DC Journal Club - November Round Up
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In response to a reader’s question, I traced “genealogical bewilderment” and “genetic mirroring” from their clinical origins to their adoption by affected communities and recent appropriation by conservative groups. While neither meets diagnostic standards, the experiences they describe are real for many donor-conceived people. I examine how these terms function as shared vocabulary and advocacy tools while risking pathologization of curiosity and weaponization by organizations like The Heritage Foundation to restrict reproductive access.
I also revisited my post on the impact of DNA discoveries. DCP’s testing decisions involve weighing family “ruptures” and disclosure management, while discoveries can trigger identity shifts and gatekeeping responsibilities protecting newly discovered matches. Current support systems fall short, with mental health professionals frequently lacking specific training, while medical organizations’ guidance hasn’t kept pace with DNA testing realities, with some still endorsing non-disclosure.
Research Recap
I attended the American Society of Reproductive Medicine’s annual conference this year and shared what I learned:
One researcher found that the median cost of a donor sperm vial ranged from $1,195 to $1,625, depending on cycle type and donor transparency, with higher costs consistently associated with ID-disclosure donors compared to “anonymous” donors. One bank saw a dramatic 40-80% increase over a two-year period.
A survey of intended parents seeking Black sperm donors found that 79% rated the search as very/extremely challenging, and 40% of future recipients were considering remaining childless.
Another research team found that in over 60% of 390 donor-recipient pairings, when one genetic parent (donor or recipient) was identified as a carrier for a genetic condition, the other genetic parent had not been tested for that same condition, creating uncertainty about the risk of passing that condition to offspring.
TikTok egg donation content is predominantly created by influencers (38%) and egg banks (34%) rather than healthcare providers (3%).
Over half of U.S. fertility clinic websites continue to use anonymity language despite ASRM’s 2022 position and DNA testing realities.
Applegarth et al. (2025) surveyed 422 donor-conceived adults (median age 32, 87% sperm donation, 94% Caucasian) across eight countries about disclosure satisfaction. While 36% learned early (birth-15 years) and 64% learned late (16+ years), those told early and intentionally were three times more likely to feel satisfied compared to late or accidental discoveries. Nearly three-quarters of people who discovered accidentally felt dissatisfied, with 94% reporting shock, 77% confusion, and 66% experiencing sadness and betrayal. In contrast, 57% of those told early and intentionally felt neutral, with 29% feeling special and 22% positive. Disclosure from birth to 7 years was associated with highest satisfaction, while ages 16-25 showed lowest satisfaction.
Turrini et al. (2025) examined how expanded carrier screening has been integrated into Spain’s gamete donation system. Following a 2016 court ruling, Spain developed a two-tier system: mandatory “basic” genetic carrier screening for five prevalent conditions and optional “expanded” screening (200-3,000+ genes) marketed as a paid add-on. Competition centers on panel size rather than clinical utility, with genetic matching increasing donor pools by allowing carriers to match with non-carrier recipients. The study revealed asymmetric practices where donors undergo mandatory comprehensive screening but may be denied access to their own results (or charged for them), while recipients retain testing autonomy. Clinics market expanded screening using scientifically imprecise terms like “genetic compatibility” and “quality guarantee,” promoting deterministic views despite experts’ acknowledgment of unavoidable residual risk and concerns that commercial imperatives drive expansion over clinical necessity.
Asante-Afari (2025) explored Ghanaian religious perspectives (Christian, Muslim, Traditionalist) on ART. While most Christian denominations (excluding Roman Catholic) and Islamic leaders accepted ART using couples’ own gametes, viewing it as permissible medical assistance, all three religious traditions unanimously opposed gamete donation, citing social, ethical, psychological, and spiritual consequences. All groups rejected surrogacy based on beliefs about maternal bonding and divine processes. Christian and Islamic leaders conditionally accepted cryopreservation only for married couples’ own gametes while both spouses are alive and married, while Traditionalists rejected it entirely. The findings suggest parents using donor gametes may face religious pressure toward secrecy despite research supporting early disclosure, though one Christian woman stated she would leave her church if it meant accessing donor services to have children.
van Bentem et al. (2025) found that while egg donor recipient families in the Netherlands valued comprehensive preconception counseling and appreciated standard psychosocial counseling for gamete donation, they reported healthcare providers lacked knowledge about egg donation and provided contradictory information, forcing recipients to seek information through online forums. Participants described the process as physically and mentally demanding, with women processing grief over genetic disconnection and male partners having unaddressed sperm quality concerns. Some providers made insensitive comments about genetic resemblance during pregnancy and delivery. The most frequent recommendation was implementing international or national guidelines to standardize counseling and healthcare management for egg donation pregnancies.
Other Tidbits
Trans activist Kenny Ethan Jones (@KennyEthanJones on TikTok) is documenting his sister Kizzy’s pregnancy after serving as her known egg donor. The siblings attended mandatory counseling to explore potential complications of intrafamily donation before Jones underwent egg retrieval, temporarily pausing testosterone therapy for the process. Jones and Kizzy plan to document how they navigate disclosure conversations with the child about their origins, offering a real-time look at known donation dynamics, family relationship navigation, and intentional communication about donor conception within families where the donor remains an active presence as the child’s uncle.
A legal analysis from an Australian law firm examines compliance challenges created by fragmented donor conception laws across Australia’s states and territories. (I mostly found this helpful for the table that documents each state’s current status!)
A Guardian investigation examines unregulated UK Facebook sperm donation groups where membership has surged to over 10,000. Women report coercive practices where donors pressure recipients into sex by falsely claiming it’s more successful than artificial insemination, with some refusing to proceed without sexual demands being met. Prolific donors, including traveling influencers, leave trails of potentially hundreds of legally untraceable siblings. Recipients face risks including sexual assault, STDs, hidden genetic disorders, unexpected legal entanglements, and potential consanguinity risks.
Knowing is not enough; we must apply. Willing is not enough; we must do.
- Johann Wolfgang von Goethe