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.

Related Posts

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

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

Menno Hofman decided to become a sperm donor during his final year of high school, two weeks before learning he was donor-conceived himself. At one relatively small Dutch clinic, he found at least two other donors who were also donor-conceived, raising questions research hasn't yet explored: What draws donor-conceived people toward becoming donors? In a guest post, Hofman argues that if we want to avoid harms of mass donation while meeting donor need, understanding donor-conceived donors could inform more thoughtful and ethical recruitment.

Research Recap

Maas et al (2026) interviewed 19 Dutch donor-conceived individuals about motivations and experiences seeking sperm donor information and contact. Curiosity ranged widely from minimal to deep preoccupation, with most interested in donor personality and medical history. The approaching age-16 access threshold heightened awareness even among those not previously curious. Many expressed stronger curiosity about donor siblings than donors, viewing them as potential social network extensions offering shared experience, though large numbers of unknown genetic relatives and possibility of inadvertent romantic encounters caused anxiety for some. Relationships with donors varied from single meetings to close ongoing bonds.

Volks et al. (2026) interviewed 12 Australian egg recipient parents, 12 South African egg donors, and 9 South African infertility counselors about expectations regarding donor anonymity in cross-border reproductive care. Australian recipients expressed discomfort with anonymous South African donations, believing children would want donor identity and anticipating eventual identification through direct-to-consumer genetic testing or online research. Donors understood donation as anonymous with no ongoing relationship, preferred anonymity, and received no counseling about future contact possibility, identification through genetic testing, or recipients in other countries holding different anonymity expectations. The mismatch between recipient expectations of future identification and donor expectations of permanent anonymity reveals gaps in cross-border implications counseling.

Goedeke et al. (2026) mapped psychosocial support and counseling services for donor-conceived people, parents, donors, and families across ten countries (Australia, New Zealand, Canada, USA, Belgium, Netherlands, UK, Germany, Ireland, Sweden). Pre-conception counseling is mandatory in five countries, offered but not required in two; only recommended in four. Post-conception support is rarely mandated. Netherlands provides government-funded counseling for identity release and donor-linking; Belgiam offers free unlimited support; some Australian states introduced free counseling. Peer support organizations exist but are volunteer-run, unfunded, and complement rather than replace professional support.

McCormick (2025) surveyed and interviewed 50 individuals forming 25 LGBTQ US couples about choosing between known versus unknown sperm donors. Overall 54% reported moderate-to-high decisional conflict; nearly half of couples were “discordant” with partners, reporting meaningfully different conflict levels. Trans and nonbinary participants (n=15) reported similar conflict levels. Some strongly disliked known donor suggestions (worried about masculine presence threatening their role as “real dad”), while others wanted known donors as “more queer” community-building.

Esmaeilivand et al. (2026) surveyed 171 Western Iranian infertility patients (117 women, 54 men) about attitudes toward oocyte donation. Participants showed generally positive attitudes toward egg donation overall with no gender differences in scores. They strongly favored anonymity between donors/recipients and children/donors. Higher male educational level was associated with stronger preference for donor-recipient anonymity. Support for disclosing egg donation use to future children was low, reflecting cultural concerns about lineage (nasab), social judgment, and family reputation, though female educational level showed modest positive association with disclosure-related attitudes.

Jacxsens et al. (2026) analyzed 23 publicly available first-person blogs written by egg providers (predominantly American). Bloggers shared highly personal accounts, motivated by desire to ensure others felt less alone and better informed than they had been. Blogs functioned as comprehensive practical guides covering hormone injections, egg retrieval, recovery, OHSS complications, using medical terminology with lay explanations. Despite sharing painful, frightening, sometimes traumatic experiences, bloggers consistently did not discourage donation, framing difficulties as things to prepare for rather than reasons to avoid, with painful experiences “worth it” for potential parental joy (only “not worth it” when compensation inadequate). Authors argue bloggers function as informal peer recruiters within framework of gendered altruism.

Drewniak et al. (2026) interviewed 20 adults conceived through anonymous sperm donation who found out ages 10-42 to build a three-phase identity framework. Identity Formation, or how and when individuals learn about donor conception shapes everything that follows, with late discovery consistently harder than planned conversations; participants understood parents’ secrecy given historical norms and stigma. In the second phase, Identity Exploration, nearly everyone wanted donor information (appearance, age, work, donation motivation, character) not father figures or ongoing contact. In Identity Integration, some reached places where donor conception became one story part rather than defining aspect, while major life events (becoming parent, new relationships, DNA testing) reopened questions even for those feeling settled; smaller group experienced finding out as ground-shaking requiring complete identity rebuilding.

Other Tidbits

• Erica Webb shares her story about finding out she and her sister are donor-conceived and from different donors. Donna Hall talks about meeting half siblings in her 40s.

• Ruby Liu examines the commodification of reproduction after repeatedly seeing Instagram ads offering $250,000 for Chinese egg donors meeting specific requirements.

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What happens when a donor-conceived person becomes a donor themselves? Our guest writer has lived on both sides of that experience and, in doing so, stumbled upon a question research hasn’t yet asked. The Netherlands has one of the more developed regulatory frameworks for donor conception in the world. They abolished anonymous donation in 2004, established a government-funded national registry, and allow donor-conceived people to access identifying donor information at age 16. Donors are expected to limit their contributions to no more than 12 families (previously 25), though enforcement has proven imperfect as high-profile cases of mass donation have made clear in recent years.

Dual Citizens: On Being Donor Conceived and Becoming a Donor

by Menno Hofman

During my final year of high school, donor conception came up briefly in Religious Education, one topic among many around sexuality. I thought about donor conception in an abstract way, convinced I knew nobody directly affected. A donor helps intended parents become parents, which I considered generous and in alignment with my progressive Christian faith. We are called to help those in need in many stories in the Bible. Donating sperm seemed like something similar. I also knew this would only be true if it would not harm others. So I imagined how I would feel if I were donor conceived. I thought I would be happy to be wanted and not particularly interested in the donor. But I also recognized that some donor-conceived people might feel differently, so I concluded it would be better, as a donor, to be open to contact. I decided then that I wanted to become a sperm donor.

That may sound like a premature plan, but I’ve always thought ahead. At the end of primary school, I chose my high school partly because it offered yoga in the third year, which I did. In my fourth year, I read loads about DNA and knew I wanted to study Biotechnology at Wageningen, which I did. I was fully aware that becoming an ID-release donor would be a lifelong commitment, and I talked openly with my mother and sister about my decision.

For my Dutch language exam, we had to discuss an article, and I chose one about the anticipated shortage of sperm donors caused by the transition to ID-release-only donation. Before I could discuss that article with my teacher, my mother called a family meeting. My sister, my aunt, and I gathered. I didn’t know what it was about, and my mother told us that my sister and I were donor conceived from an anonymous donor. I was stunned. It was heart-wrenching to see her cry. The weight of the long-kept secret and her fear of our reaction were visible all at once.

As it turned out, I had predicted my own reaction fairly well. I did feel positive about being donor conceived, and I was not drawn to find the donor. My donor contributed 50% of my DNA, but that doesn’t automatically translate into a relational connection. I’ve come to realize that the definitions of parenthood are many, and he doesn’t meet my personal criteria for what a father is. My interest in DNA has always been scientific, not relational. This is simply how I feel, though I found it surprisingly difficult to explain to others. Research has not yet determined why some donor-conceived people feel a longing to connect with their donor, and others don’t. In my case, I simply don’t feel that longing. My mother’s revelation did, however, plant the seed of my aversion to secrecy.

Three Donors, One Clinic

Between deciding I wanted to become a donor and finding out I was donor conceived myself: two weeks. I shared both my donor conception origins and my plans of wanting to become a sperm donor with the rest of my family. For me, being donor conceived was not a reason to change plans.

I did wonder whether it would be possible to become a donor without knowing my own donor’s identity. Since he had gone through screening himself, I had some indirect knowledge of his medical history — but would that be enough? When I returned to the article on donor shortages to prepare for my exam, I felt more certain than ever knowing I would help people like my own parents. So, after I turned 18 in 2000, I went to the AMC (now Amsterdam UMC) to begin the process.

During the screening, I told them I was donor conceived. They said it was fine — and that I was the first person with such a story ever to come to their clinic. I felt genuinely unique.

But I am not unique at all.

Since then, I’ve found at least two other donors at that same clinic who are also donor conceived, both through a Facebook group. Our stories share similarities, but one crucial difference stands out: when we each found out.

Ties van der Meer, chairman of Stichting Donorkind, a Dutch foundation for donor-conceived people, learned he was donor conceived as a child and later chose to become a sperm donor himself, following in the path of his genetic father. For him, being donor conceived was part of his motivation to donate.

I found out just after I had decided to donate, so when I came to the clinic, I could provide accurate health information, but my donor conception status played no role in my original decision.

A third person donated at the AMC during the era of anonymous donation and only discovered he was donor conceived when he did a DNA test to make himself findable to his own donor children. Because he hadn’t known, he had unwittingly given the clinic incomplete health information.

Three donors at one relatively small clinic in one small country. That strongly suggests I am not unusual. More must be out there. Some of them are still unaware they are donor conceived.

This matters, and not only in the abstract. When donor-conceived people don’t know their origins, they may provide inaccurate medical histories and incorrect ethnic backgrounds to clinics. Given the higher number of offspring per donor compared to natural conception, this increases consanguinity risk: a recipient could, for instance, be donor conceived from the same donor as the donor themselves. To manage this risk, it may sometimes be necessary for a donor-conceived donor to donate in a different region, or for clinics to exchange gametes across regions. These precautions are only possible when the donor knows their own origins. And ideally, they would know not just that they are donor conceived, but also the identity of their donor.

A Question Worth Studying

To allow meaningful contact between donor and donor conceived, and between half siblings, requires reasonable limits on the number of offspring per donor. To do so while continuing to treat the same number of patients, requires recruiting more donors. Donor-conceived people could play a role in this!

In my small clinic, at least three donors were also donor conceived. This makes me wonder: what is it that draws donor-conceived people toward becoming donors? And when they do, would they be more likely to be open about it with their families and more open to early contact? Would this be genetically determined? Or could it be that donor-conceived people are somehow raised differently, that families who used donor conception communicate values around altruism and gratitude in ways that orient children toward donation, even without full disclosure? We don’t yet know. The questions themselves are worth taking seriously and studying. Scientific research on the motivations of sperm and egg donors who are themselves donor conceived could help inform more thoughtful and ethical donor outreach.

If we want to avoid the harms of mass donation and still meet the need for donors, recruitment is of the utmost importance. At the same time, especially when donor-conceived people become donors themselves, it is important that this is done safely and ethically, ensuring that the number of genetically closely related people does not become too large, particularly within a specific region.

So no, I am not unique as a donor who is also donor conceived. And that provides opportunities. It also shows that donor conceived people do not remain children. After being conceived in a special way, we grow up and become adults, just like naturally conceived children. And when we do, some of us may need a donor to fulfill our own desire to have a child and some of us will become donors ourselves.

Paraphrasing My Own Profile

I did DNA ancestry testing to give the next generation — my donor children — information about their genetic grandfather (my donor) and the option to find me. I have since found a half-brother through MyHeritage, and together we identified our donor. When I read his profile and the way he describes being open to contact, while leaving the timing entirely up to the donor conceived, it was as if someone had paraphrased my own donor profile. It felt impossible that this was coincidence. But although it feels that way, it isn’t scientifically established. I’ve heard from several donors that they share this way of thinking. Perhaps there is something there — genetic, relational, or something we don’t yet have language for.

We exchanged brief messages through Fiom, which is a not-for-profit organization subsidized by the government to facilitate contact between donors and donor conceived. I still don’t feel a personal longing for deeper contact. And, despite the fact that most of my donor children are likely now over 16, none have initiated contact. If and when they do, I will welcome them with open arms. As an ID-release donor, I have prepared my family for future contact, including my children at home. Being open to contact is a moral commitment I made when I chose to donate as an ID-release donor, but it could also enrich my life as well!

Menno Hofman is a quality assurance specialist, regularly preaches in different churches, and has a special interest in donor conception. He is a genetic father through his donations, and he has his own three kids, with Levi being named after Dr. Levie, the doctor who helped his parents.

Geographic Region: Switzerland, Germany, and Austria

Research Question: How do adults who were conceived through anonymous sperm donation experience and integrate their donor-conceived status into their sense of identity across the life course?

Design: Qualitative, theory-building study using semi-structured interviews. Interviews were conducted between January and July 2022, either in person (at participants’ homes or in public spaces) or via video call. An interview guide was developed by the research team and refined through a citizen science workshop and a pre-fieldwork workshop involving people with lived experience of infertility, same-sex families, and sperm donation. The guide covered: biographical background; family dynamics and communication about conception; social and genetic origins; how and when participants learned about their conception; emotional responses to disclosure; interactions with donors; and relationships with same-donor siblings. The researchers analyzed transcripts in four stages: open coding, team review and refinement, pattern identification, and finally synthesizing everything into a broader theoretical framework cross-checked against adoption research and other relevant studies.

