P-446 Sperm Donors’ Identity Disclosure: Is It REALLY Crucial? For Whom?
Authors: Ronen M , Kaufman S , Kedem A , Avraham S , Youngster M , Yerushalmi G , Hourvitz A , Gat I 
Published: June 2023

Abstract

Study question
What is the actual preference of sperm donors with identity disclosure vs. anonymous donors among recipient patients? Does this selection affect clinical outcomes?

Summary answer
Identity disclosure donation is important for certain sections, while almost half of the patients used anonymous donation. An Identity disclosure-only policy should be considered carefully.

What is known already
A major shift over the last decades focuses on sperm donation identity disclosure. Opposed to historic anonymity, related to heterosexual parents’ tendency to avoid conception disclosure to their children, the growing proportion of single women and same-sex lesbian couples has raised this issue to high priority. Recipients’ perceptions of anonymity vs. identity disclosure are influenced by family structure.

Study design, size, duration
Israeli regulations permit two sets of sperm donation - local and imported. Israeli sperm donors is anonymous only, while imported sperm donors may be anonymous donors or identity disclosure. This retrospective study included only patients who chose imported sperm donors during 2017-2021.

Participants/materials, setting, methods
This retrospective study included patients who chose imported sperm donation during 2017-2021. 526 and 43 patients who used autologous eggs and egg donation, respectively. The primary endpoint was the type of chosen donor – ID vs. AD. We examined the tendency towards identity disclosure according to demographic parameters and the theoretical impact of donor type selection on reproductive outcome and compared patients who performed autologous treatments vs. egg donation.

Main results and the role of chance
Among patients who used autologous eggs, 385 (73.2%) were single (368 never married and 17 divorced) while 57 (10.8%) and 84 (16%) had same-sex and heterosexual relationships, respectively. 270 (51.3%) patients chose ID compared to 256 (48.7%) who selected AD. Single women had a significantly higher probability to choose ID compared to heterosexual couples (55.6% vs. 33.3%, OR 2.5, 95 CI 1.52-4.11, p &lt; 0.001). Same-sex couples were also more likely to choose ID (49.1%) compared to heterosexual couples with a statistical trend (OR 1.93, CI 95% 0.97-3.85, p = 0.06). 2501 vials were imported, 698 IUI and 812 IVF cycles were performed, respectively, resulting in 283 pregnancies without differences between patients who chose ID vs. AD. To assess donor type selection stability over time we explored 105 patients' selection who changed their donor. 81.9% of patients preserved their initial preference (46 and 40 who chose ID and AD, respectively, p &gt; 0.05). ID selection among ED patients was 44.2% compared to 51.3% among autologous patients without reaching statistical significance.

Limitations, reasons for caution
Religious and cultural aspects, which differ from societies and countries, contribute to patients’ perspectives and preferences. Implementation of current findings to other societies may be challenging. Research retrospective design may be attributed as an additional limitation.

Wider implications of the findings
An Identity disclosure only policy may result in a global sperm donations shortage which will impact a substantial fraction of recipients who do not select or seek contact with ID. A double path policy, seems like an optimal and preferable solution in this era.

Trial registration number
not applicable