P-712 A national survey of women’s perspectives and experiences of pursuing donor eggs
Authors: Kieu V , Lensen S , Polyakov A , Lew R , Agresta F , Caughey L , Peate M 
Published: July 2024

Abstract

Study question
What are the experiences of women who consider a donor egg, and the outcomes of those who receive donor eggs for conception?

Summary answer
Of 255 respondents, 59 women (23.1%) were formally placed on a donor egg waitlist, despite 80.6% respondents considering donor eggs with an IVF clinic (166/206).

What is known already
There is a shortage of donor eggs worldwide. Oocyte donation is a treatment option that is increasingly used for infertile women, as seen through the percentage of patients undergoing IVF who are over 40 years. Previous international studies report oocyte donation recipients to be predominantly aged 34-40 years, white, nulliparous, well-educated, married and financially secure. Although there are records in Australia for the number of donor and recipient cycles undertaken, there is no published data on the number of patients considering a donor oocyte, or on oocyte donor waitlists. In Australia egg donation is altruistic, non-commercial and not anonymous.

Study design, size, duration
A 52-point online survey was distributed via social media to women in Australia who had ever considered or pursued donor eggs, or come to the end of their own IVF treatment. The survey was sent to all clinical members of the Fertility Society of Australia and New Zealand (FSANZ) and available on the Victorian Assisted Reproductive Technology Authority (VARTA) website. The survey was open from 1 February to 30 April 2023. Hospital ethics approved.

Participants/materials, setting, methods
A cross-sectional, anonymous, online survey of women in Australia who were potential egg donor recipients. Survey questions included demographics, potential donor egg recipient preferences, IVF clinic experiences, barriers, any impact of the COVID-19 pandemic, attitudes around the reimbursement for donor eggs, and fertility costs already incurred. Responses were collected via the Qualtrics XM platform. Statistical analysis for quantitative data was analysed using Microsoft 365 Excel. Qualitative coding performed on the commentary in free text fields.

Main results and the role of chance
This study identified a large gap between those who considered a donor egg (80.6%), pursue a donor egg on an IVF clinic waitlist (23.1%), and those who actually received a donor egg. Of the 59/255 women who were placed on an oocyte donor waitlist at an IVF clinic in Australia, less than a quarter (23.1%) received a donor egg (13/58), with a pregnancy and live birth rate of 76.9% and 61.5%, respectively. Thus, of those that were on an Australian waitlist, one quarter received donor eggs, with over half of these recipients having a live birth.
‘Women preferred donor eggs from Australia than overseas, preferred an unknown donor from an IVF clinic program, and wished to know source information for themselves and children in the future. Attitudes towards financial reimbursement were generally positive towards compensation. Barriers to pursuing donor eggs included grief of loss of own fertility, cost, availability and time.
When on an Australian donor egg list, many respondents still looked at other sources of donor eggs in Australia and overseas. Reasons women came off an Australian donor egg waitlist included receiving donor eggs and donor embryos elsewhere, including from overseas, as well as advancing age and expense.

Limitations, reasons for caution
Risk of respondent selection bias of those who chose to response to a public survey, with incomplete data for some respondents. Given survey in English, may have underrepresentation of some cultural groups and sampling a limited range of women from diverse social, economic and religious settings.

Wider implications of the findings
In this first paper of potential egg recipients’ preferences in the Asia-Pacific region, we have identified a gap where demand for donor eggs exceeds local supply. A majority of potential recipients would support financial reimbursement for eggs already cryopreserved by women initially freezing for own elective purposes.

Trial registration number
not applicable