Sample: Twenty adults conceived through anonymous sperm donation participated, from Switzerland (9), Germany (10), and Austria (1). They were between 25 and 49 years old (average 37.5). Fifteen identified as female, four as male, and one as gender-diverse. All were raised by heterosexual parents; nearly half (7) had experienced parental divorce or separation. The sample included some sibling pairs and one set of twins. Participants found out about their conception anywhere from age 10 to 42. Most learned later in life — only six found out between ages 10 and 15, while the majority learned as adults. At the time of the interview, 14 had not yet met their donor; six had. How they found out varied considerably: six learned through consumer DNA testing, five through a deliberate parental disclosure, three through medical or genetic circumstances, two following their father’s death, and the rest through a range of other situations. Participants were recruited through online forums, social media, interest groups, and personal referrals.

Key Findings

The study’s main contribution is a proposed framework for understanding how donor-conceived adults make sense of their identity over time.

The Theoretical Framework

• The framework organizes identity development across three phases.

  • Identity Formation (Childhood): When the individual finds out about their donor conception, and the circumstances under which they find out, shape everything that follows. This is where the groundwork is laid. The individual begins to develop a sense of self. How open the family is shapes how the individual first makes sense of their origins.

  • Identity Exploration (Adolescence): Active exploration begins. Curiosity about the donor and same-donor siblings intensifies, personal narratives about being donor-conceived start to form, and peers and social contacts play a growing role.

  • Identity Integration (Adulthood): People work to integrate what they know into a coherent sense of self, a process that can be revisited repeatedly as life circumstances change.

• The framework is grounded in Grotevant and colleagues’ theory of adoptive identity formation, which describes identity as a dynamic, ongoing process shaped by three interacting forces: psychological factors (experiences of rupture or disruption in one’s life story); sociological factors (shifts in how kinship and family are understood); and biological factors (the absence of knowledge about genetic origins). The authors adapt this theory to donor conception, where the genetic link to one parent, the possibility of same-donor siblings, and the growing role of at-home DNA testing all add dimensions that adoption research doesn’t fully account for.

• The authors identify three dimensions that shape identity throughout life: the social dimension (the family someone grows up in, regardless of genetic ties); the genetic dimension (questions about biological origins, the donor, and same-donor siblings); and the personal narrative dimension (the ongoing process of building a life story that makes sense of all of this).

• How people experience being donor-conceived varies considerably. Some people integrated it without major upheaval; others were deeply and lastingly affected, particularly when they found out late or in unexpected circumstances. The study frames this as a spectrum, not a hierarchy.

• Factors that shape someone’s donor-conceived identity include: when and how they found out; how open their family was; how much access they have to information about their donor; the legal and cultural context they grew up in; and increasingly, whether and how DNA testing has entered their life.

• Being donor-conceived does not produce a single, predictable experience. The same person may find it central to their sense of self at one point in life and largely irrelevant at another. The framework treats identity as something that shifts over time rather than something that gets resolved once and stays that way.

Identity Formation (“Childhood”)

• How participants learned about their donor conception varied widely. Six found out through at-home DNA testing, either their own or a family member’s. Five were told through a deliberate parental decision. Three found out through a medical or genetic event. Two found out after their father died. Others learned through a parent’s remarriage, a difficult relationship with their social father, a therapist’s recommendation to the mother, or a disclosure by a third party. Only five described something that might be called a planned, parent-led disclosure.

• Finding out late, especially through DNA testing, a parent’s death, or another crisis, was consistently harder than finding out earlier through a planned conversation. Participants who found out this way often described the experience as destabilizing in a way that went beyond the information itself: suddenly feeling like a stranger to their own life, or like half of what they thought they knew about themselves was no longer true. Several described the days and weeks after as some of the hardest of their lives.

• Several participants described their parents treating their doctors’ medical advice about disclosure almost as a vow, something they felt bound to keep for decades. The impact of that advice is visible throughout the study: it shaped when and how people found out, and the conditions under which they did.

• Participants generally understood their parents’ choices in the context of the time, a period when secrecy around donor conception was the norm, infertility (especially male infertility) carried significant social stigma, and the idea that a secret could be kept forever was not unreasonable. Most expressed some generosity toward their parents while still being clear about the harm the secrecy caused.

• Family warmth and stability made a meaningful difference. When relationships at home were close and secure, finding out—even late—was something people could work through without the family relationship itself being called into question. When the relationship with the social father had been strained or distant, the news often landed harder, and some participants connected those earlier difficulties to questions about genetic relatedness.

Identity Exploration (“Adolescence”)

• Nearly everyone in the study wanted to know something about their donor. Most were looking for information, not a father figure or hoping for ongoing contact. What they wanted to know was basic: what did he look like, how old was he, what did he do for work, why did he donate? And underneath those questions, for many: was he a good person? Several participants described anxiety not about the absence of the donor but about what kind of person he might be.

• For participants who hadn’t identified their donor, one way of managing that uncertainty was to imagine him. One participant described painting a picture of the donor at age 15, naming him, and writing down what she imagined his traits to be—not because she wanted a relationship, but because having a concrete image of him, even an invented one, helped her feel less unsettled.

• For those who did identify their donor, the process often felt like something that came to a natural close once they had a photo or a few basic details. The curiosity was satisfied by less than many might expect. Where meetings happened, they were often described as meaningful, but without the expectation of anything ongoing.

• Same-donor siblings played a different role than donors did. When the donor was unknown or unreachable, same-donor siblings offered something the donor couldn’t: a real person who shared part of your genetic background and could be known. Participants described looking to same-donor siblings for clues about what the donor might have been like, and sometimes for a sense of what traits or abilities might have come from that side of their origins.

• What these donor sibling relationships meant varied considerably. Some participants described them as carrying a sense of shared fate—something that felt like genuine kinship. Others described brief connections that didn’t develop into ongoing relationships. For most, it was too early to know what these connections would become.

• DNA testing revealed same-donor sibling networks that were often much larger than participants had anticipated. People reported knowing between 0 and 14 confirmed same-donor siblings at the time of their interview, with many uncertain about the real total.

Identity Integration (“Adulthood”)

• Some participants reached a place where donor conception had become one part of their story rather than the defining part. Other aspects of life, like being a parent, a partner, a professional, moved to the center, and being donor-conceived moved to the background. This part of their identity found its place alongside everything else. One participant described it this way: “I am no longer primarily a donor child, I can now primarily be the father of my children.”

• For others, the process was ongoing and not straightforward. Major life events, like becoming a parent, entering a new relationship, and encountering DNA testing, brought questions back up even for people who had felt settled.

• A smaller group experienced finding out as something that shook the ground beneath them. These participants described having to rebuild a sense of who they were from the ground up, sometimes accompanied by real psychological distress. One described it as “a nuclear bomb,” the sense of being literally a different person, with parents who had lied for an entire lifetime. Another described feeling like “science fiction,” someone who, given the particular circumstances of how her gametes came together, felt she shouldn’t exist in the way she does.

• DNA testing also sometimes revealed that a sibling raised in the same home (someone they had grown up thinking of as a full sibling) was actually a half-sibling through the same donor. In nearly every case, this made no difference to the relationship.

• DNA testing continued to reshape things even for people who had felt they’d worked through it. Finding new genetic relatives, or having information arrive unexpectedly, reopened questions for people who thought they were settled.

Cross-Cutting Findings

• Participants consistently noted that discussions of donor conception in public, in research, and in media disproportionately feature people who struggle. Several pointed out the absence of voices from donor-conceived people who feel neutral, positive, or simply unaffected and expressed concern that this skew creates a distorted picture of donor-conceived experience.

• The study found that what matters to donor-conceived people is not uniformly about genetics. Most participants were not seeking a substitute father figure, even when relationships with social fathers were difficult. The desire was primarily for information—traits, medical history, basic facts—not for a parental relationship with the donor.

Limitations: As a qualitative, exploratory study, findings cannot be generalized or used to make claims about the frequency or distribution of different identity experiences among donor-conceived people. The study cannot tell us how common any given response is. Recruitment through support networks and online communities may overrepresent people who are more engaged, more critical of secrecy, or more motivated to share their experiences. The entire sample was conceived under conditions of legally mandated anonymity and most discovered their donor-conceived status in adulthood, often under crisis conditions (DTCGT, a parent’s death, a parent’s remarriage). The framework developed here may not apply—or may apply very differently—to people conceived under open-identity regimes, disclosed to in early childhood, or who grew up in families where openness was the norm from the beginning. The all-heterosexual-parent sample is a significant limitation, as single parents and same-sex couples are major recipients of donor sperm and tend to have very different disclosure practices and family communication patterns. The framework cannot be assumed to apply the same way to these populations.

Applications: The framework validates that the experience of identity disruption after late disclosure is not pathological but a predictable response to a significant autobiographical revision. Clinicians should avoid assuming that all adult donor-conceived clients need to work through their genetic origins. The study’s own data show substantial variation. Some people find donor conception genuinely unimportant; forcing or implying that genetic exploration is necessary for wellbeing may be harmful. Future research should test this framework with populations that do not resemble this sample: people disclosed to in early childhood, people raised by same-sex or single parents, people with access to open-identity donors, and people from non-Western contexts where donor conception carries very different social meanings.

Funding Source: University Research Priority Program “Human Reproduction Reloaded” (URPP H2R) at the University of Zurich

Lead Author: Daniel Drewniak is a research fellow and post-doctoral researcher at the Institute of Biomedical Ethics and History of Medicine at the University of Zurich, where he is also affiliated with the URPP Human Reproduction Reloaded (H2R) program; his research focuses on empirical bioethics, medical decision-making, and qualitative research methods, with current work on reproductive care services from the perspectives of patients, clinicians, and researchers.

Regulatory Context

Switzerland

• Switzerland ended anonymous sperm donation in 2001 under the Federal Act on Medically Assisted Reproduction. Donor-conceived individuals have the right to access identifying information about their sperm donor at age 18, or earlier upon application if they can demonstrate good reasons.

• A national donor registry is maintained by the Federal Office of Civil Status. Egg donation remains illegal in Switzerland.

Germany

• Germany passed the Sperm Donor Registry Act in 2018, which requires that the identity of sperm donors be registered in a central national registry and made available to donor-conceived individuals upon request. The Act applies prospectively and does not cover donations made before 2018.

• Oocyte (egg) donation remains prohibited in Germany. Embryo donation has a legally ambiguous status.

• Prior to 2018, donor anonymity was standard practice and parents were routinely advised not to disclose donor conception to their children—a practice documented directly by participants in this study.

• German court rulings since 2013 have established that donor-conceived people have the legal right to know the identity of their donor, independent of age.

Austria

• Austria ended anonymous sperm donation in 1992 under the Reproductive Medicine Act (FMedG). Donor-conceived individuals have the right to access donor identity information at age 14.

• Egg donation became legal in Austria in 2015 with strict conditions, including the requirement that donors be identifiable.

Related Posts

• Survey of 422 donor-conceived adults reveals impacts of timing and intentionality of disclosure (Applegarth, 2025)

• How French donor-conceived adults experience learning about their origins (Martin, 2026)

Geographic Region: Primarily United States

Research Question: What do egg providers discuss and share in their online blogs, and how do they describe their day-to-day experiences with egg donation?

Design: Qualitative study using reflexive thematic analysis of publicly available online blogs. The researchers conducted a systematic online search in August 2021 and in September 2023 using Google and Yahoo. They deliberately mimicked the search strategy of a non-expert prospective egg donor. Search terms combined keywords such as “egg donor,” “egg donation,” “oocyte donor,” and “oocyte donation” with “blog,” “story,” and “experience.” Results were explored up to the tenth page. The researchers adopted a broad definition of “blog” to include any text written by an egg provider about her experience with egg donation, across any platform, including personal websites, online magazines, Twitter, and Reddit. Vlogs and videos were excluded; the study focused only on written text. Blogs hosted on fertility clinic or agency websites were excluded to avoid commercial influence. Blogs that covered only social or legal dimensions without addressing the physical or medical experience were also excluded. The reflexive thematic analysis framework was explicitly feminist, and all three authors declared a feminist standpoint.

Sample: 23 first-person account blogs written by egg providers/donors. The bloggers were not recruited as research participants; their publicly available written content served as the data. Of the 25 blogs initially identified as meeting inclusion criteria, two were excluded—one because a blogger opted out, and one because a publication’s copyright required consent the researchers could not obtain. The blogs varied considerably in form: 10 were written over extended periods with multiple posts; 9 were published as articles in online magazines (including Vice, The Guardian, The Atlantic, Allure, Goodhousekeeping, and others); 6 came from the We Are Egg Donors website; and others appeared as a Twitter thread or a Reddit post. The majority of bloggers appear to have been American, though the search imposed no geographic restriction. No demographic data such as age, race, or socioeconomic status were systematically collected, as these were often not disclosed in the blogs.

