissive ART regulations.

• Field of study was the strongest predictor of MAR attitudes, with a large effect size, meaning academic discipline explained about 46% of the variance in attitudes.

• Theology students scored dramatically higher on MAR disapproval compared to philosophy students, medical students, and law students. All differences involving theology were statistically significant.

• No statistically significant differences were found among philosophy, medicine, and law students. Law students had the lowest disapproval scores (i.e., most supportive of MAR access).

• Women had significantly lower MAR disapproval scores than men. Gender explained a meaningful portion of the variance.

• Believers had significantly higher MAR disapproval scores than both indifferent respondents and non-believers, with a large effect size. No significant difference was found between the indifferent and non-believer groups. Religiosity was one of the most powerful individual-level predictors.

• Right-oriented participants had the highest MAR disapproval; left-oriented participants had the lowest, with a large effect size. Differences between center and ‘not interested’ groups were not significant.

Limitations: The MAR instrument is new and has not been widely validated. The scale collapses attitudes across very different dimensions of MAR (gamete donation, accessibility, embryo handling) into a single ‘disapproval’ score. This may obscure meaningful variation in which specific aspects of MAR are viewed negatively vs. positively. The cross-sectional design prevents causal conclusions. Use of an English-language questionnaire may have presented comprehension challenges for students with lower English proficiency. Terminology for MAR procedures may have been unfamiliar.

Applications: Jurisdictions that share cultural roots or have common identities can have differing legal, theological, and socio-political contexts, which influence people's orientations toward medically assisted reproduction.

Funding Source: Croatian Science Foundation under project IP-2020-02-7450.

Lead Author: Ivana Tutić Grokša is a researcher at the Adult Education Institution Dante in Rijeka, Croatia, and is affiliated with the Department of Social Sciences and Medical Humanities at the Faculty of Medicine, University of Rijeka, where she has published on Mediterranean bioethics, transgender minority stress in Croatia, and diversity competency in healthcare. No personal connection to donor conception was disclosed.

Regulatory Context

Croatia

• Croatia’s Law on Medically Assisted Fertilization (Official Gazette 86/12) permits both homologous and heterologous fertilization.

• Egg donation is legal but no local egg donors are available, so eggs must be imported. Sperm donation is permitted. Surrogacy is prohibited. Post-mortem fertilization is prohibited.

• Single women can access MAR via donated eggs. Same-sex couples do not have legal access to MAR in Croatia.

• Donors are not required to be identifiable; the law does not mandate identity-release donation.

Italy

• Donor conception was permitted following a Constitutional Court ruling in 2014.

• Access is limited exclusively to different-sex married or cohabiting couples—single women and same-sex couples are excluded.

• Anonymous donation is mandatory; donor-conceived individuals have no legal right to identifying information about their donors.

• Surrogacy is prohibited and since 2023 has been criminalized even when performed abroad by Italian citizens.

• Embryo donation is prohibited.

• The restrictions have contributed to significant cross-border reproductive travel, with many Italian residents seeking treatment in Greece, Spain, and other countries.

Greece

• Surrogacy is legal under court-approved arrangements. The upper age limit for women accessing MAR is 54, compared to 45 in most European countries. Egg donation, sperm donation, and embryo donation are all permitted.

• Single women have access to MAR. Same-sex female couples do not have legal access to MAR through the standard framework, though surrogacy is accessible to some.

• Greece is a significant destination for cross-border reproductive travel, receiving approximately 1,000 patients per year from countries with more restrictive laws (including Italy and Germany).

Related Posts

• Research shows conservative attitudes toward donor identity in Brazil (Rocha, 2023)

• Religious Opposition to Donor Conception Spans Multiple Faith Traditions in Ghana (Asante-Afari, 2025)

• Religious and social pressures shape Muslim couples' fertility choices (Hammond, 2024)

Geographic Region: United Kingdom

Research Question: Does shared biological motherhood (a process in which one partner provides the egg and the other partner carries the pregnancy using donor sperm) result in stronger mother–child relationships than donor IVF, in which only one mother has any biological connection to the child?

