Cross-border egg donation creates a contact mismatch that counseling is not addressing
Mismatched expectations regarding donor anonymity: The implications of Australians crossing-borders for egg donation in South Africa. (Volks, 2026)
Volks, C., Hammarberg, K., & Whittaker, A. (2026). Mismatched expectations regarding donor anonymity: The implications of Australians crossing-borders for egg donation in South Africa. Human Fertility, 29(1), 2618232. https://doi.org/10.1080/14647273.2026.2618232
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.
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