Editor’s Note: The study's analytic focus on the physical, medical, and informational dimensions of egg donation meant that psychosocial dimensions of the donor experience were largely outside its scope. The blogs were not analyzed for content related to how providers navigated disclosure to family, friends, or partners, their attitudes toward future contact with donor-conceived people, their understanding of or feelings about the children born from their donations, or their sense of ongoing donor identity over time.

Key Findings

This study identified four major themes organizing bloggers’ experiences and behaviors, which the researchers organized using the metaphor of a “journey.”

Theme 1: Intimate Journeys Into the Digital Public Landscape

• Bloggers shared highly personal accounts that blurred the boundaries between private experience and public space. They wrote candidly about physical symptoms (vomiting, bloating, sexual discomfort during stimulation, vaginal examinations), emotional experiences (fear, crying, anxiety), and life circumstances (divorce, religious faith, body image concerns).

• Bloggers’ stated motivations for sharing included a desire to ensure that others would feel less alone and would be better informed than they had been. Many said they had searched online for experiential accounts before donating and found nothing adequate, so they created what they wished had existed.

• Bloggers addressed their audiences directly, invited questions, and engaged with readers in ways that created a sense of community between egg providers.

Theme 2: The Lonely Donation Planet—A Guide for a Solitary Voyage

• The blogs functioned as comprehensive, practical guides covering every stage of the egg donation process: hormone injections (sensations, timing, side effects), the egg retrieval procedure, recovery, and specific complications such as ovarian hyperstimulation syndrome (OHSS).

• Bloggers regularly used medical terminology (drug names, dosages, hormonal processes) and often explained that terminology for lay readers. Some explicitly stated their intent to be educational.

• Practical advice was frequently offered: how to manage injections, how to communicate with a partner, tips for managing OHSS symptoms (hydration, soy sauce).

Theme 3: Online Travel Guides Emerging as Solicitation Tools

• Despite sharing painful, frightening, and sometimes traumatic experiences, the bloggers consistently did not discourage readers from donating. Most explicitly stated that their intent was not to deter others.

• Difficult experiences were framed as things to be informed about and prepared for, not as reasons to avoid donation. Bloggers encouraged readers to “know the precautions” and advocate for themselves, and reassured them that challenges were manageable.

• Many bloggers framed painful experiences as “worth it” because of the potential joy it could bring to intended parents. Even bloggers who described terrible experiences often focused on a positive outcome (the possibility of pregnancy for an infertile couple) as the overriding justification.

• The only time the experience was described as “not worth it” was in relation to financial compensation. Some bloggers concluded that payment was not adequate for the physical and emotional investment required, particularly if financial gain was someone’s sole motivation.

• Several bloggers took on roles functionally similar to professional recruiters: one explicitly encouraged readers to contact her to learn about her agency; another eventually took a paid role as “egg donor support” at her agency; a third began working at a fertility clinic answering questions, comparing that job directly to her blogging.

Theme 4: Repeat Tourism

• Nine of the 23 bloggers donated more than once, all anonymously. For most who donated repeatedly, the decision to donate again was described as automatic or self-evident; they rarely articulated a deliberate decision-making process. For them, continued donation appeared to be a default choice.

• By contrast, decisions not to donate again were described at length, with detailed justifications, emotional processing, and sometimes apparent self-persuasion. Common reasons for stopping included physical and mental exhaustion, described by one blogger as “burnout.”

• A striking pattern emerged: some bloggers felt guilt or a sense of “moral obligation” toward intended parents even when their bodies or minds were telling them to stop.

Analytical Conclusion: Bloggers as Potential Peer Recruiters and the Question of Complicity

• The authors argue that bloggers functioned not just as information-sharers but as informal peer recruiters. The authors argue that this recruitment function operated within a framework of gendered altruism, the culturally enforced expectation that women will be selfless, emotionally invested in others’ reproductive outcomes, and willing to make personal sacrifices in service of those outcomes.

• The authors raise the question of complicity: whether bloggers who continue to encourage donation despite their own difficult experiences may be inadvertently reinforcing gendered norms that place others’ reproductive desires above providers’ own wellbeing and bodily autonomy. They note that this complicity, if present, would likely be unintentional.

Limitations: Bloggers motivated to promote donation may also donate more frequently, which could inflate the apparent prevalence of repeat donation in the sample and make continued donation appear more “default” than it actually is across the broader population. The dataset was homogeneous: predominantly American, with little variation in sexual identity and limited demographic diversity overall. Findings may not translate to altruistic donation contexts (like the UK or Australia) or to countries where donation is illegal or highly restricted.

Applications: Egg provider blogs can be a valuable source of embodied, practical information that clinical sources often omit, including minor but common side effects, emotional challenges, and the reality of recovery. Prospective donors who seek out these blogs may come away better prepared for the physical and logistical demands of donation than those who rely only on clinic materials. Clinics should develop more honest, complete, and experience-informed consent and information materials. Mental health professionals working with egg providers should be alert to dynamics in which a client’s sense of responsibility toward intended parents is overriding their own self-care.

Funding Source: Special Research Fund (Bijzonder Onderzoeksfonds, BOF) of Ghent University (reference: BOFSTG2020000901).

Lead Author: Lara Jacxsens is a PhD researcher in the Department of Philosophy and Moral Sciences at the Bioethics Institute Ghent, Ghent University, where she has been conducting doctoral research since 2019 focused on the ethical aspects of egg donation, particularly informed consent and information provision. No personal connection to egg donation or donor conception was disclosed.

Regulatory Context: Egg donation regulations and guidelines vary by jurisdiction. Because the majority of bloggers in this study appear to have been American egg providers donating through commercial agencies, the US regulatory context is most relevant.

• There are no comprehensive federal laws governing gamete donation in the US. The process is largely self-regulated by the fertility industry. The Food and Drug Administration (FDA) oversees donor screening for infectious diseases but does not regulate compensation, limits, anonymity, or information requirements.

• The American Society for Reproductive Medicine (ASRM) provides ethical guidelines, including recommendations on compensation and minimum donor age of 21, but these are not legally binding.

• There are no legal limits on donor compensation. A 2011 court ruling determined that price caps on compensation violate antitrust law.

• Anonymous donation is legal; there is no right to donor identity.

• Some states have enacted their own laws on assisted reproduction and parentage, but these vary widely and generally do not address donor information rights.

Related Posts

• Informed consent and coercion in recruitment advertisements for oocyte donors (Lake, 2024)

• Current egg donor counseling often prioritizes short-term preparation over long-term emotional resilience (Pote, 2025)

• Analysis of college newspaper ads shows how recruitment commodifies racial and intellectual traits (Hagan, 2025)

Geographic Region: Western Iran (Kermanshah province)

Research Question: What are the attitudes of infertility patients in western Iran toward oocyte (egg) donation, and which sociodemographic characteristics predict those attitudes?

Study Design: Cross-sectional survey conducted between October 2023 and January 2024. Participants were recruited through consecutive sampling, meaning every eligible patient who came to the clinic during the study period was approached and invited to participate. Only one partner per couple was included, so all responses reflect individual rather than joint views. Attitudes toward egg donation were measured using a validated 52-item questionnaire developed specifically for use in the Iranian context. The questionnaire covers 12 domains including decision-making, donor and recipient characteristics, anonymity, disclosure, legal issues, and the parent-child relationship.

Sample: 171 infertility patients - 117 women (68%) and 54 men (32%) - attending a public infertility clinic in western Iran. The majority had more than a high school diploma (84%), and most had primary infertility (61%) rather than secondary infertility (39%). The most common infertility causes were female-factor (41%), both partners (34%), and male-factor (26%). About 36% of participants had previously used at least one assisted reproductive technology (ART) procedure, and 36% reported they had considered or actually used egg donation.

Key Findings

• Participants showed generally positive attitudes toward egg donation overall, with a mean total score well above the midpoint, suggesting overall acceptance of egg donation as a treatment option. There was no significant difference between men and women in overall attitude scores.

• Participants strongly favored anonymity between donors and recipients and between children and donors, with clear preferences for secrecy toward extended family and the broader community. Higher male educational level was significantly associated with stronger preference for donor-recipient anonymity.

• Support for disclosing the use of egg donation to the future child was low, reflecting cultural concerns about lineage (nasab), social judgment, and family reputation. Female educational level showed a modest positive association with disclosure-related attitudes, possibly reflecting women’s greater engagement with emotional and relational dimensions of family communication.

• Despite favoring secrecy, participants reported highly positive attitudes about the parent-child relationship and sense of belonging, indicating confidence that strong emotional bonds are possible regardless of genetic connection.

• Age, infertility type, infertility cause, and prior ART experience were not significantly associated with any attitude domain.

Limitations: No a priori power calculation was reported. The study is correlational, so no causal claims can be made. Self-report questionnaires may produce socially desirable responses, especially on sensitive topics like secrecy and disclosure. Religious and social norms in Iran may have led participants to underreport stigmatized attitudes.

Applications: In Iran’s legally anonymous system, donor-conceived people currently have no pathway to access donor information. The strong cultural preference for non-disclosure documented in this study means many donor-conceived people in this context are likely unaware of their origins. Advocates should understand the sociocultural context shaping non-disclosure in Iran even when they may not agree with it. Counselors working in or with populations from Muslim-majority countries should recognize that secrecy preferences reflect broader social pressures (concerns about lineage, marital stability, and community judgment) rather than simply individual psychological avoidance. At the same time, counselors have a professional obligation to help clients consider the long-term implications of non-disclosure for their children, including the possibility of inadvertent discovery through DNA testing.

Funding: Student Research Committee of Kermanshah University of Medical Sciences (Grant No. 4020594).

Lead Author: Masoumeh Esmaeilivand is a physician-researcher affiliated with the Clinical Research Development Center at Motazedi Hospital and the Department of Obstetrics and Gynecology at Kermanshah University of Medical Sciences in Kermanshah, Iran, where her research focuses on reproductive health, fertility, and assisted reproductive technologies. No personal connection to donor conception was disclosed.

Regulatory Context

• Iran is governed by Islamic jurisprudence (Sharia law), primarily Shi’a interpretations issued by religious scholars (fatwas). Unlike many Sunni-majority countries, Iran has developed a relatively permissive framework for some forms of assisted reproduction under specific conditions.

• Egg donation is legally and religiously permitted under Shi’a jurisprudence in Iran. The 2003 Act concerning Embryo Donation to Infertile Couples provides a legal framework, primarily for embryo donation, but egg donation has been accepted through religious rulings. Sperm donation remains more religiously contested.

• Donor anonymity is mandated under Iranian law. Fertility centers are required to keep donor and recipient identities confidential. There is no legal mechanism for donor-conceived individuals to access identifying information about their egg donors.

• Non-commercial donation is required; payment for gametes beyond basic expense reimbursement is prohibited, though the enforcement of this is not comprehensively documented.

• Access to ART, including egg donation, is primarily available to legally married heterosexual couples. Single individuals and LGBTQ+ people are not legally entitled to access donor-assisted reproduction in Iran.

• There is no centralized national registry tracking donation outcomes or offspring numbers per donor, which limits the monitoring of consanguinity risks and donor usage patterns.

• Cultural and social enforcement of secrecy is strong. Families are not legally required to disclose donor conception to their children, and there is a pervasive norm of keeping ART use private, including from extended family members and the donor-conceived child.

Related Posts

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

• Marital preservation, parenting concerns primary needs for oocyte recipients (Ghelich-Khani, 2025)

• Iranian study shows similar parenting styles in embryo donation and natural conception families (Kaveh, 2025)

Geographic Region: United States

Research Questions:

• How much decisional conflict do LGBTQ couples experience when choosing between a known versus unknown sperm donor?

• What do LGBTQ couples find most difficult about this decision, and what resources would help them?

• What role do emotion regulation skills, decision-making style, and relationship intimacy play in the decision-making process?

• Are there meaningful differences between cisgender couples and couples that include one or more transgender or nonbinary people?

Editor’s Note: This study uses the terms “known donor” and “unknown donor.” The American Society for Reproductive Medicine (ASRM) now prefers “directed donor” (or “identified donor”) and “nonidentified donor” respectively. DCJC uses the study’s original language in this summary to accurately represent the research, but readers should be aware that preferred terminology in clinical and professional settings is shifting.

Design: Mixed-methods needs assessment that combined an online survey with individual semi-structured interviews. Data collection occurred from November 2023 to June 2024. Online surveys measured how much uncertainty couples felt about their decision, how well they could manage their emotions, how close they felt to their partner, and what style they used when making decisions. After the surveys, each partner was interviewed separately to talk about their experience making this decision. The researcher analyzed the survey data using statistical methods that account for the fact that both people in a couple are connected to each other. The interview data was analyzed to find common themes and understand the deeper meaning of couples’ experiences.