Design: Cross-sectional comparative study using structured interviews. Data were collected over 20 months beginning in December 2019. Due to COVID-19 restrictions, nearly all interviews were conducted online. The primary measurement tool was the Parent Development Interview (PDI), a validated tool that assesses how parents think and feel about their children, themselves as parents, and their relationship with the child. Each parent in a family was interviewed separately. Parents also answered simple questions about which parent the child seemed closer to, whether they experienced jealousy toward their partner regarding the child, and how the baby was fed (breastfeeding only vs. a mix of breast and bottle). Statistical analysis used multilevel modeling to account for the fact that data came from two parents within the same family. The study sample was large enough for statistical analyses to detect medium-to-large differences, not small ones.

Sample: 60 lesbian two-mother families: 30 families formed through shared biological motherhood (also known as reciprocal IVF or co-IVF or ROPA) and 30 families formed through donor IVF in which only one mother has a biological connection to the child (the same partner’s eggs and uterus are used for the pregnancy). Both mothers participated in all 60 families, for a total of 120 individual interviews. All mothers identified as cisgender. Children ranged in age from infancy to 8 years old. Families were recruited through the London Women’s Clinic. Families were matched as closely as possible for children’s age, followed by child gender, maternal age, number of siblings, and presence of financial difficulties. Recruitment ended when 30 families in each group had both mothers participate. The study did not report on racial or ethnic composition, donor type (anonymous vs. identity-release), whether families had disclosed to their children, or children’s awareness of their conception.

Key Findings

• Mothers in shared biological motherhood families and mothers in donor IVF families did not differ in how they felt about their children, how they saw their child’s emotional experience, or how well they could reflect on the relationship. Both groups showed high levels of warmth, joy, confidence, and low levels of hostility or disappointment in their parenting role.

• When birth mothers and non-birth mothers across both family types were compared, no differences were found on any PDI variable.

• Within the shared biological motherhood families, the gestational mother (who carried the pregnancy) did not differ from the genetic mother (who provided the egg) on any measure of parental representations of the relationship, reflective functioning, or child affect.

• The majority of children in both family types were reported as equally close to both mothers. In shared biological motherhood families, about 30% of birth mothers and 33% of non-birth mothers reported the child was closer to the birth mother. In donor IVF families, 37% of birth mothers and 43% of non-birth mothers reported the child was closer to the birth mother. These differences were not statistically significant.

• Most mothers in both groups reported no jealousy toward their partner regarding the child. Roughly one-third reported a little jealousy, and fewer than 10% reported considerable jealousy. Rates did not differ significantly between family types.

• Feeding arrangements were similar across both groups: approximately 40% of birth mothers in both family types breastfed exclusively, while the majority used a combination of breast and bottle feeding.

Limitations: All families were recruited through a single clinic (London Women's Clinic), limiting generalizability. Because the study began when shared biological motherhood was newly available in the UK, only a small number of eligible families existed, limiting recruitment. The wide age range of children (infancy to age 8) made it difficult to control for developmental stage, which can substantially affect how parents experience the relationship. The study measures parental representations of the relationship rather than directly observed parent–child interaction or child-reported experiences. No information is provided about whether children had been told about their conception or the type of donor used (known, anonymous, identity-release). The study’s framing centers on whether shared biological motherhood improves upon donor IVF by offering more “equal” biological connection. This framing implicitly positions biological connection as a goal worth pursuing and may subtly reinforce the idea that non-genetic parenting is a deficit to be compensated for, even while the findings show no differences.

Applications: This study found no differences in mothers' feelings toward their children based on whether shared biological motherhood or donor IVF was used, suggesting that couples can make decisions based on practical, medical, and personal factors. This study offers preliminary reassurance that worries about the non-birth or non-genetic mother feeling left out did not, on average, materialize, though individual variation will surfaces.

Funding Source: Economic and Social Research Council (ESRC), grant number ES/S001611/1

Lead Author: Susan Golombok is Professor Emerita of Family Research and former Director of the Centre for Family Research at the University of Cambridge, where she conducted longitudinal research on the psychological wellbeing of children in lesbian-mother families, gay-father families, and families formed by assisted reproductive technologies including IVF, egg donation, sperm donation, and surrogacy.

