Three Perspectives on DCP Wellbeing, Recruitment Challenges, and Family Outcomes
Donor conception in the interests of the well-being of donor-conceived persons, and other parties connected through donor conception
Goedeke, S. (2025). Donor conception in the interests of the well-being of donor-conceived persons, and other parties connected through donor conception—A review. Fertility & Reproduction, 7(1), 16-26. https://doi.org/10.1142/S2661318225300028
Sonja Goedeke (New Zealand) completed a narrative review of the key considerations and practices needed to ensure donor conception is conducted in the interests of the wellbeing of donor-conceived persons and other parties involved in the donor conception process. The review drew mostly from Western literature and included qualitative studies that examined the experiences of donor-conceived individuals, parents, and donors; quantitative studies on disclosure rates and outcomes; systematic reviews of contact experiences; and policy analyses of regulatory frameworks.
Key Findings
Five key practices seem to support donor-conceived people's wellbeing: disclosure of donor conception, access to identifying information about donors and siblings, ability to contact donors and/or siblings if desired, altruistic rather than commercial donation, and adequate support systems.
Early disclosure is associated with better outcomes than late disclosure, with research consistently showing that delayed or accidental disclosure is associated with negative experiences for donor-conceived people.
Direct-to-consumer DNA testing has effectively ended anonymity even in jurisdictions that maintain anonymous donation policies, as people can now identify genetic relatives regardless of legal frameworks.
Contact experiences between donor-conceived people and donors or siblings are generally reported as positive, with satisfaction and fulfillment commonly described, particularly when donors are receptive and supportive.
Cross-border reproductive care presents significant challenges, including limited access to donor information, potential exploitation of financially vulnerable donors, and complications in tracking donor limits across jurisdictions.
Informal donation through home insemination lacks screening protocols, legal protections, and information recording systems that clinic-based donation provides.
Large or unlimited donor limits create emotional distress for donor-conceived people who may discover numerous half-siblings and raises concerns about inadvertent consanguinity.
Counseling and professional support are frequently required in many countries, but gaps exist in ongoing support, particularly for linking services that help people connect with genetic relatives.
The author advocates for professional counseling before and after donation for all parties, central registries for maintaining donor information, limits on the number of families per donor, altruistic rather than commercial donation, and public education about fertility and donation needs.
Global factors affecting sperm donation in the 21st century
Mincheva, M., Fraire-Zamora, J. J., Sharma, K., Liperis, G., Ammar, O. F., Kirkman-Brown, J., Egeberg, D. L., Veloso Martins, M., Frith, L., & Uraji, J. (2025). To be or not to be a sperm donor: global factors affecting sperm donation in the 21st century. Human Reproduction, 00(00), 1-7. https://doi.org/10.1093/humrep/deaf073
As demand for donor sperm increases, driven by growing numbers of same-sex couples and single women seeking fertility treatment, recruitment is struggling to keep pace. The European Society of Human Reproduction and Embryology (ESHRE) Journal Club conducted a comprehensive peer perspectives review examining the global factors influencing sperm donation recruitment in the 21st century.
Key Findings
Pacey et al (2023) found that only 5.16% of sperm donor applicants ultimately become active donors, with the majority (55%) withdrawing or failing to respond during the screening process, representing a significant barrier to maintaining adequate donor pools.
While demand for sperm decreased due to ICSI technology enabling men with infertility to use their own sperm, it increased following legal recognition of same-sex couples and single women in many countries. One US study found that 75% of sperm bank customers are same-sex couples and single women.
Direct-to-consumer DNA testing has effectively eliminated anonymity guarantees in donor conception regardless of jurisdictional policies, as donor-conceived people can now trace biological parents and half-siblings through genealogy databases, yet many donors were promised anonymity decades ago.
Discriminatory restrictions persist in some countries (the USA’s FDA currently bans men who have had sex with men in the last 5 years from donating sperm) despite evidence showing these restrictions are outdated, don’t increase recipient safety, and exclude willing, suitable donors.