Sample: 50 people forming 25 couples who identified as LGBTQ and were either currently deciding between a known and unknown sperm donor or had recently made this decision without yet having children. Everyone in the study had at least some college education, and most couples (68%) included one or two people with graduate degrees. All couples except one were from middle- or high-income backgrounds. Nine (36%) included one or two people of color, 13 (52%) included one or two transgender or non-binary individuals, and 21 (84%) included one or two non-lesbian individuals. Most couples had already made their donor decision by the time they joined the study and said they were unlikely to change their minds. At the time of the study, there were no instances of a couple disagreeing about their chosen donor route (although some had disagreed at previous points in the decision-making process). The research team purposefully recruited approximately equal numbers of couples interested in using a known donor (N=13) versus an unknown donor (N=12). Participants were recruited between October 2023 and April 2024 via Facebook, Reddit, professional contacts, and snowball sampling.

Key Findings

How much decisional conflict do LGBTQ couples experience when choosing between a known versus unknown sperm donor?

Editor’s Note: 88% of participants (22 of 25 couples) had already made their donor decision before completing the survey and interview. Only 3 couples were still actively deciding. This means that for most participants, the decisional conflict scores and interview responses reflect retrospective accounts of a process they had already completed not real-time experience.

• Overall, 54% of participants (27 of 50) reported feeling moderate to high uncertainty when deciding between choosing a known or unknown donor.

• Nearly half of the couples (12 of 25) were "discordant," meaning partners reported meaningfully different levels of decisional conflict from each other. Partners reporting higher conflict tended to have felt less certain about wanting to be a parent, arrived at the decision later, or described themselves as temperamentally more indecisive.

• People who looked back and said the decision felt hard (i.e., had high decisional conflict) were also more likely to report struggling with emotional regulation and putting decisions off than participants with low or moderate decisional conflict. These findings were statistically significant.

What do LGBTQ couples need to make this decision easier?

• Almost every couple (92%) said they didn’t have enough information. They lacked knowledge about donor options themselves (many had never heard of known donors), the costs, legal implications, long-term implications, and medical aspects of each choice. Many wanted to hear the perspectives of donor-conceived people to better understand their options.

• Most couples (88%) struggled with limited informational, emotional, and financial resources. They couldn’t find websites, articles, books, or healthcare professionals explaining the donor decision process. Research was often behind academic paywalls and written in technical language. Many lacked LGBTQ friends or family who could offer guidance. Resources were designed for straight couples dealing with infertility, not for LGBTQ couples experiencing joy in family building or grief over losing privacy and autonomy (not grief over infertility). Some couples couldn’t afford sperm banks, limiting their choices.

• About half of couples (52%) struggled to figure out how much weight to give different factors. Many couples struggled with how to weigh competing considerations (e.g., wanting their child to appear physically like both parents vs. wanting a known donor on principle; or valuing a child’s access to biological origins from birth vs. concerns about the complexity of an ongoing known donor relationship). For interracial couples, decisions about donor race were often emotionally fraught.

• Some couples (32%) felt overwhelmed by how many additional decisions were embedded in the initial choice. Choosing an unknown donor meant deciding which sperm bank to use, what donor characteristics matter, anonymous versus identity-release, how much to spend, how many vials to buy, and whether to join sibling registries. Choosing a known donor meant deciding where to find them, who to ask and how, what role they’ll play, legal protections, insemination methods, genetic testing, and who to tell about the arrangement.

• Some couples (24%) believed there had to be one “correct” choice with no negative consequences. Their search for the perfect answer led to procrastination or obsessive research, which frustrated their partners. These participants often struggled with anxiety about doing things “right” in life generally.

• Couples identified seven types of support they wanted:

  • All 25 couples wanted a better understanding of both options and their implications before making a decision.

  • Most couples (20 of 25) wanted to hear how other couples made this decision.

  • Most couples (15 of 25) sought out donor-conceived people’s perspectives online and found them influential (both validating and alienating). Participants wanted a balanced, contextualized presentation of DCP perspectives and noted that many DCP who advocate most strongly for known donation were raised by heterosexual parents who deceived them about their conception.

  • Many couples (10 of 25) wanted prompts to help them identify what mattered most to them and structure difficult conversations with their partners. Several wished they'd had something similar to what couples therapy offered.

  • Some couples (8 of 25) wanted validation that this decision is difficult and that there’s no wrong choice.

  • Several couples (7 of 25) felt uncertain about the role of the non-gestational/non-genetic partner in the decision-making process and wanted explicit encouragement to assert their preferences.

  • Most participants of color (9 of 12) wanted preparation for the reality that finding a donor of a specific race or ethnicity might be difficult, potentially requiring them to choose a donor route they hadn’t preferred. Interracial couples described needing support to have explicit, values-driven conversations about the significance of race in their future child's identity.

How do personal factors (emotions, decision-making style) and relationship factors (closeness) affect their decision-making?

• Most correlations between decisional conflict and intimacy, decision-making style, and emotion regulation were not statistically significant in the full sample, which the author attributed primarily to the small sample size. Trends generally moved in expected directions: higher decisional conflict trended with lower intimacy, greater emotion regulation difficulties, and greater use of non-adaptive decision-making styles (procrastination, buck-passing).

• In the qualitative interviews, participants reflected back on how emotions and relationship dynamics had shaped their decision-making process. Participants described emotions as double-edged, helpful when they provided information about values (e.g., an “ick” reaction to a specific donor type that clarified preferences), and harmful when they became overwhelming and led to avoidance or delayed decision-making. Several couples reported using individual or couples therapy specifically to process emotions related to the donor decision. Couples who could speak honestly with each other about vulnerability-inducing topics described navigating the decision more smoothly, while those who struggled to “get on the same page” described confusion, hurt feelings, and delays.

• The study also identified a common dynamic in which one partner (the “initiator”) drove the information-gathering process while the other (the “follower”) engaged later, sometimes creating resentment or misalignment. Couples fared better when both partners were engaged with information from approximately the same starting point.

What differences in the decision-making process exist between cisgender couples and couples in which one or both members identify as trans or nonbinary?

• Trans and nonbinary participants (n=15) reported similar overall levels of decisional conflict to their cisgender counterparts, but were more likely to lack tools for managing their emotions when upset (statistically significant).

• Two main needs emerged from interviews: (1) help sorting through strong emotions and conflicting values about choosing a known donor, and (2) resources that acknowledge unique challenges (like gender dysphoria) and strengths (like expansive ideas of family).

• Some trans and nonbinary participants strongly disliked when partners suggested using a known donor. They worried about having a “masculine” person in their child’s life who wasn’t them. They feared not being seen as their child’s “real dad” or feeling less masculine. Some resolved this by choosing more distant known donors or preferring gay, genderqueer, or effeminate donors because they felt less threatened. One opposing view: Some nonbinary participants wanted a cisgender male presence to give their child positive masculine role models, especially since they had few cisgender men in their lives.

• Some gender-minority participants wanted known donors because it felt “more queer” (less like straight couples) and built community. This came up less often among cisgender couples.

• Some trans participants described dysphoria arising during the donor decision-making process itself, particularly when confronting physical limitations of their bodies (e.g., inability to impregnate a partner). For some, this slowed their engagement with the process.

• Some trans men and masculine-presenting nonbinary people described concerns about the donor decision revealing their gender identity to people who did not already know, particularly if using a known donor meant regular contact with someone in their community.

• Several trans men noted that available resources about trans parenthood were predominantly cautionary or trauma-focused, failing to reflect the excitement and gender-affirmation many felt about becoming a father.

• Two participants described having had to disavow interest in having children as adolescents in order to access gender-affirming care, and were still processing the psychological complexity of now pursuing parenthood.

Limitations: The sample was mostly white, highly educated, and all but one couple identified as middle or high income. Most couples had already made their decision at the time of recruitment (22 of 25 couples). Decisional conflict scores and qualitative accounts of the decision-making process reflect retrospective reconstruction, not real-time experience. People who have settled on a choice tend to reframe their prior uncertainty in ways that make their decision feel more coherent and less fraught than it was at the time, a well-documented phenomenon in decision research sometimes called “choice-supportive bias.” The quantitative sample was small, limiting statistical power and the ability to conduct subgroup analyses or mediation analyses. Correlations should be treated as general estimates of association rather than definitive findings. The Decisional Conflict Scale was originally developed for medical decisions (e.g., cancer treatment choices). It has not been validated specifically for family-building decisions among LGBTQ people.

Applications: Therapists working with LGBTQ couples should recognize that decisional conflict around donor choice is common and that addressing emotion regulation skills, communication patterns, and decision-making styles can support couples through this process. Mental health professionals should be prepared to help transgender and nonbinary clients process complex emotions, including gender dysphoria, concerns about gender identity in relation to parenthood, and fear of being outed. Professionals can also validate that becoming a parent can be a joyful and gender-affirming process for transgender and nonbinary people.

Funding Source: Not explicitly stated

Lead Author: Nora McKillop McCormick earned her PhD in Psychology from Clark University in August 2025, where she worked in Dr. Abbie Goldberg’s Diverse Families and Sexualities Lab. Her research focuses on LGBTQ family formation, adoption, donor conception, and supporting diverse families through decision-making processes. No personal connection to donor conception was disclosed.

Regulatory Context

• The United States has no comprehensive federal legislation governing donor conception, with regulation primarily occurring at state level, creating a patchwork of laws across the country. The Food and Drug Administration (FDA) provides minimal federal oversight, mainly focused on screening requirements for disease prevention.

• There are no federally mandated limits on the number of children conceived from a single donor. The American Society for Reproductive Medicine (ASRM) recommends limiting donors to 25 live births per population area of 850,000, but this is voluntary and not enforced. Colorado became the first state to establish a statutory limit in 2022, capping donor use at 25 families per donor, regardless of location, effective January 2025.

• No centralized national registry exists to track donor-conceived births OR donors, making it difficult to enforce any limits in practice.

• Commercial donation is permitted throughout most of the United States. Donors can be compensated for their gametes.

• Access to donor conception is generally open to a wide range of individuals regardless of marital status, sexual orientation, or gender identity. Most major medical organizations support the position that fertility treatments should be available to any individual who is fit to parent.

• The U.S. does not have national laws prohibiting anonymous donations, but this practice is gradually changing. Colorado’s 2022 “Donor-Conceived Persons Protection Act” (effective January 2025) bans anonymous donation and gives donor-conceived individuals the right to access their donor’s identity upon reaching age 18. In January 2024, the Uniform Law Commission amended the Uniform Parentage Act to require disclosure of donor identifying information to adult donor-conceived persons upon request, though states must adopt this amendment for it to become law in their jurisdictions.

Related Posts

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

• Unique experiences of transgender and cisgender fathers who use donor sperm (Mendes, 2024)

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

Geographic Region: Australia, New Zealand, Canada, United States, Belgium, the Netherlands, United Kingdom, Germany, Ireland, and Sweden

Research Question: What psychosocial support and counseling services are currently available to donor-conceived people, parents, donors, and their families across ten jurisdictions, and how well do these services meet the growing complexity of donor conception at all life stages?

Design: Descriptive, cross-national mapping study using publicly available information and expert consultation. Data were collected in three areas: (1) the legislative and regulatory context of donor conception in each country, including identity-release provisions; (2) psychosocial support available before or during treatment; and (3) psychosocial support available after treatment or donation, including at the time of information release and donor-linking. Information was gathered through publicly available government and organizational documents, with verification from key researchers and representatives of professional counseling bodies in each country. Data were accurate at the time of publication (early 2026).

Sample: Ten jurisdictions: Australia, New Zealand, Canada, USA, Belgium, the Netherlands, UK, Germany, Ireland, and Sweden. Countries were selected based on two criteria: having a professional fertility counseling organization, and/or having published research on donor conception in English. The authors consulted with key informants from each country, including researchers, psychosocial practitioners, and members of fertility counseling organization boards.

Key Findings

Legislative Landscape

• Legislation governing donor conception varies widely across the ten countries. While Belgium, Ireland, Germany, the Netherlands, New Zealand, Sweden, and the UK have national legislative frameworks, Australia and Canada regulate ART at the state/provincial level, and the USA has almost no federal legislation.

• Sperm donation is permitted in all ten countries. Egg donation is prohibited in Germany. Gestational surrogacy using donor gametes is not permitted in Sweden and is not yet legally available in Ireland.

• Seven of the ten countries (Australia, Germany, Ireland, the Netherlands, New Zealand, Sweden, and the UK) require identity-release donation, meaning DCP can access identifying information about their donor when they reach a certain age (typically 18). Anonymous donation remains an option in the USA (except for one state), most of Canada, and Belgium (though Belgium has committed to ending anonymity by 2027).

• Donor-conceived people generally have the right to access identifying donor information at age 18 in identity-release jurisdictions, but parents have far more limited rights in most countries, and donors have even fewer rights to information about the children born from their donations.

• Restrictions on the number of children or families that can be created from one donor are inconsistently applied. Ireland legally restricts one donor to four families; Belgium limits one donor to six women; Sweden recommends (but does not mandate) six families. The UK allows up to ten families; the US allows up to 25. No international limits exist, and enforcement across borders is largely impossible.