Regulatory Context

• In the United Kingdom, the Human Fertilisation and Embryology Authority (HFEA) is the independent regulator overseeing fertility treatment and research involving human embryos.

• Shared biological motherhood (reciprocal IVF / co-IVF) is legal and regulated in the UK. Under the Human Fertilisation and Embryology Act 1990 (as amended in 2008), both female partners in a same-sex couple can be recognized as legal parents of a child born through licensed fertility treatment, provided both consent. The non-birth mother is recognized as the “second legal parent.” Same-sex female couples have had access to licensed fertility treatment in the UK for many years.

• In 2005, the UK changed its law regulating gamete donation from anonymous to identifiable donation. As of October 2023, donor-conceived people conceived on or after April 1, 2005 can access identifying information about their donor at age 18. Children conceived before the 2005 law change do not have the same legal right to identifying information, though a voluntary register (the Donor Conceived Register) exists for pre-2005 donors and donor-conceived individuals who wish to connect.

Related Posts

• Navigating complex biological connections through reciprocal IVF (Bower-Brown, 2024)

• Study reveals complex motivations behind two-mother family formation (Shaw, 2023)

• Study reveals how medical practitioners’ conceptual frameworks restrict access to donor treatments (Lindgren, 2025)

Geographic Region: Denmark

Research Question: How do men experience being rejected as a sperm donor, how do they cope with the rejection and any new health or genetic information they receive, and how do they integrate that information into their lives over time?

Study Design: Semi-structured in-depth interviews conducted between April and September 2024, approximately 5 to 12 months after participants’ rejections. The interview topics included motivations for applying, the application process, the rejection experience and emotional reactions, coping strategies, and reflections in hindsight. Participants were encouraged to raise any topics they considered relevant.

Sample: 19 men rejected as sperm donors by Cryos International in Denmark. Of 3,031 applicants in the one-year recruitment window, 188 who met inclusion criteria were invited by email; 24 responded and agreed to participate; 5 could not be reached, yielding a final sample of 19. Inclusion criteria required applicants to have been rejected in Denmark within the prior year, to have consented to being contacted, and to have available contact information. The researchers intentionally sought variation by age, parental status, reason for rejection, and time since rejection. The sample had a mean age of 28 years. Ten participants had a partner. Four had children of their own. Twelve were students; six held a master’s degree. All 19 participants identified as Danish; no participants of other ethnicities were included. Reasons for rejection included reduced sperm quality (n=6), physical illness (n=5), genetic predisposition to disease (n=4), mental illness (n=2), and lack of information about family medical history (n=2). Mean time since rejection was 8 months (range: 5–12 months).

Key Findings

• Most participants cited altruism as their primary motivation for applying, specifically the hope of helping others fulfill their dream of having a child. Many of these men had personal proximity to infertility through their own experiences, fertility treatment, being donor-conceived themselves, or seeing friends struggle to conceive.

• Nine of the 19 men identified passing on their genes as a significant motivating factor. Some had resigned themselves to not having children of their own (due to age or lack of a partner) and saw sperm donation as a way to achieve a genetic legacy. Others simply expressed curiosity about the potential for future contact with any offspring. One participant expressed a sense of personal and social duty to preserve his red hair ‘minority genes.’

• For 5 of the 19 men, the content of the rejection, specifically new medical or genetic information received during screening, caused significant concern. These concerns focused on their own health, their fertility, and the potential impact on their existing or future children. For these men, the health information overshadowed the rejection itself as a source of distress.

• For the remaining 14 men, the rejection itself, rather than the reason for it, was what hit hardest. Many had already begun to see themselves as donors and described feeling that a part of their emerging identity had been taken from them. Ten men described strong disappointment; four expressed disbelief; six described the rejection as a sense of defeat and feeling ‘not good enough.’ For some, the rejection felt like a blow to their masculinity.

