Public opinion regarding oocyte donation in Sweden

BACKGROUND: Oocyte donation has been permitted by Swedish legislation since January 2003. According to the law, offspring have the right to receive identifying information about the donor when they reach a mature age. The aim of the present study was to investigate public opinion regarding different aspects of oocyte donation. METHODS: A study-specific questionnaire regarding attitudes towards aspects of oocyte donation was sent to a randomized sample of 1000 women (73% response) and 1000 men (56% response). RESULTS: A majority of respondents supported treatment with oocyte donation. Seventeen per cent of the women considered donating in the future, whereas 56% of the men would support their partner. While nearly half of the respondents considered that offspring should receive identifying information of the donor, one-third were opposed to this. Overall, women were more positive towards disclosure to the offspring than were men (P < 0.001). CONCLUSIONS: The present results indicate strong support for the use of oocyte donation among a subset of the Swedish population. There was considerable interest among women in donating oocytes anonymously. While a majority advocated openness regarding the donation between parents and child, there was less support for the offspring to have a legal right to receive identifying information about their donor.     

A survey of public attitudes toward oocyte donation between sisters

Oocyte donation offers the possibility of pregnancy for manypatients with premature ovarian failure (POF) and recently anumber of patients have been requesting egg donation by a sister.While patients anxious to achieve a pregnancy are favourablydisposed toward egg donation, the existence of favourable attitudesin others, and thus the amount of social support such patientswill receive, depends upon the wider social environment. A surveyof public opinion was conducted utilizing a random sample of501 adults in Orange County, CA in an attempt to identify demographiccorrelates of attitudes. Log linear analysis demonstrated norelationship between attitudes and an array of demographic data(income, political party, age), but showed a significant relationshipbetween sex of the respondent and attftudes towards egg donation.While more than half of respondents of both sexes were favourablydisposed towards egg donation, men exhibited significantly (P= 0.005) more positive attitudes towards oocyte donation bya sister than did women. Women in the general population showedmarkedly less support for egg donation by a sister than POFpatients have been demonstrated to show. The theory is proposedthat female respondents are more wary of the symbolic meaningof the repductive connection between a sister-in-law and a husband,while the POF patient's attitude is shaped in part by her desirefor a pregnancy. The results have implications for the attitudesPOF couples may face in the social environment and for the typeof social support which may be recommended.     

A relationship between traditionally motivated patterns and gamete donation and surrogacy in urban areas of Greece

BACKGROUND: Although gamete receipt or donation has become an integral part of infertility management, previous research in the field of social attitudes and intention to use medical technologies is limited. The aim of this paper was to investigate people's intentions to receive or donate sperm, oocyte or uterus (surrogacy) and to identify possible motivational patterns explaining this intention. METHODS: Personal interviews were conducted with 365 men and women of reproductive age (18-45 years). Stratified random sampling was performed to select the men and women for interview. The content of the instrument used was derived from in-depth qualitative interviews with physicians experienced in assisted reproductive technologies, as well as from people who had recourse to gamete donation and surrogacy. RESULTS: The results obtained highlighted the following major aspects: (i) approximately 50% of the survey's participants would be prepared to receive/donate sperm and oocyte; (ii) the results from multiple regression analysis suggest that the 'traditional gender roles' pattern is positively associated with 'intention to use gamete donation and surrogacy'. On the contrary, 'confidence in emotional relationship' is negatively associated with 'intention to use gamete donation and surrogacy, and (iii) men are more likely than women to report 'intention to use gamete donation and surrogacy'. CONCLUSION: These data suggest that specific motivational patterns of the population need to be thoroughly analysed and taken into consideration, in order that appropriate counselling be addressed to individuals and couples.     

British women's attitudes towards oocyte donation: ethnic differences and altruism

OBJECTIVE: This study assessed the importance of altruism and willingness to donate oocytes in British Asian and Caucasian samples. The Theory of Planned Behaviour (TPB) was used to test the importance of attitudes towards oocyte donation, normative and control beliefs to attitudes to donate oocytes. METHOD: One hundred and one participants (55% Asian, 45% Caucasian) completed questionnaires measuring altruism and attitudes to Oocyte donation. There were no socio-demographic differences between ethnic groups. RESULTS: Few women were willing to donate oocytes, Asian women were least likely to donate oocytes, and altruism was not related to willingness to donate. Forty-one participants considered themselves 'possible' oocyte donors and 54 as definite 'non' donors. Possible donors reported significantly more positive attitudes towards egg donation; asking women to donate under various circumstances; to the consequences of donating their eggs; positively experiencing egg donation and to factors that would induce women to donate. Subjective norms and behavioural control also influenced intention to donate. CONCLUSION: A number of components of the TPB were able to predict possible oocyte donation, and non-oocyte donation. Practice implications: This study provides some empirical support for specific factors influencing cultural differences in gamete donation in the UK. A future culturally appropriate targeted approach to donation education could redress the present imbalance in supply and demand of gametes in infertility treatment.     