• Record-keeping requirements vary significantly, with some countries specifying that records must be kept for 70 to 110 years, and others having no legal time limits. This inconsistency has implications for DCP’s future ability to access information about their origins.

• None of the jurisdictions surveyed explicitly address donor conception that occurs outside the formal medical system (e.g., home insemination) or cross-border reproductive care, leaving many DCP without legal protections or access to support.

Pre-Conception Counseling

• Mandatory pre-conception counseling exists in some form in Ireland (at least one implications counseling session required by law), Quebec/Canada (an information session required by law), Sweden (mandatory psychosocial assessment, though not implications counseling), and Australia and New Zealand (two counseling sessions required for clinic accreditation, making attendance effectively mandatory).

• In Belgium and the UK, counseling must be offered, but attendance is not required. In Germany, the Netherlands, Canada (outside Quebec), and the USA, counseling is recommended by professional guidelines but not mandated.

• Qualification requirements for fertility counselors also vary significantly. Australia, New Zealand, the UK, Ireland, and Canada have established professional associations with training and registration requirements. In the USA, the ASRM Mental Health Professional Group recommends certain qualifications but has no official accreditation, and anyone can join regardless of training. In the Netherlands, counselor qualifications are loosely defined.

Post-Conception and Long-Term Support

• Post-treatment psychosocial support is rarely mandated in legislation. The Netherlands stands out as having the most developed post-conception support system, providing government-funded counseling to DCPs and donors on identity release and donor-linking. The Belgian Flemish Ancestry Centre (‘Het Afstammingscentrum’) offers free, government-funded support without session limits.

• Some Australian states (Queensland, New South Wales, and South Australia) have recently introduced provisions for free counseling when DCP access the register. However, in Victoria, the Assisted Reproductive Treatment Authority (VARTA), which had provided free counseling and donor-linking services, was dissolved at the end of 2024.

• In the UK, the HFEA previously offered time-limited free counseling when people requested donor information; this service was discontinued in September 2024 and replaced with online information pages only.

• Peer support organizations exist in most countries and provide valuable community-based support. However, these organizations are largely run by volunteers with lived experience, are typically unfunded, and should be seen as complementary to (not a replacement for) professional support. This leaves DCP, parents, and donors without adequate support as they navigate disclosure, donor-linking, large sibling networks, and DNA testing discoveries across their lifetimes.

Limitations: Notably absent from the study are countries in the Global South, Asia, the Middle East, and Eastern Europe, including countries with significant ART industries, such as Spain (a major destination for reproductive tourism), Denmark (a major sperm-exporting country), India, and Thailand. Countries where anonymous donation remains the norm (e.g., China, South Africa, Iran, Italy, Brazil) are also not included, even though many DCPs globally were conceived in these contexts. The study does not examine whether the counseling that does exist is culturally appropriate, linguistically accessible, or relevant to families of color, Indigenous families, LGBTQ+ families, or families with lower socioeconomic resources. Legislative and practice provisions are under active review in several of the included countries. Publicly available data may not reflect the most recent changes, and individual clinic practices within jurisdictions may vary and were not captured.

Applications: The study highlights the need for post-conception counseling to be treated as a distinct and specialized practice area, separate from pre-conception fertility counseling. The study identifies direct-to-consumer DNA testing as a growing source of unexpected DC discoveries, early donor contact, and large sibling network identification. Very few jurisdictions have support systems designed for these situations. Clinicians, counselors, and DCP organizations should be prepared to support individuals who encounter these situations without warning. This mapping study identifies multiple important research gaps, including studies on the psychosocial needs of donors (particularly as DCP seek contact), the effectiveness of different counseling models for DC-linking, experiences of families using cross-border or informal donor conception, and the support needs of DCP from non-Western or non-disclosure contexts.

Funding Source: No funding source is identified

Lead Author: Sonja Goedeke is an Associate Professor in the Department of Psychology and Neuroscience at Auckland University of Technology (New Zealand), a registered clinical psychologist, and a specialist in the psychosocial and ethical implications of infertility treatment and donor conception; she is also Co-Chair of the ASPIRE Special Interest Group on Psychology and Counseling. No personal connection to donor conception was disclosed.

Regulatory Context: Varies by jurisdiction

Related Posts

• Framework proposed for supporting clients through transformative DNA recognition events (Shepard, 2025)

• Perspectives on early disclosure support for donor-conceived families (Hershberger, 2026)

• Parents who used egg donation say better counseling and consistent guidelines are urgently needed (van Bentem, 2025)

Geographic Region: Australia and South Africa

Research Question: What are the expectations of Australian egg donation recipients, South African egg donors, and South African infertility counselors regarding donor anonymity, identification, and future contact?

Study Design: Semi-structured interviews were conducted with three participant groups between 2021 and 2023. Australian recipient parents were asked about their experience traveling to South Africa, their views on future implications of donor anonymity for their child, and whether they had tried to find the donor or donor siblings. South African egg donors were asked about their donation experience and their views on anonymity and potential future contact. South African infertility counselors were asked about their counseling practices, impressions of donor motivations and attitudes toward anonymity, and approaches to the possibility of future identification.

Sample: 33 participants across three groups. 12 Australian recipient parents were aged 40 to 51 at the time of their first egg donation in South Africa. All identified as heterosexual; six were in a relationship (partnered or married), and six were single. All had at least one live birth resulting from their South African egg donation. The 12 South African egg donors ranged in age from 19 to 31. All described themselves as Christian. Two were married, three were single, and the remainder described themselves as having a long-term partner. Five were from White backgrounds; the remaining donors were Black South Africans. Three were students; others worked in various occupations. Donors were recruited through fertility clinics, an egg donor agency, and Facebook. The 9 South African infertility counselors included psychologists, social workers, and one counselor, ranging in age from 30 to 61. Most had been practicing for over ten years. South African counsellors were recruited through the Special Interest Group in Psychology and Counselling of SASREG (the South African Society for Reproductive Medicine and Gynaecological Endoscopy).

Key Findings

• Most Australian recipient parents had first tried unsuccessfully to conceive with their own eggs, and many had actively but unsuccessfully sought an Australian egg donor before traveling to South Africa. For some, traveling overseas for an anonymous donation was experienced as a last resort. Several recipients expressed discomfort with the anonymous nature of South African donations, believing that their child would want to know the donor’s identity. Some chose specific donor agencies partly because they asked donors whether they would be open to future identification. While all recipients accepted that the donation was currently anonymous, most anticipated that their child would eventually be able to find the donor through direct-to-consumer genetic testing or online research.

• After the birth of their donor-conceived children, some Australian recipient parents actively engaged in online searching to find their child’s donor’s identity and locate donor siblings before their child reached adulthood, sometimes within months of their child’s birth. Recipients described using donor codes shared in Facebook groups and Google searches to identify donors and connect with other families who had used the same donor.

• All egg donors interviewed understood their donation to be an anonymous act and had been counseled by the donor agency that their identity would not be disclosed. Most donors preferred anonymity and did not seek information about recipients or the resulting children. Several compared egg donation to blood donation, an act of generosity with no expectation of ongoing relationship. None of the donors had received any counseling about the possibility of future contact, identification through genetic testing, or the existence of recipients in other countries who held different expectations about anonymity. One donor who had been adopted expressed openness to future contact, reflecting an understanding of the curiosity donor-conceived people might have about their origins.

• South African counselors reported that the majority of egg donors expected and preferred anonymity, and that most donors did not consider themselves genetically related to the donor-conceived children they helped create. Counselors described their role as supporting donors to conceptualize their donation as providing ‘tissue,’ not as creating a child with whom they would have a relationship. Direct-to-consumer genetic testing was not consistently discussed with donors. Some counselors were unaware it was easily accessible in Australia; others reported it simply never came up.

Limitations: The sample is small and non-representative. The study is focused on a specific cross-border context (Australia to South Africa) and findings may not apply to other cross-border arrangements or to domestic egg donation in either country. The study does not examine what happens after contact attempts occur: whether donors are found, how they respond, or what the psychological consequences are for all parties. The ‘mismatch’ identified is prospective and relational rather than empirically measured in terms of outcomes. The framing of donor-conceived people’s interest in knowing their donor’s identity as a universal or self-evident good draws heavily on Australian advocacy discourse and on research conducted primarily with donor-conceived adults who have sought contact. The perspectives of South African donor-conceived people, who grow up in a context of mandated anonymity and different cultural norms about family, are entirely absent from this study.

Applications: The study provides a clear rationale for expanding implications counseling in cross-border egg donation to include explicit discussion of direct-to-consumer genetic testing, online searching, and the realistic possibility of future identification even in jurisdictions where donation is legally anonymous.

Funding: This research was funded by the Australian Government through an Australian Research Council Discovery Project Grant (DP 200101270).

Lead Author: Cal Volks is a postdoctoral research fellow at Monash University, Melbourne, Australia, whose work focuses on donor conception relationships, policy, and counselling, with a background in sexual and reproductive health research and education. Volks holds certification in infertility counselling from the British Infertility Counselling Association (BICA) and has been a member of the ANZICA executive since 2019. No personal connection to donor conception was disclosed.

Regulatory Context

Australia

• Australia’s gamete donation laws vary by state and territory, but all states and the federal ethical guidelines (National Health and Medical Research Council, 2017) require that donor-conceived people have the legal right to access identifying information about their donors when they reach adulthood — at age 16 in Western Australia, and 18 in all other states.

• Only altruistic donation is permitted in Australia. Donors can be reimbursed for verified expenses but cannot be paid for gametes.

• Recipients and donors are required to undergo implications counseling before proceeding with domestic gamete donation, including a discussion of the donor-conceived person’s future rights to identify the donor.

• There are no federal laws governing cross-border reproductive care by Australians, and some Australian practitioners may face legal liability if seen to be facilitating arrangements that contravene domestic anonymity laws. Australian medical staff may therefore be unable to refer patients for implications counseling ahead of overseas treatment.

• VARTA (the Victorian Assisted Reproduction Treatment Authority), a statutory authority that provided information and support to donor conception stakeholders, was dissolved at the end of 2024, and its functions were transferred to the Victorian Department of Health.

• There is a growing trend in Australia among recipient parents to seek early contact with donors and donor siblings before the donor-conceived child reaches the legal age of access.

South Africa

• Gamete donation in South Africa is governed by the National Health Act 61 of 2003 and its Regulations Relating to Artificial Fertilisation of Persons (GN R175, 2012).

• Donor anonymity is currently mandated in South Africa for donations arranged through egg donor agencies and egg banks. Donors’ identities are not disclosed to recipients or offspring.

• Donors receive fixed compensation set by SASREG, approximately R8,000–9,000 per cycle (approximately USD $450–506 at the time of the study). Commercial trading in gametes is prohibited but compensation is permitted.

• A donor’s gametes may not result in more than six live births (excluding the donor’s own children). Fertility clinics maintain records to enforce this limit.

• Donors have no legal parental rights or obligations to donor-conceived children.

• Recipients traveling to South Africa from overseas are not required to undergo counseling prior to treatment at South African clinics.

• South African law on donor anonymity is described in this paper as ‘evolving,’ with legal scholarship (Thaldar & Shozi, 2022) examining whether open-identity donation could be lawful under current legislation. A 2020 survey of 150 South African egg donors found that a majority (54%) would have chosen identity-release if given the option, while 34% preferred anonymity.

Related Posts

• How Australian egg donors interact with recipient families (Volks, 2026)

• Providing implications counseling to South African anonymous oocyte donors donating to Australian recipients (Volks, 2024)

Geographic Region: The Netherlands

Research Question: What are the motivations, needs, and experiences of donor-conceived adolescents in the Netherlands when seeking sperm donor information and making contact?

Study Design: Semi-structured in-depth interviews conducted in two rounds of recruitment: June 2021 and August-September 2022. Participants were asked to reflect on their experiences during adolescence, broadly defined as ages 10–24. New themes emerging from earlier interviews were incorporated into later interview guides, consistent with iterative qualitative methods.

Sample: 19 donor-conceived individuals participated across 18 interviews. In one interview, a mother also participated; in another, two mothers participated alongside their donor-conceived son and daughter. The average age was 22.6 years, ranging from 17 to 26 years. Participants were predominantly female (n=16; 84%). Family structures included single-mother families (n=11; 58%), mother-father families (n=4; 21%), and mother-mother families (n=4; 21%). All participants had an identifiable sperm donor. Disclosure of donor conception occurred from birth for most participants (n=15; 79%). One participant was not told until age 21. The majority began their donor search between ages 16 and 17 (n=11; 58%). At the time of the study, 14 of the 19 participants had made contact with their donor, and 12 had had contact with donor siblings. Nearly all participants (n=16) received counseling from a Fiom counselor during the information exchange process. Purposive and snowball sampling were used, with recruitment through Fiom’s social media, newsletter, website, and direct email to people already in Fiom’s counseling system.