• One participant expressed relief at being rejected, describing feeling depersonalized during the application process.

• In general, participants reported being satisfied with the information they received during the application process and at the point of rejection.

• For 14 of the 19 men, the emotional impact of rejection faded within days to weeks. By the time of the interview (5–12 months post-rejection), the experience was no longer playing a significant role in their lives.

• For the 5 men who had received worrying health or genetic information, residual concerns still surfaced in certain situations (e.g., when discussing family plans with a partner), but had not become a persistent source of distress.

• The researchers identified five coping strategies used by participants:

  • (1) Information seeking - two men (both fathers, both rejected for genetic predispositions) actively sought more detailed information about their conditions through medical contacts or online, which helped reduce anxiety once they learned the risks to their children were low;

  • (2) Actionable reasoning - three men attributed the cause of rejection to modifiable lifestyle factors (e.g., diet, smoking, alcohol), framing it as something within their control and therefore not a real problem;

  • (3) Positive reframing - eight men refocused attention on positive aspects of their lives or on other favorable information gained during screening (e.g., being told their sperm quality was good in other respects);

  • (4) Normalizing - seven men reduced feelings of failure by contextualizing the rejection as common (noting that only ~10% of applicants are accepted);

  • (5) Postponing - two younger men chose to mentally set aside concerns about fertility or health, treating the new information as relevant only to a future life stage.

Limitations: The study was conducted entirely within a single commercial sperm bank (Cryos International) in Denmark. Denmark has a distinctive, commercially developed relationship with sperm donation. The sample is ethnically homogeneous. This may reflect the demographics of Cryos's applicant pool rather than a sampling gap. Given Cryos's international recruitment and global distribution model, questions about who applies, who is accepted, and who is rejected along ethnic and racial lines are relevant but unaddressed by this study. The response rate was low: 24 of 188 eligible participants responded, yielding a final sample of 19. People still in acute distress months after rejection may have been less likely to participate, meaning the sample likely over-represents men who had already processed their experience. The finding that most participants resolved their distress within weeks should be interpreted with this selection effect in mind. Social desirability bias is a particular concern here given researcher positionality. Participants were speaking, in effect, with a researcher affiliated with the institution that had rejected them. Thematic saturation was not discussed.

Applications: Sperm banks and clinics could consider developing structured support pathways for rejected applicants, particularly those who receive unexpected health or genetic information to meaningfully reduce harm for this group.

Funding Source: Cryos International Sperm & Egg Bank

Lead Author: Lina Thirup is a researcher with a master’s degree in Public Health who was employed by Cryos International Sperm & Egg Bank; she is listed as a former Cryos employee in the paper’s competing interests statement. No personal connection to donor conception was disclosed.

Regulatory Context

• Denmark permits both anonymous and identity-release (non-anonymous) sperm donation. Prior to 2007, only anonymous donation was permitted. Since 2007, donors may choose either status. Donor-conceived individuals using non-anonymous donors can access the donor’s identity at age 18.

• Denmark is home to a large, commercially developed sperm banking industry, including Cryos International, which recruits donors internationally and distributes to over 100 countries.

• Lesbian couples and single women gained access to fertility treatment in Denmark in 2006.

• Denmark has no legally mandated cap on donor compensation, distinguishing it from countries like the UK, Australia, and Canada, where only altruistic donation is permitted. This makes Denmark an important international supplier of donor sperm.

• Donors at Cryos may choose to be identity-release (ID Release) or non-identity-release, and donor-conceived individuals conceived using ID Release donors may access identifying donor information at age 18.

Related Posts

• The emotional impact of sperm donor rejection (Pennings, 2024)

• Identity-release donors more likely to be accepted than anonymous donors in international screening study (Pacey, 2023)

• Two-thirds of withdrawn sperm donor candidates believe sperm banks could not have prevented their decision to quit (Pennings, 2025)

Geographic Region: United Kingdom

Research Question: Do young adults born through egg donation, sperm donation, or surrogacy show greater psychological problems or poorer relationships with their mothers than young adults born through unassisted conception, and does the age at which children were told about their biological origins predict the quality of those relationships and their psychological wellbeing at age 20?

