Marital preservation, parenting concerns primary needs for oocyte recipients
Development and psychometric evaluation of a questionnaire addressing the psychosocial needs of oocyte recipient women. (Ghelich-Khani, 2025)
Ghelich-Khani, S., Kazemi, A., Fereidooni-Moghadam, M., & Nekuei, N. (2025). Development and psychometric evaluation of a questionnaire addressing the psychosocial needs of oocyte recipient women. BMC Psychiatry, 25(1), 885. https://doi.org/10.1186/s12888-025-07330-0
Geographic Region: Iran
Research Question: What are the psychosocial needs of women receiving donor oocytes?
Design: This study created and tested a questionnaire in two phases from 2023-2024. In the first phase, researchers tested and refined a questionnaire. The final version proved reliable and consistent - when people took it twice, they gave similar answers both times. In the second phase, 180 women receiving donor eggs completed the refined questionnaire. Researchers used statistical analysis to see which questions grouped together into themes and whether the questionnaire reliably measured women’s psychosocial needs. Data were collected at various points during treatment before women took pregnancy tests.
Sample: The 180 women were on average 37 years old and had been trying to get pregnant for an average of 8.6 years. About one-third had high school education or less, 5% had completed high school, and 4% had college degrees or higher. About two-thirds were employed. Women who absolutely refused to tell anyone about using donor eggs couldn’t participate. Researchers recruited participants through fertility clinic staff using convenience sampling.
Key Findings
The 26 questions of the questionnaire were grouped into four main themes that together explained about 56% of women’s psychosocial needs. These four themes were related but distinct - women could have high needs in one area but lower needs in another. The questionnaire showed strong reliability, meaning it consistently measured these needs.
Need to Protect Marriage - Women worried that fertility problems and involving a third person (the egg donor) might damage their marriage, sex life, and understanding with their husbands. This was the strongest theme, accounting for about 30% of women’s concerns.
Need for Ethical and Legal Reassurance - Women needed to trust their doctors, get complete information about the legal and ethical aspects of using donor eggs, know their privacy would be protected, feel confident the donor was healthy, and be assured the donor wouldn’t try to claim the child later.
Need for Parenting Support - Women worried about whether they would be able to develop mother-like feelings during pregnancy, form emotional bonds with a child who wasn’t genetically theirs, and successfully take on the parent role.
Need for Partner Support - Women needed their husbands to understand what they were going through emotionally, support them throughout treatment, and protect them from blame or judgment from family and friends.
Limitations: This study took place only in Iran, so the findings may not apply to women in other countries with different cultures and religious backgrounds. In Iran, Islamic law requires a temporary marriage between the husband and the egg donor, which creates unique emotional stress not present in other countries. This means some of the needs identified in this questionnaire may be specific to the Iranian context and might not be relevant elsewhere.
Applications: The 26-item instrument offers a structured assessment tool to systematically identify psychosocial needs of oocyte recipient clients, enabling tailored counseling interventions addressing specific concerns.
Funding Source: Isfahan University of Medical Sciences (Grant number: 398387)
Lead Author: Shohre Ghelich-Khani is affiliated with the School of Nursing and Midwifery at Isfahan University of Medical Sciences in Iran and has research interests in the psychosocial experiences of oocyte recipient women in assisted reproductive technology. No personal connection to donor conception was disclosed.
Regulatory Context
Iran has a regulatory system shaped by Islamic religious law and national legislation. The Act concerning Embryo Donation to Infertile Couples (2003) permits embryos resulting from fertilization of a husband’s sperm and his wife’s egg to be donated to other infertile couples, provided both donor and recipient couples are legally married.
Because there are no explicit legal provisions for gamete (egg or sperm) donation, whether it’s allowed depends on religious rulings (fatwas) from Shiite religious leaders. Different religious authorities have different opinions - some permit gamete donation while others consider it impermissible.
A distinctive feature in Iran is the requirement for temporary marriage (sigheh) between the male partner and egg donor within assisted reproductive technology involving oocyte donation. This practice aims to preserve genealogical clarity (nasab), ensure moral legitimacy, and uphold religious norms within Islamic societies. However, this requirement creates unique psychological stressors for recipient couples including feelings of jealousy, insecurity, and emotional vulnerability about the husband’s marital bond with the donor.
Within Iran’s legal and religious context, inheritance and familial identity are strictly defined by biological lineage, and donated oocytes introduce legal and ethical ambiguity concerning maternal identity. Religious rulings regard couples receiving oocytes as adopted parents rather than genetic parents.
Fertility centers are legally required to keep donor and recipient identities confidential, treating this information with the same level of secrecy as state secrets. There is a strong cultural tendency for Iranian couples to keep their use of donor conception private, often not telling extended family members or even the resulting children about the donor conception.
Related Posts