Key Findings

• Curiosity about donor information ranged widely, from little to none to deep and enduring preoccupation. Some participants integrated their donor conception into their identity from an early age with minimal urgency for further information, while others experienced intense curiosity beginning in early childhood.

• Most participants were interested in the donor’s personality (questions such as, ‘Who is he?’, ‘What kind of man is he?’, ‘What does he look like?’, ‘What characteristics does he have?’, ‘Why did he donate?’, ‘Where is he from?’, ‘What interests and hobbies does he have?’) and his medical history.

• The approach of the age-16 access threshold heightened awareness and desire among many participants: the legal right to request information became a more prominent thought, even for those who had not previously been curious.

“Around the age of 14 or 15, I started thinking about the donor more as the time to make the request got closer. I was just really curious.” - Liam, 21 (single mother family)

“‘I told my parents, ‘It’s allowed at sixteen, so I really want to do it then’.” - Maud, 17 (mother-mother family)

• The decision to seek donor information was rarely purely internal. Siblings’ curiosity often catalyzed or accelerated others’ searches. Parents frequently shared in or initiated the process, and some participants delayed their search out of loyalty to parents or fear of causing distress. Broader societal influences (e.g., television programs featuring donor-conceived people searching for their donors) could make the idea feel possible and open conversations within families. Two participants also feared that the donor might die before contact.

• For many participants, receiving information about the donor and recognizing shared physical traits, personality characteristics, or interests contributed to their emerging self-image. Several participants also described a fully settled sense of identity prior to receiving information about the donor.

• The relationship with the donor varied enormously: from a single meeting out of curiosity, to occasional contact at significant life events, to close ongoing personal relationships. None of the participants described the donor as a father figure, though some formed meaningful bonds (e.g., mentorship, friend).

• Many participants described challenges in establishing contact with the donor, including a lack of shared history that made interactions feel awkward, uncertainty about the donor’s expectations, and practical factors like geographical distance. Some participants encountered concerning donor behaviors, including donors who shared private information without consent, expressed extreme views, or had psychological difficulties that complicated or made contact unsafe.

• Many participants expressed that their curiosity about donor siblings was stronger than their curiosity about the donor himself. Donor siblings were seen as a potential extension of their social network, people who could offer shared experience and recognition, particularly for those who grew up without siblings. At the same time, the prospect of having large numbers of unknown genetic relatives and the possibility of inadvertently meeting a donor sibling in romantic or social contexts were sources of anxiety and ongoing distress for some participants.

“It would be so nice to have a lot of siblings, because I don’t have any myself. I thought about that a lot. At school, I would hear others talking about their brothers and sisters and think, ‘Maybe I’ll have them too.’” - Elise, 25 (mother-father family)

“It’s complicated because there are probably people who have half your DNA and are your age. You could easily meet them while dating or through friends. The idea of meeting someone and only finding out later that they are your sibling is scary to me.” - Tessa, 23 (mother-mother family)

“I find the subject of half-brothers and sisters difficult; I’d rather not think about it. After all, my family is complicated enough as it is, with brothers, sisters, stepbrothers and stepsisters.” - Emma, 19 (mother-mother family)

• Almost all participants received Fiom counseling, and most valued it highly. They appreciated empathetic, personalized support, a step-by-step approach, and counselors who allowed them to proceed at their own pace without pressure. Participants particularly valued having control over the process and retaining agency to decide if and when to request information or make contact. Some participants felt that counseling support did not keep pace with the complexity of evolving donor sibling networks, particularly when group dynamics became complicated.

• Participants suggested that family support played an important role. Parents who showed active interest, listened without judgment, and encouraged their children’s autonomy helped normalize the topic over time. In many families, parents sometimes initiated conversations or information seeking themselves rather than waiting for children to ask. Most parents were open to their children making contact with the donor and donor siblings, accompanied them to meetings, and provided practical and financial support.

“My parents had a little book that explained everything in simple language, and they would read it to me from time to time. So, ever since I became aware of my existence - ever since I knew I was alive - I also knew that I was a donor-conceived child.” - Annabelle, 19 (mother-father family)

“My parents’ support was valuable. We did it as a family. Although it was about my sister and me, my parents were involved in everything and knew everything.” - Tessa, 23 (mother-mother family)

Limitations: Three of the 19 participants were outside the 10–24 age range used to define adolescence in this study, meaning their experiences were captured only retrospectively. The study focused exclusively on sperm donation; findings may not apply to those conceived with egg or embryo donation. Participants were predominantly female (84%), which the authors note aligns with research suggesting kinship work is primarily done by women, but limits the representation of male donor-conceived people’s experiences. Single-mother families were overrepresented (58%), which may limit the range of family dynamics reflected. The study may be affected by self-selection bias, overrepresenting people with strong interest in their genetic background, though the authors note that one participant specifically joined to represent those who did not want donor contact. Families who avoided disclosure, had difficult experiences, or never sought professional support are absent. The research team is based at Fiom, the same organization whose counseling services are evaluated in the study.

Editor’s Note: The authors conclude that early disclosure is associated with lower urgency regarding donor information; however, I think this is a reach for a small, self-selected sample from a qualitative study.

Applications: The findings validate that curiosity about donors and donor siblings is normal, varied, and evolving. Donor-conceived people who feel little interest are not unusual, and those with intense curiosity from an early age are also not unusual. Participants valued personalized, empathetic, and responsive counseling that matched their individual timing, not a fixed process with predetermined steps. The complexity of growing donor sibling networks appears to exceed what individual counseling is currently designed to handle. Support that addresses group processes, not just individual ones, may be needed. Professionals should be alert to the range of donor behaviors that can arise, including donors who are unsafe, who have not disclosed their donation to their own partners, or who have significant psychological difficulties. Preparing young people for the possibility that contact may not go as hoped is important, but should be done in a way that does not pre-emptively dampen genuine excitement.

Funding Source: ZonMw (project number 554002007) as part of a broader research program on age limits in the Dutch Donor Data Act, commissioned by the Dutch Ministry of Health, Welfare and Sport

Lead Author: A. Janneke B. M. Maas is a Senior Specialist in Policy and Researcher in Donor Conception at Fiom in ‘s-Hertogenbosch, the Netherlands. She holds a PhD in Developmental Psychology from Tilburg University, with her dissertation focused on prenatal influences on infant development and parent-infant relationships. No personal connection to donor conception was disclosed.

Regulatory Context:

• The Netherlands abolished donor anonymity through the Artificial Fertilisation Donor Information Act (Wdkb) in 2004. Under this law, all donations made after 2004 must be identifiable.

• From birth, parents can request a ‘donor passport’ containing the donor’s physical and social characteristics. Donor-conceived individuals can request this passport themselves at age 12. At age 16, they gain the right to access identifying information, including the donor’s name, date of birth, and place of residence.

• The national donor register (College donorgegevens kunstmatige bevruchting, or Cdkb) is government-funded and manages all donor records.

• Fiom is contracted by the Cdkb to provide counseling to donor-conceived people and donors during information exchange and contact processes. Contact between donor-conceived people and donors is not a legal right; it requires mutual consent.

• For donations made before 2004, donors who previously donated under anonymity had the option to register in the voluntary Fiom KID-DNA Database and release their identity. Donors who donated before 2004 and died without changing their status cannot release information; in those cases, next of kin may be approached.

• All forms of gamete donation in the Netherlands must be altruistic; commercial trading of gametes is prohibited. Counseling is provided to both donors and recipients. The Netherlands permits access to assisted reproduction for heterosexual couples, lesbian couples, and single women.

Related Posts

• Legal age limits in accessing donor information: experiences of donor-conceived people, parents, sperm donors and counsellors (Bolt, 2024)

• Majority of donor-conceived teens want donor information access, regardless of family or donation type (Groundstroem, 2024)

• How donor-conceived people feel about discovering they have multiple donor half-siblings (Sørensen, 2025)

Should you search for other families who used the same donor? When should you tell your child that genetic half-siblings might exist? What level of contact makes sense for your family? I wrote about these decisions and what research actually shows about same-donor peer relationships.

Sonja Klug, founder of Storydo, wrote a guest post about how parents’ donor conception conversations with children are stories to keep building rather than talks to get through, drawing on research about elaborative reminiscing. And then, I tried to create some practical guidance on how to do it!

Research Recap

Gilman and Davis (2026) interviewed 49 UK participants (30 intended/recipient parents, 19 sperm donors) about how digital technologies shape informal donor conception knowledge management. Four interconnected themes emerged: managing identifying information, (dis)embedding connections, communicative knowledge, and creating digital artifacts.

Volks et al. (2025) interviewed 24 Australian egg donors who met recipients through online platforms (23 donated to multiple families). Donors described strong empathy for recipients arising from reproductive difficulties or witnessing others' struggles. Online platforms enabled direct recipient selection based on shared values and perceived openness to contact, with platform discourse emphasizing early disclosure significantly influencing decisions.

Hurley and Goedeke (2026) interviewed nine New Zealand participants (two embryo donor couples, one recipient couple, three individual recipients) with donor-conceived children aged 2-8 about early contact. All described strongly positive experiences with kin-like connections, choosing partners based on shared values.

Hershberger et al. (2026) interviewed 20 US parents (6 pregnant, 15 with children aged 3-24 months, mostly White female) and 10 clinicians about disclosure needs. All parents intended to tell children about donor conception, citing honesty and transparency, though several reported no healthcare professional discussed disclosure despite required counseling sessions. Clinicians, particularly outside the fertility setting, felt unprepared to counsel families, constrained by time (15-minute appointments) and lacking training. Parents requested support via multiple delivery modes, customization by family/donation/donor anonymity type, peer connections, privacy protection, and low/no cost.

van Rooij et al. (2026) interviewed 17 Dutch donor-conceived people (average age 32, mostly women) who met sperm donors through professionally supported counseling. Motivations included seeking resemblances, incomplete identity, curiosity, medical information, and closure, often triggered by major life events. Those with identifiable donors had straightforward paths through government bodies, while those with formerly anonymous donors experienced long, emotionally draining searches with repeated dead ends and clinic discouragement. The gap between expectations and actual meetings shaped experiences.

Other Tidbits

• Researchers with Morehouse Center for Maternal Health Equity are recruiting Black participants who have considered or used fertility treatments (ovulation-inducing medication, IUI, or IVF) since June 2022 to examine how abortion bans impact fertility care decision-making. The study involves a 20-minute online survey with optional in-person focus groups in Atlanta (April 15, 3:00-5:00pm during Black Maternal Health Week) or Raleigh (April 25, 11:00am-1:00pm during National Infertility Awareness Week). Focus group participants receive incentives and meals. The study team includes people who have used medically assisted reproduction and aims to improve Black families' experiences and outcomes with fertility care. To participate: https://bit.ly/ReproIntersect

• In Psychology Today, Zoe Weil describes discovering at age 51 through 23andMe that she was donor-conceived with 62 half-siblings, an experience that was both fascinating and deeply unsettling as it called into question "how much of who we think we are is woven from stories told to us and by us and layered on like garments we eventually mistake for our self."

• Professor Vasanti Jadva delivered an inaugural lecture at City St George’s, University of London reflecting on 25 years of research examining families formed through assisted reproduction including IVF, egg and sperm donation, and surrogacy.

• Riki Lindhome’s song about asking someone to be a known sperm donor had me rolling.

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This guest post makes the case for why the donor conception conversation is less a talk to get through and more a story to keep building. The research she draws on - particularly the elaborative reminiscing work of Robyn Fivush - points toward something specific and learnable for parents. If you want to go deeper on what that looks like in practice for donor conception families, check out my companion post on how to use elaborative reminiscing for talking to your child about your family story.

The Science of Family Storytelling and What It Means for Families Through Donor Conception

by Sonja Klug

Two questions come up again and again when people consider donor conception. Firstly: “Will my child reject me because I’m not their genetic parent?” And secondly: “How on earth will I talk to my child about donor conception?”

I’m Sonja, the founder of Storydo, a platform that helps parents tell their family stories to their children. It’s for all family storytelling, and donor conception origin stories are one variety of story Storydo has been designed to tell. Building the Storydo BookBuilder took me deep into family storytelling research. I also worked closely with child psychologists, social workers, and child development experts to determine how best to facilitate family storytelling through bespoke books.

We’ve now made hundreds of books, and I’m more convinced than ever that the sometimes dreaded ‘talk’ is an opportunity to bring families closer. Family storytelling helps parents build close, resilient families and can help ease fears of rejection.

The Research on Family Storytelling

Robyn Fivush, Professor of Psychology at Emory University, has spent over three decades studying family storytelling and its impact on children’s development. Her research focuses on a style of parent-child conversation about past shared events called elaborative reminiscing, which is characterised by open-ended questions, rich detail, emotional content, and a focus on following the child’s lead.

For example, instead of just asking “Do you remember when we went to the zoo?” and waiting for a yes or no, an elaborative parent builds the story out loud with the child, asking open questions like “What animals did you see?” and “How did you feel when the lion roared?”, filling in details when the child gets stuck, and responding warmly to whatever the child contributes.