Design: Seventh phase of a prospective longitudinal cohort study that followed the same families from infancy (ages 1 and 2) through early childhood (age 3), middle childhood (age 7), later childhood (age 10), adolescence (age 14), and early adulthood (age 20). The study design allowed researchers to examine how family functioning and child adjustment changed over nearly two decades. Data collection for Phase 7 took place online due to COVID-19 restrictions. Mothers completed standardized questionnaires and were interviewed using an adapted semi-structured interview assessing the quality of the mother-child relationship. Young adults completed separate questionnaires.

• Maternal wellbeing was measured using the Trait Anxiety Inventory (TAI), the Edinburgh Depression Scale (EDS), and the Golombok Rust Inventory of Marital State (GRIMS).

• Family relationship quality was assessed using a structured interview coded by trained researchers, the Parental Acceptance Rejection Questionnaire (PARQ), the Index of Family Relationships (IFR), and the communication subscale of the Family Assessment Measure (FAM).

• Young adult psychological adjustment was measured using the Strengths and Difficulties Questionnaire (SDQ) - completed by both mothers and young adults, the Flourishing Scale, and a psychiatrist’s blind ratings of psychiatric disorder severity from interview transcripts.

Sample: Phase 7 included 117 mothers (average age 56) and their 20-year-old children (61 female, 56 male). The sample included 22 surrogacy families, 17 egg donation families, 26 sperm donation families, and 52 unassisted conception families (comparison group). All families had two heterosexual parents at the start of the study. Donor type varied: almost all sperm donation families used anonymous donors, as did most egg donation families (the study began before identity-release donation was common in the UK). Surrogacy families all knew their surrogates.

• Of the 117 mothers eligible to participate, 91 (78%) completed questionnaires. Fewer than half of the mothers held a university degree (41%), and only 4% (n=5) identified as belonging to an ethnic minority group.

• For the young adults, only those who were aware of their method of conception, plus those born through unassisted conception, were eligible to participate (n=98). Of these, 76 young adults (78%) took part in interviews (15 surrogacy, 11 egg donation, 9 sperm donation, 41 unassisted conception). Most self-identified as White British (91%).

• The Phase 7 sample represents 83% of families who participated in Phase 6 (age 14). Families who dropped out between Phases 6 and 7 were marginally less likely to have disclosed their child’s conception origins by age 14.

Key Findings

• Mothers in egg donation, sperm donation, and surrogacy families were doing just as well emotionally as mothers in families where conception happened without medical assistance. Researchers found no differences between the four groups in anxiety, depression, or relationship quality with their partners.

• Mothers across all four family types were parenting in similar ways, showing similar levels of warmth and closeness with their 20-year-old children, and similar levels of conflict.

• Mothers in all groups felt similarly accepted and close to their adult children, and reported similar levels of openness and ease of communication within their families. The 20-year-olds themselves reported similar perceptions of how accepted they felt by their mothers, how close their family relationships were, and how freely they could communicate within their families, regardless of how they were conceived.

• The 20-year-olds in all four groups showed similar levels of psychological wellbeing and were doing well overall. Both mothers’ assessments and the young adults’ own reports placed the group’s average wellbeing scores comfortably within the normal range, comparable to national norms for young people of the same age. An independent child psychiatrist who reviewed interview transcripts (without knowing which family type was which) found no meaningful differences between groups in the severity of psychological difficulties.

• Egg donation mothers reported their family relationships as somewhat less positive than sperm donation mothers did. This difference was statistically significant, and it replicates a finding from the same families when the children were 14. The researchers suggest this may reflect the additional emotional weight that some mothers carry when they have no genetic connection to their child, a challenge that appears more pronounced for mothers than for fathers in this context.

• Twenty-year-olds conceived by sperm donation reported that communication within their families felt less open than those conceived by egg donation reported. The researchers link this to the historically higher rates of secrecy around sperm donation compared to egg donation. Fathers who used donor sperm have tended to be less willing to disclose, and less comfortable talking about it even after disclosing, than mothers who used donor eggs.