No global consensus exists on comprehensive genetic screening protocols for donors. While cystic fibrosis testing is standard and ethnic-specific carrier screening is recommended, guidelines vary on whether proven carrier status should be an exclusion criterion or managed through informed consent and recipient screening.
Recruiting donors from minority ethnic groups faces significant cultural barriers related to attitudes toward donor conception, diverse family structures, and masturbation, creating shortages that limit access for recipients seeking ethnically matched donors.
Medical screening requirements must balance recipient safety with practical accessibility—lengthy quarantine periods, extensive testing, and strict criteria can increase logistical burdens and costs while potentially reducing the available donor pool to unsustainable levels.
International coordination on donor limits is lacking, creating risks of individual donors fathering hundreds of children across multiple countries and sperm banks, raising concerns about inadvertent consanguinity and overwhelming emotional impact on donor-conceived people who discover numerous half-siblings.
Young donors may not fully grasp long-term consequences of donation, including having numerous genetic offspring, potential impact on their own family planning and relationships, possibility of future contact requests from donor-conceived children, and the reality that DNA testing has made anonymity impossible to guarantee.
The authors advocate for evidence-based international standardization of regulations regarding identity release, offspring limits per donor, fair compensation, and donor eligibility criteria; removal of discriminatory restrictions based on sexuality; comprehensive psychological counseling throughout the donation process; improved recruitment strategies to diversify donor pools; and adaptation of regulations and counseling to reflect the reality that DNA testing has eliminated anonymity in donor conception.
‘The kids (and adults) are alright:’ what can we learn from donor-conceived families that thrive?
Scheib, J. E., & Mackenzie, S. (2025). ‘The kids (and adults) are alright:’ what can we learn from donor-conceived families that thrive? Reproductive BioMedicine Online, 00(00), 1-2. https://doi.org/10.1016/j.rbmo.2025.105132
Scheib and Mackenzie (USA) authored a viewpoint commentary responding to Carone et al.’s longitudinal study findings on donor-conceived adults raised by lesbian parents. The commentary synthesizes evidence from this landmark study and broader research to identify what factors enable donor-conceived families to thrive, emphasizing the importance of family processes over structural factors like donor anonymity.
Key Findings
The 20-year U.S. National Longitudinal Lesbian Family Study shows that donor-conceived adults (ages 30-33) raised by lesbian parents demonstrate robust psychological adjustment sustained from childhood through adulthood, providing reassurance that donor conception can lead to positive family outcomes.
No differences in psychological outcomes were found between donor-conceived adults based on donor type (anonymous/closed-identity, open-identity, or known donors), challenging assumptions that access to less donor information would be associated with poorer well-being.
Family processes, and in particular communication practices and relationships within families, matter more for donor-conceived people’s well-being than structural factors like family type or donor anonymity, though research has only begun to examine how specific variations in these processes impact outcomes.
Early, open disclosure of donor origins by parents is associated with positive outcomes, while donor-conceived people who learn late, in negative circumstances, or from non-parental sources often report feeling distressed and betrayed, highlighting that secrecy represents a key challenge to well-being.
Two distinct groups of donor-conceived experiences have emerged: those whose parents shared origins information early and worked to normalize donor conception through community support, who demonstrate robust well-being; and those raised with parental secrecy due to societal shame around infertility, who often experience distress when learning of their origins as adults.
Direct-to-consumer genetic testing has made donor anonymity arguments largely obsolete, as donors will be identified regardless of promises made about anonymity or their desire for privacy, creating increased urgency for policies that prepare all parties for potential contact.
Contact between donors and donor-conceived people may be challenging, especially when unprepared for, as donor conception remains poorly understood and not uniformly accepted in society.
The authors advocate for reproductive policies and programs that support parents in sharing donor origins with their children early, adequately prepare and support both donors and donor-conceived people for possible contact, and implement legal protections for parentage in all families with donor-conceived children (particularly LGBTQ+ families who face inconsistent and weaker legal protections than heterosexual families). They emphasize that focusing efforts on these supportive practices will be more effective than debating donor anonymity policies that are now rendered obsolete by genetic testing technology.