P-478 Investigating the attitudes, beliefs and motivations of egg donors, recipients and egg sharers
Authors: Goh R , Bracewell-Milnes T , Nicopoullous J , Thum Y 
Published: July 2024

Abstract

Study question
What are the attitudes, motivations and experiences of egg donors, sharers and recipients in the United Kingdom?

Summary answer
Participants’ experiences were generally very positive, but also diverse and nuanced.

What is known already
Most studies on egg-sharers are based on quantitative surveys rather than explorative interviews, precluding a more nuanced understanding of insights. A study found that 54% of egg-sharers would have donated their oocytes regardless of their ability to afford their own treatment. Another study demonstrated that around half of egg-sharers believed that the child’s parents should decide whether to disclose the nature of the conception to their children, while the other half believed in the offspring’s right to knowledge. These studies demonstrate the divided nature of certain topics and the need for a deeper exploration.

Study design, size, duration
Participants who consented to research were recruited via email to participate in exploratory, semi-structured interviews. The interviews were transcribed and analysed via thematic analysis. Braun and Clarke highlighted various analytical approaches to consider when writing a thematic analysis. For this paper, an ‘inductive’ analytical framework was chosen, in which themes were grounded strongly in data. This minimised the influence of researchers’ epistemological preconceptions on the analysis.

Participants/materials, setting, methods
Participants were recruited from Lister Fertility Clinic London, one of the largest private IVF clinics in UK. These patients had begun their treatment with Lister Fertility Clinic after 2019, thus minimising recall bias. After holding the initial set of interviews, the team then decided whether theoretical saturation was reached. Interviews were conducted with a total of 22 patients, half of whom were egg-donors/-sharers and half of whom were egg-recipients.

Main results and the role of chance
The first theme explored two negative emotions amongst egg-recipients — grief and tension. Most women, while feeling overwhelming love for their children, all shared strategies they adopted to establish strong maternal ownership of their child. The loss associated with infertility dealt a severe emotional blow to many women, especially when they foresaw having biological children as a virtually guaranteed part of their future. Nonetheless, as participants grappled with the grieving process, feelings of acceptance gradually emerged. All egg-recipients believed that it was their child’s right to contact their biological parents. However, a few participants admitted feeling reluctant about a potential connection between their child and their biological mother, due to fears that the new mother-figure may threaten the exclusivity of the child-to-mother bond.
The next theme explored participants’ motivations and their in-clinic experiences. All interviewees cited altruism as an important motivating factor. The final theme focused on reciprocal donor-/sharer-recipient thoughts. Amongst the egg-donors and -sharers, none of the participants minded who their eggs were received by, regardless of demographics. A few stressed the importance of good parenting behaviour over any superficial characteristics in determining a potential parent’s merit.

Limitations, reasons for caution
Future investigation into assisted donor-conception experiences in diverse family systems (eg. gay males and surrogate families) and the use of a prospective study design to minimise selection bias would enrich this study’s promising findings.

Wider implications of the findings
The Human Fertilisation and Embryology Authority decided not to ban egg-donation or -sharing. Some ethicists responded with concern that subsidies still form a financial incentive, compromising the validity of consent. This study provides support to HFEA by demonstrating that reciprocity, rather than exploitation, is the more likely principal driver.

Trial registration number
Not applicable