The research behind this style of conversation is substantial. A 2006 review by Fivush et al. found that parents regularly talking with their young children about shared experiences in rich, open, collaborative ways is associated with positive outcomes for children. There’s a clear relationship between maternal elaborative reminiscing and benefits for children’s memory, language, and literacy development. There’s also evidence for a link between elaborative reminiscing about emotions and coherence of children’s self-concept.

A narrative literature review by Elias and Brown (2022) adds to this picture, showing that knowing one’s family history is consistently linked to better mental health outcomes in adolescents, such as lower anxiety, higher self-esteem, greater sense of control, and fewer behavioural problems. And it’s not just about knowing the facts. Fivush et al. (2011) found that adolescents who told richer intergenerational narratives - ones that included perspective-taking, emotional content, and explicit connections between their parents’ past experiences and their own lives - tended to have higher wellbeing overall.

You might wonder, though, whether it’s only the positive stories that do this work. Marin et al. (2008) examined whether sharing negative emotions with children could be harmful. They asked middle-class two-parent families to tell stories about a recent negative experience, like the death of a family member or pet, a child’s illness or injury, or an accident or disaster. Interestingly, families that named and explained specific negative emotions (”we were scared,” “it was so sad when Grandma died”) in a collaborative way, building on each other’s feelings rather than arguing or dismissing them, were more likely to have children who reported higher social and academic competence two years later.

The Role of Storytelling in Donor Conception

A parent’s journey to having a family is, of course, a fundamental part of family storytelling. How does this look in practice? In my experience from working closely with families through donor conception, most parents focus on the happy emotions when talking about donor conception to their young children. Most tell their toddlers and preschoolers how much they wanted a baby, about the people who helped them make it happen, about how grateful they are, and how overjoyed they were at the birth of their much-desired child.

But the truth is, many parents also faced barriers to having a family, like infertility, finding a partner, discrimination, and financial restrictions. In my experience, most parents naturally don’t want to focus too much on their own emotional struggles when explaining donor conception. However, when the children are older and able to understand nuance, the fuller narrative can emerge: the parents’ emotions, how they coped with difficulties, and what it took to build their family. Research on intergenerational family narratives suggests that what matters is not just that children know the facts of their family history, but that those stories are told with emotional honesty, coherence, and a clear sense of meaning, the kind of storytelling that helps children locate themselves within something larger than themselves.

What Donor Conceived People Say Matters About How They Were Told Their Story

Navarro-Marshall (2025) argues that the field has spent too long debating whether and when to tell children about their donor conception origins, and not nearly enough time on how those conversations should happen. She proposes a framework that reframes origin story sharing as a rich, responsive, emotionally open storytelling about their origins, one where parents ask questions, follow the child’s lead, and return to the story over time. This aligns with the elaborative reminiscing style of family storytelling discussed above.

A study by Applegarth et al. (2025) of 422 donor-conceived people also makes clear that how people learn about their conception matters enormously. Among those who found out at 16 or older, about two-thirds were dissatisfied with how they learned. Among accidental discoverers, nearly three-quarters were. The most difficult experiences combined both late and accidental discovery, bringing shock, confusion, sadness, and feelings of betrayal. What donor-conceived people in this study consistently valued was being told directly by a parent.

Parents can take real comfort from this. Whatever challenges may come, what matters might not be the story itself, but how, when, and by whom it’s told.

Family storytelling has benefits for parents, too. It can help address the fear of rejection that many parents carry. It’s been shown that elaborative reminiscing can be learnt, and that it creates closer and more resilient families over time, families where children feel secure, connected, and known.

I think something else can be transmitted via family storytelling. Most people who choose donor conception believe that love, shared history, and showing up for each other day after day, year after year, is what makes a family, not genetics. Stories are one of the most natural ways to communicate this value. You can point to it when you see it: a step-parent and child who are clearly devoted to each other, friends who are family. You can explain what is genetic (eye and hair colour), what is a mix of genes and environment (personality, how tall someone grows), and what is purely about the life you share, such as the fun you have together, the close bond you share, how much you enjoy each other’s company and how much you care about each member of your family, and communicate that this what matters.

For children, elaborative reminiscing means they learn about their beginnings in an open, warm way, where they have space to explore, to question, and make it their own (rather than stumble upon it, or it being shared under pressure). For the parents, it can help to address fear and to build stronger bonds. The child’s conception story is integrated into the whole family story and becomes one part of the many wonderful things that make their family who they are.

Bringing Storytelling Into Everyday Life

Working with families, I see every day that telling the conception story is an opportunity for family storytelling, to build trust and even to show some vulnerability that can bring you closer.

So how best to incorporate family storytelling into family life? There are as many ways as there are families, but one thing that really works for us is letting my children look through my camera roll on my phone. They’ll often pick up my phone, when we’ve got 10 minutes before we have to leave the house, for example, or they ask me to look at photos when we’re on the train or waiting in a queue. They scroll, and stop at photos that catch their attention, remembering the day, asking questions and giving me the opportunity to fill in any details or link to other events and stories.

Family storytelling doesn’t have to be a big deal. The in-between moments, like the queue, a cab ride, the 10-minute wait, are often where meaningful conversations happen.

Sonja Klug is the Founder of Storydo, a UK-based company that helps parents create personalised books to tell their children their family stories, including their donor conception story. For more tips on family storytelling, visit storydo.co.uk/blog.

References

Applegarth, L. D., Kaufman, N. L., Thomas, C., Beroukhim, G., Tsai, S., & Joseph-Sohan, M. (2025). Secrets and lies and donor conceptions: What donor-conceived individuals feel about their disclosure/discovery experience. Human Reproduction. Advance online publication. https://doi.org/10.1093/humrep/deaf215

Elias, A., & Brown, A. D. (2022). The role of intergenerational family stories in mental health and wellbeing. Frontiers in Psychology, 13, 927795. https://doi.org/10.3389/fpsyg.2022.927795

Fivush, R., Haden, C. A., & Reese, E. (2006). Elaborating on elaborations: Role of maternal reminiscing style in cognitive and socioemotional development. Child Development, 77(6), 1568–1588. https://doi.org/10.1111/j.1467-8624.2006.00960.x

Fivush, R., Bohanek, J. G., & Zaman, W. (2011). Personal and intergenerational narratives in relation to adolescents’ well-being. New Directions for Child and Adolescent Development, 2011(131), 45–57. https://doi.org/10.1002/cd.288

Marin, K. A., Bohanek, J. G., & Fivush, R. (2008). Positive effects of talking about the negative: Family narratives of negative experiences and preadolescents’ perceived competence. Journal of Research on Adolescence, 18(3), 573–593. https://doi.org/10.1111/j.1532-7795.2008.00572.x

Navarro-Marshall, J. (2025). Beyond the disclosure debate in donor-conception: How do we help families to discuss origin stories with their children? Human Reproduction, 40(3), 405-409. https://doi.org/10.1093/humrep/deaf004

This is a companion piece to a guest post about family storytelling. As I reviewed the research, I realized that this approach wasn’t too far off from what I use for my own family. Sharing the facts through Silverberg’s What Makes a Baby, making my kids their own Parts of Me book, and revisiting their “coming here” story in small moments when they present… all of that aligns with elaborative reminiscing. I decided to operationalize the conversation style for parents seeking concrete guidance for talking about donor conception.

I want to emphasize that knowing your genetic origins and finding them meaningful are different things. This piece is built on the first — that children deserve access to accurate information about how they came to be — without assuming the second. For some donor-conceived people, their origin story becomes a significant thread in how they understand themselves. For others, it remains background information. The goal is not that donor conception matters to your child in a particular way, but that they have what they need to decide for themselves whether and how it matters at all.

Robyn Fivush, a psychologist at Emory University, has spent decades studying how families talk about the past and what those conversations do for children. The style she identifies as most beneficial - elaborative reminiscing - is characterized by open-ended questions, emotional content, rich detail, and a consistent focus on following the child's lead. An elaborative parent doesn't ask "do you remember the zoo?" and wait for a yes or no. They build the story out loud together: "What animals did you see?" "How did you feel when the lion roared?" They fill in details when the child gets stuck and respond warmly to whatever the child contributes.

Research on elaborative reminiscing assumes that both the parent and the child were present for the event being discussed: a family vacation, a birthday party, or a family loss. Donor conception is different. The story is about something that happened before the child existed, that the child has no independent memory of, and that may involve people and circumstances they have never encountered.

Because there is no shared memory to revisit, the goal for family building storytelling shifts from “let’s remember this together” to “let’s craft this story together.” Elaborative reminiscing in this space is similar to narrative construction, and means returning to the story regularly, adding new details as the child grows, answering new questions as they arise, and letting the story evolve as the child’s understanding develops and circumstances change. It means helping the child become the protagonist of the story, not just the recipient, while leaving room for the possibility that some children, especially as they grow older, may want their donor conception identity to occupy a smaller place in their self-narrative. Ownership means they get to make that choice too.

While elaborative reminiscing was not developed with donor conception in mind, the principles offer useful guidance, and what follows is one possible way to apply them.

Lay the Foundation

To begin building a story together, your child needs one thing: a foundation of facts you return to and build on as your child grows up.

Every child has questions about where they came from, and every child deserves answers. A child cannot ask questions about a story they don’t know, and they cannot begin to make meaning from information they don’t have. The donor conception facts are part of your child’s origin story, but they are not the whole of it. Grounding them within a broader narrative means your child receives them in the context of everything else that is true about their family and their place in it.

These foundational facts are answers to questions like:

• How are babies made?

• What kind of help did your family have from donors, surrogates, or medical providers?

• What do we know about the donor(s)?

• Who was excited for you to be born?

• What happened when you arrived?

• How did people feel when they first met you?

• Who loves you and takes care of you every day?

Anchor the Story

Anchors keep a story present and give your child something important: agency. A child who can pick up a photo, open a book, or return to a folder on their own time and at their own pace is a child who owns their story.

Books are one of the most powerful anchors available and can do some of the work for you. Read alongside other beloved stories, they make the origin story ordinary. Let your child choose when to read them. Let them ask questions, or not. This includes books others have written or those you make yourself. (I maintain a summary of research and a list of the books I think get it right. I’m always adding new ones and welcome suggestions.)

Artifacts from the family-building experience, such as a good-luck charm from fertility treatment, a picture from the donor profile (if one exists), a pregnancy announcement photo, and mementos from the birth, kept in an accessible place rather than filed away, create natural openings for conversation without requiring a formal sit-down talk. The child can pick it up. The child can ask questions. You can say, “That’s from when we were hoping you’d come along,” and see where the conversation goes.

A simple folder or box that holds pieces of the family-building story (a parent’s reflection on a years-long journey, the people who showed up, and the community that formed around the child’s arrival; a donor profile and medical history) is more than a practical resource. It is a message that says: this is yours, it has always been yours, and it will be here whenever you are ready for it. Let your child know it exists and that they can return to it whenever they want. The contents of this folder will look different for every family. Genetic information is not the piece of the story, and it is not always the most important one.

Not every family has donor information. Some families have almost nothing. Name the unknown explicitly. “We don’t know what the donor looks like, but here is what we do know” makes the gap present and manageable rather than absent and potentially anxiety-provoking. A placeholder, like an envelope with a note that says “this is where we will put things as we find them out”, gives the unknown a home and communicates that new information is welcome when it comes.

Elaborate Over Time

Once your child has the facts and the story has a physical presence in their life, something new becomes possible: you can start building the story together. Remember, elaborative reminiscing is not about having the right answers. It is a way of being in a conversation: curious, responsive, and led by your child. Here is what it could look like in practice:

• Ask open questions. Instead of questions that can be answered with a yes or a no, ask questions that open things up. “What do you think about that?” “Tell me more.” “What happened next?” Open questions invite your child into the story as an active participant rather than a passive listener.

• Expand and add detail. When your child contributes something, build on it. Add the how, who, what, where, when, and why. If they say, “I wonder what the donor looks like,” you might add what you know or what you wonder too. This is how a bare fact becomes a story, and how a story becomes shared.

• Follow their lead. Listen to the question your child is actually asking, not the one you fear they are asking. Follow it with curiosity rather than rushing to respond. Be led by what interests them, what confuses them, what they want to know more about. Your job is not to direct the conversation but to go where they take it. One important caveat: children are sensitive to parental emotion, and a child who has gone quiet may not be a child who is satisfied. They may be protecting you, or themselves. Periodic, low-stakes invitations (“I've been thinking about your story lately; anything on your mind?”) keep the door open without requiring the child to knock. Likewise, watching for signs that a child is performing curiosity rather than feeling it — asking questions to please a parent — is its own form of following their lead.

• Validate their perspective. Accept your child’s view of the story, including feelings you find hard to hear. If they are sad, or angry, or curious in ways that feel uncomfortable, resist the urge to correct or reframe. “That makes sense” or “I can understand why you’d feel that way” matters more than setting the record straight. The goal is not accuracy; it is trust.