• Of the 65 donor conception and surrogacy families in the study, 37 had told their child about their origins before age 7 and 11 had told their child after age 7. Seventeen families (almost all of them sperm donation families) had still not told their child by the time they turned 20.

• Mothers who told their child before age 7 were less anxious and less depressed at the age-20 follow-up than mothers who waited until after age 7. The finding was statistically significant.

• Mothers who told their child before age 7 also showed less conflict and negativity in their parenting at age 20 than mothers who disclosed later. The finding was statistically significant.

• Several other measures of family health, including how accepted children felt by their mothers, overall family closeness, and how openly families communicated, showed the same pattern, with families who disclosed earlier faring better. These differences did not reach statistical significance.

• The 20-year-olds who had been told about their origins before age 7 tended to report better wellbeing, more positive family communication, and greater life satisfaction than those told later, though again, these differences did not reach statistical significance on their own.

Limitations: The overall sample size was small, which limited statistical power, particularly for comparisons between the smaller subgroups (egg donation, sperm donation, surrogacy families) and between disclosing and non-disclosing families. Families who dropped out of the study in the preschool years often did so because they were concerned about participation affecting their decision to keep their child’s origins secret, meaning the sample is biased toward disclosing or more open families. The sample is homogeneous in race, ethnicity, and family structure. Seventeen families (26% of assisted reproduction families, almost entirely sperm donation families) had not disclosed their child’s conception origins by age 20. These families could not participate in the young adult data collection on ethical grounds, but their exclusion means the study captures almost nothing about the experiences of young adults who remain unaware of their donor conception origins. Disclosure timing is described as before or after age 7, but disclosure is not a single event. The nature of disclosure conversations, if/how families continued to discuss origins over time, and children’s individual reactions are not captured. The study began before widespread use of DNA ancestry testing, a contextual change that may affect both disclosure practices and outcomes in future cohorts.

Applications: This study provides reassuring evidence, drawn from 20 years of follow-up, that children born through donor conception and surrogacy are not at greater risk for psychological problems or difficulties in family relationships simply because of the method of their conception. The consistent finding that earlier disclosure is associated with better outcomes for family relationships and maternal wellbeing adds to a growing evidence base supporting disclosure in early childhood, ideally before age 7.

Funding Source: Wellcome Trust Collaborative Award (Grant 208013/Z/17/Z)

Lead Author: Susan Golombok is Professor of Family Research and Director of the Centre for Family Research at the University of Cambridge, and a Professorial Fellow at Newnham College, Cambridge. She was a member of the Nuffield Council on Bioethics Working Party on Donor Conception (2012-2013).

Regulatory Context

• The Human Fertilisation and Embryology Authority (HFEA) is the independent regulatory body overseeing fertility treatment and research involving human embryos in the UK.

• In 2005, the UK changed its laws on gamete donation from anonymous to identifiable: all donors who donated from April 1, 2005, onward must be willing to be identified to donor-conceived offspring who request their information at age 18. However, the families in this longitudinal study were recruited around 1999-2000, when their children were infants, meaning virtually all donor conception in this sample predated the 2005 law change, and most donors were anonymous.

• Donor-conceived people conceived on or after April 1, 2005, can access identifying information about their donor, and can also request information about the identity of donor siblings who have expressed interest in contact, at age 18.

• Those conceived before the 2005 law change do not have the same legal right to identifying information. A voluntary register, the Donor Conceived Register (DCR), allows pre-2005 donors and donor-conceived people to register and potentially match, but participation is not mandatory.

• The UK does not legally require parents to disclose donor conception to their children. Disclosure is encouraged but remains a personal decision.

• Commercial gamete donation (payment beyond expenses) is prohibited in the UK; donation must be altruistic, with donors receiving compensation for expenses and inconvenience only.

• All licensed treatment must be carried out at HFEA-approved clinics. Informal or private arrangements for donor insemination are not regulated in the same way.

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• Study reveals nuances in how young DCP feel about their origins (Jadva, 2023)