Parents who used egg donation say better counseling and consistent guidelines are urgently needed
The perspectives of recipients and their partners conceiving through oocyte donation on counselling and healthcare: A qualitative study. (van Bentem, 2025)
van Bentem, K., Lashley, E., Visser, A., Vermeulen, M., ter Kuile, M., & van der Hoorn, M. L. (2025). The perspectives of recipients and their partners conceiving through oocyte donation on counselling and healthcare: A qualitative study. Women’s Health, 21, 1-15. https://doi.org/10.1177/17455057251374891
Geographic Region: The Netherlands (with some participants receiving treatment abroad in countries including Finland and Spain)
Research Question: What are the perspectives and experiences of women and their partners regarding counseling and healthcare when conceiving through egg donation, and what improvements do they recommend?
Design: Qualitative case study. Three in-depth focus groups conducted between September 2021 and June 2022 via online platforms due to the COVID-19 pandemic. Focus groups were structured around four predefined themes: Preconception counseling, egg donation treatment, Pregnancy, and (Post-)Delivery, with semi-structured questionnaires guiding discussions. Each session lasted approximately 1 hour and 42 minutes on average.
Sample: 18 participants (13 women and 5 male partners) who had experienced pregnancy and/or delivery after oocyte donation within the past 10 years. They were recruited through Freya, the Dutch Association for People with Fertility Problems, via online advertisement. Participant ages at focus group time ranged from 30-45 years. All couples were heterosexual with male partners; none required sperm donation. Treatment locations were split between the Netherlands (7 participants) and abroad (9 participants). Donor types included anonymous donors (7 participants), identity-release donors (8 participants), and non-anonymous/known donors (9 participants).
Key Findings
Comprehensive preconception counseling, which covered medical logistics, emotional impact, and ethical issues, was highly valued and positively evaluated by participants who received it.
Participants who received oocyte donation treatment in the Netherlands were generally informed about possible pregnancy complications during preconception counseling, but this counseling was often lacking for those who went abroad.
Participants felt that healthcare providers lacked knowledge about oocyte donation and provided contradictory information, which forced recipients to seek information independently through online forums.
Psychosocial counseling with social workers or psychologists before egg donation treatment was standard in the Netherlands and universally appreciated, but was typically absent at foreign clinics.
The egg donation process was unanimously described as physically and mentally demanding by both women and their partners.
Women needed to process the grief of being unable to conceive with their own oocytes, while male partners had specific concerns about sperm quality that weren’t always adequately addressed.
Peer support was frequently valued, though couples experienced a lack of guidance from healthcare providers on how to connect with peers in similar situations.
Some healthcare providers lacked sensitivity about egg donation-specific concerns, making comments about genetic resemblance that were distressing to parents. One participant shared: “I always appointed to all the gynaecologists that it was an oocyte donation pregnancy, and later with the delivery I really wanted everyone at my bedside to know that. That they do not immediately start saying ‘that baby looks exactly like its mother.’”
The most frequently stated recommendation was implementing an international or national guideline to standardize counseling and healthcare management for oocyte donation.
Limitations: Possible recall bias as egg donation treatment, pregnancy, and delivery occurred up to 10 years prior for some participants. The study may be biased regarding need for peer support, as participants were recruited through a patient association where those seeking peer connections are overrepresented.
Applications: Obstetricians and midwives can ensure all team members caring for a patient (especially in group practices) are aware of gamete conception and understand implications for pregnancy and birth.
Funding Source: Not explicitly stated
Lead Author: Kim van Bentem, MD, is a physician researcher in the Department of Obstetrics and Gynaecology at Leiden University Medical Center in the Netherlands, where she is pursuing MD/PhD training focused on oocyte donation pregnancies and maternal-fetal medicine. No personal connection to donor conception was disclosed.
Regulatory Context
Gamete donation is regulated by Dutch law, with the 2004 Artificial Fertilisation Donor Information Act abolishing donor anonymity and regulating access to donor information.
Both sperm and egg donation are permitted. Embryo donation became legal in 2019.
Only altruistic gamete donation is allowed. Donors can receive compensation for expenses and inconvenience but not payment for the gametes themselves.
Anonymous donation is prohibited. All donors must agree to be identifiable to offspring. Donor-conceived individuals have the legal right to obtain identifying information about their donor when they reach “sufficient maturity,” typically interpreted as age 18, though no specific age is mandated by law.
Same-sex female couples have had access to donor insemination since 2005 and IVF since 2016. Single women gained access in 2016. Donation is only allowed at authorized fertility clinics; private arrangements are not legal.
Donors must be 18 years or older. All prospective donors and recipients must undergo counseling and medical/psychological screening.
There are restrictions on how many children/families can be created from one donor’s gametes, but the exact number can vary between clinics.
Parents are encouraged but not legally required to tell children about their donor conception. However, the information is recorded in medical records that the child can access as an adult.
A central register of all donor treatments is maintained by the National Board of Health and Welfare.
Donors do not have any legal or financial obligations to offspring and are not considered the legal parents.
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