• Encourage and affirm. When your child contributes a question, a memory, a feeling, or an observation, tell them it matters. “That’s a really important question.” “I’m so glad you told me that.” “I hadn’t thought about it that way before.” Positive affirmation is what keeps the conversation open. A child who feels that their contributions are valued will keep contributing. A child who feels managed or corrected might go quiet.

• Talk about thoughts and feelings. Stories are not just sequences of events. What makes them meaningful is the inner life they carry, and the inner life that matters most here is your child’s. What do they think about what they’ve heard? How does it feel to know this about themselves? What do they wonder about? Invite your child to name their feelings, and make space for whatever comes up. Specific emotion words - curious, confused, proud, sad, excited, worried, unsure - give children a richer vocabulary to draw on and signal that all feelings about their story are welcome. Parents can share their own emotions too, not to ask the child to carry them, but to model that feelings can be named. “I felt scared because I didn’t know if it would work, and what helped was...” is not a burden; it is an invitation. It shows the child that difficult feelings belong in this conversation, and that they don’t have to protect you from theirs.

No parent gets this right every time. You will stumble over words, misjudge the moment, or say something you wish you could take back. It is not the perfect telling that matters, but the telling and retelling, the accumulation of conversations over the years that weave a story into the fabric of your family.

The research on elaborative reminiscing suggests that children who grow up in families where the past is talked about richly - openly, honestly, and repeatedly - develop better emotional understanding, stronger coping skills, and a more stable and coherent sense of who they are. We don’t yet have longitudinal research specific to donor-conceived children and family storytelling. For donor-conceived children, this storytelling model could help them hold their own story and make their own meaning from it. They will find their own labels for the relationships in their story. They will decide what meaning and value to place on those connections. They will determine how central their donor conception is to their identity, and what place it holds in the larger picture of who they are.

That is the goal: not a child who has been told their story, but a child who owns it.

Geographic Region: United States

Research Question: What are the views and needs of pregnant and new parents who used donor-assisted conception - and the clinicians who work with them - regarding disclosure to their children?

Design: Qualitative descriptive study. Data were collected between September 2023 and February 2024. Each participant completed a one-on-one, semi-structured interview conducted over Zoom, lasting an average of 45 minutes for parents and 36 minutes for clinicians. Interviews used a “think-aloud” method, where participants verbalize their thoughts as they work through questions.

Sample: 20 parents and 10 clinicians. Parents ranged in age from 27 to 52 years. Six were pregnant at the time of the interview and 15 were new parents with children aged 3 to 24 months (one participant was both pregnant and a new parent). The majority of parents identified as female (18), White (15), and straight (18). Fifteen were married or living with a partner. Types of donation used included egg (n=11), sperm (n=5), embryo (n=3), and double donation (n=1). Donor anonymity type was split between nondirected (anonymous) and directed (open-identity) donors. Clinicians (n=10) represented a range of disciplines including Advanced Practice Nurses (n=4), Registered Nurses (n=2), a Psychologist, a Clinical Counselor, a Social Worker, and a Physician. They worked in fertility/infertility (n=4), obstetrics and women’s health (n=3), and family and reproductive health settings (n=3), with experience ranging from 3 to 47 years. Nearly all clinicians identified as White (9) and female (8). Notably, half identified as sexual or gender minorities (lesbian, bisexual, or queer). One clinician also participated as a parent. Recruitment used multiple channels including online advertisements targeted at pregnant individuals and new parents, professional email lists for fertility and obstetrics clinicians, and the research team’s newsletter.

Key Findings

Theme 1: Reasons for What Matters Most

• All 20 parents said they intended to tell their children about their donor conception origins, most citing values like honesty, transparency, and avoiding shame. As one parent said, “I want it to be clear. I want it to be transparent. I don’t want there to be any shame attached to it.”

• Parents also wanted their children to know they were deeply wanted and intentionally created.

• Several parents reported that no healthcare professional had discussed disclosure with them, even within the required counseling session. One said: “No, not a soul. Nobody except for the therapist, and that was because [it was required].”

Theme 2: Managing Emotions, Conflicts, and Needs

• Most parents described a need for emotional support that they felt had been largely absent from their clinical care. Clinicians, particularly those outside fertility settings, also described feeling genuinely unprepared to counsel families on disclosure. One clinician said plainly: “Oh, I feel completely unqualified to do that [educate parents about disclosure]. I feel like that’s an incredibly personal, like, parent decision. And I don’t think it’s something that I have any training or knowledge and feel confident, giving any advice about at all whatsoever.” Parents experienced this gap directly. One parent observed: “…but I feel like every time I’ve hit a healthcare professional with like, ‘she’s donor conceived,’ like they are like deer in headlights, like they don’t know what to do. They don’t know what to say.”

• Even clinicians who recognized parents’ emotional needs described being constrained by time. One said, “In my current practice, I am [time] limited. We only have 15-minute appointments. And I have to make sure I touch on all the important things…. And they have to check with their insurance company, etc., etc. So, I hadn’t even thought of talking to [patients] about that [disclosure to their children].” Another clinician added that parents’ emotional needs around family stigma alone were time-consuming: “So usually what takes the most amount of time is just them telling me about the family situation and how they’re afraid their children [will] get disowned.”

• Several parents used the language of grief and loss to describe their experience of using donor-assisted conception. One parent described the emotional weight of the selection process: “It’s really emotional going through the process of looking at people’s pictures [to select a gamete donor]. It’s like you’re shopping for somebody that’s like you. But nobody is gonna be like you. And you have this weird mixture of excitement but sadness…. And you need to get through all that in order to make it to the end stage of being the parent, and then from there on out, being able to tell them… So that you tell them in a healthy way. And in order to get to the point of being able to tell them in a positive way, you have to process your own grief and trauma.”

• Fear that their child would reject them or feel like a second choice was one of the most consistently voiced concerns across the parent interviews. Parents described both the emotional pain the fear evoked and how it shaped how they thought about disclosure. One parent shared, “the biggest question that comes to my head, and my greatest fear is still acceptance. Her, you know, accepting what I did. And not finding faults in it at the end of the day is like my greatest fear.”

• Several parents worried about their child feeling like a “last resort”: “I don’t want them to ever feel like they are second choice, because obviously it’s like ‘Oh! She tried, she tried, she tried it, didn’t work, and she couldn’t have one the other way. So her last resort was us.’”

• For parents in two-parent families, partner disagreement was a distinct and significant stressor. While some couples described being aligned, others were at opposite poles of the spectrum. Even among couples who broadly agreed on disclosure, the specifics (when to start, how often to bring it up, what to say to a very young child) could be a source of friction. One parent recounted their partner’s resistance: “He’s like, ‘Our kids are so little. Why is this a conversation that we’re having right now?’” Another parent reported that they had largely avoided the conversation altogether: “We’ve not had much discussions about that because we’re a little bit confused [about how to tell].”

Theme 3: Desired Content for Support

• Parents wanted help understanding how their choice of donor (e.g., anonymous/nondirected versus open-identity/directed) would shape the disclosure process and their child’s future access to information.

• Parents wanted more information about the disclosure process itself, specifically when to start, what frequency of conversations was appropriate, and what “tell them early” actually looked like in practice with an infant or toddler.

• Parents wanted explicit guidance on what words to use, both for the donor and for others within the donor network. Many described uncertainty about terminology, even in the day-to-day language of their own families.

• Several parents raised a need that is often overlooked in the disclosure literature: guidance on how to talk with extended family, friends, and the broader social world. Donor conception doesn’t exist in a family bubble, and families with limited language and support for their wider network face additional complexity.

• Parents and clinicians almost unanimously wanted perspectives from donor-conceived adults, and importantly, they wanted DCP voices framed around practical guidance, not cautionary testimony.

• Peer connection with other parents navigating disclosure was also frequently mentioned. Some parents wanted to hear from parents who were “ahead of their timeline,” while others said talking to other parents would cause them to second-guess themselves.

• Parents, especially those with open-identity donors, expressed significant confusion and anxiety about how to navigate relationships with donors, donor siblings, and the donor’s family.

Theme 4: Recommended Support Characteristics

• Most parents said disclosure support should begin well before a successful pregnancy, ideally before or during the donor selection process, when consequential decisions with long-term disclosure implications are still being made. At the same time, clinicians were divided on timing. Some felt support was best introduced once pregnancy was confirmed and parents were emotionally ready to engage. Others saw value in multiple touchpoints across the entire journey.

• Parents and clinicians were clear that support delivered in a single format would inevitably exclude some families. Multiple delivery modes (video, audio, and written text) were seen as essential to reaching parents with different learning styles, cognitive loads, and life circumstances.

• Customization was understood not as a convenience feature but as a signal of inclusion. Parents and clinicians were explicit that support designed around a default family type would feel alienating to the many families that don't fit that template. They asked for content tailored to family type (single parent by choice, same-sex couple, heterosexual couple), donation type (egg, sperm, embryo), and donor anonymity type.

• Over half of parents wanted a way to connect with other parents navigating similar experiences: “It’s nice to know you’re not alone.”

• Privacy protection and low or no cost were identified as essential features. Cost was seen as a barrier for families already managing expensive fertility treatment.

• Clinicians emphasized that support must be evidence-based and tested. They needed confidence in its validity before recommending it to patients.

Editor’s Note: All parents in this sample intended to disclose and volunteered to participate in a study about telling, so these findings reflect a motivated, disclosure-positive group. The emotional complexity described is real and important, but may not capture the full range of experiences among parents who are more ambivalent or opposed to disclosure.

Limitations: The sample is largely White, female, English-speaking, and US-based, limiting generalizability to other racial/ethnic groups, languages, and countries. The gap between intention and action is critical context here. The study does not examine how race, ethnicity, class, or cultural background shape parents’ experiences of donor conception or their disclosure decision-making.

Applications: Most clinicians outside of fertility settings feel unprepared to counsel donor-conceived families about disclosure, yet many donor-conceived families encounter these clinicians during obstetric care, pediatric visits, and primary care. Professional education about disclosure, including basic language, what research shows, and how to refer families to appropriate resources, is an unmet need across disciplines. Very little is known about what makes disclosure experiences high-quality beyond timing. Components like ongoing conversations, how donor kinship relationships are navigated, how donor type shapes the experience, and how racial and cultural context affects family communication patterns are important directions for future research. The ASRM already recommends psychoeducational counseling about disclosure, but this study suggests the counseling requirement is inconsistently implemented and often perceived by parents as a procedural hurdle rather than meaningful support. Clearer standards, better training, and integration of support across clinical settings might strengthen the translation of recommendations into practice.

Funding Source: American Society for Reproductive Medicine (ASRM) Research Institute through an educational grant from EMD Serono, a pharmaceutical company that manufactures fertility medications

Lead Author: Patricia E. Hershberger is the Rhetaugh G. Dumas Endowed Professor and Chair of the Department of Health Behavior and Clinical Sciences at the University of Michigan School of Nursing, where she leads a transdisciplinary research program focused on improving outcomes for individuals and families created through donor-assisted conception. No personal connection to donor conception was disclosed. Hershberger served on the ASRM Taskforce on the Needs and Interests of Donor Conceived People.

Regulatory Context

• The United States has no comprehensive federal legislation governing donor conception, with regulation primarily occurring at state level, creating a patchwork of laws across the country. The Food and Drug Administration (FDA) provides minimal federal oversight, mainly focused on screening requirements for disease prevention.

• There are no federally mandated limits on the number of children conceived from a single donor. The American Society for Reproductive Medicine (ASRM) recommends limiting donors to 25 live births per population area of 850,000, but this is voluntary and not enforced. Colorado became the first state to establish a statutory limit in 2022, capping donor use at 25 families per donor, regardless of location, effective January 2025.

• No centralized national registry exists to track donor-conceived births OR donors, making it difficult to enforce any limits in practice.

• Commercial donation is permitted throughout most of the United States. Donors can be compensated for their gametes.

• Access to donor conception is generally open to a wide range of individuals regardless of marital status, sexual orientation, or gender identity. Most major medical organizations support the position that fertility treatments should be available to any individual who is fit to parent.

• The U.S. does not have national laws prohibiting anonymous donations, but this practice is gradually changing. Colorado’s 2022 “Donor-Conceived Persons Protection Act” (effective January 2025) bans anonymous donation and gives donor-conceived individuals the right to access their donor’s identity upon reaching age 18. In January 2024, the Uniform Law Commission amended the Uniform Parentage Act to require disclosure of donor identifying information to adult donor-conceived persons upon request, though states must adopt this amendment for it to become law in their jurisdictions.

Related Posts

• Most egg donors tell their partners and friends about their donation, but only half disclose to their own children (Adlam, 2025)

• Egg donors report lack of follow-up for medical updates from clinics (Adlam, 2025)

• A promising disclosure tool could help close pediatric provider knowledge gaps about donor conception (Hershberger, 2025)