British women's attitudes towards oocyte donation: Ethnic differences and altruism

ObjectiveThis study assessed the importance of altruism and willingness to donate oocytes in British Asian and Caucasian samples. The Theory of Planned Behaviour (TPB) was used to test the importance of attitudes towards oocyte donation, normative and control beliefs to attitudes to donate oocytes.MethodOne hundred and one participants (55% Asian, 45% Caucasian) completed questionnaires measuring altruism and attitudes to Oocyte donation. There were no socio-demographic differences between ethnic groups.ResultsFew women were willing to donate oocytes, Asian women were least likely to donate oocytes, and altruism was not related to willingness to donate. Forty-one participants considered themselves ‘possible’ oocyte donors and 54 as definite ‘non’ donors. Possible donors reported significantly more positive attitudes towards egg donation; asking women to donate under various circumstances; to the consequences of donating their eggs; positively experiencing egg donation and to factors that would induce women to donate. Subjective norms and behavioural control also influenced intention to donate.ConclusionA number of components of the TPB were able to predict possible oocyte donation, and non-oocyte donation. Practice implications: This study provides some empirical support for specific factors influencing cultural differences in gamete donation in the UK. A future culturally appropriate targeted approach to donation education could redress the present imbalance in supply and demand of gametes in infertility treatment.     

Parents' knowledge about the donors and their attitudes toward disclosure in oocyte donation

BACKGROUND: Oocyte donation is a popular treatment option among women with ovarian dysfunction. Little is known about the amount of information recipients have about their donors and if the amount of information the couple has relates to their plans to disclose. The purpose of this study was to assess the amount of information recipients had about their donors and their disclosure plans. METHODS: Sixty-two sets of oocyte donation parents from five programmes completed a self-report questionnaire. RESULTS: Ninety percent of both men and women knew their donor's age, ethnicity, hair colour, eye colour, height, weight, education and medical history. Significantly more women than men told others about using a donor to conceive, but two-thirds of women and men would not tell others if they had to do it over again. Fifty-nine percent of women and 52% of men planned to or had told their child; 34% of women and 41% of men do not plan to tell. The amount of information known about the donor was related to plans to tell the child for men only. CONCLUSION: Approximately half of couples plan to tell their child of their oocyte donor origin and a majority have told others but many regret having done so. Knowledge about the donor is related to disclosure for men only.     

Community attitudes to maternal age and pregnancy after assisted reproductive technology: too old at 50 years?

Community attitudes toward oocyte and embryo donation, and towardassisted reproduction after the menopause were assessed in thissurvey of 1131 Australians. Of the respondents, 64.2% believedthat oocyte or embryo donation was an acceptable treatment forinfertile couples, 54.6% felt that it was a acceptable for awoman to have her own embryos transferred after the menopause,and 37.9% are accepting of the donation of eggs or embryos topost-menopausal women. There were no significant differencesin response amongst different religious groups, or in relationto gender or income level. Significantly higher levels of acceptancewere noted for all categories amongst those respondents aged< 35 years. Despite the established clinical ability to achievepregnancy in the over 50 years age group, this survey revealsonly minority community support for this practice. However,public opinion may alter in the future if the attitudes of theyounger proportion of the sample are maintained.     

Follow-up study of Finnish volunteer oocyte donors concerning their attitudes to oocyte donation

A questionnaire was sent to the first 30 Finnish volunteer oocytedonors at 12–18 months after donation to determine theirexperiences concerning treatment and attitudes to donation.All donations were carried out anonymously and without payment.The donors were recruited by advertising in newspapers. Mostdonors were very satisfied with the experience. The side-effectsof the treatment had been slight and tolerable. In all, 85%of the respondents reported no gynaecological problems afterwards.The problems reported by the other 15% were minor and unrelatedto the donation. A total of 67% of the respondents would haveliked to have known if pregnancy had been achieved in the recipient,and 89% reported that they had thought about the possibilityof a child from their donation. Some 42% of the respondentspreferred to receive no information concerning either the childor the recipient couple. Of the respondents, 59% thought theoffspring should be told about its origin and 33% thought thechild should be given identifying information about the donor.About half of the others would agree to the release of non-identifyinginformation. In all, 96% of the respondents reported that theirown feelings were sufficiently taken into consideration duringthe treatment and 78% would donate again. No-one regretted theirdonation.     

A comparison of the attitudes of volunteer donors and infertile patient donors on an ovum donation programme

The attitudes of anonymous volunteer donors (n = 20) and infertile patients who were undergoing treatment in an IVF programme and who donated oocytes (n = 15) towards the donation, the recipient, the potential children conceived, the recording of information and their experience of the procedures were sought by posted questionnaires. All donations were made for altruistic reasons and no payments other than expenses were made. Both groups agree that donors should not be paid and they both deny any connection with the child resulting from their donation. The majority in both groups also did not object if their eggs were donated to unmarried single women and they did not wish to meet with the recipient. The majority of both groups would however agree to donate to known recipients. Over 80% had told others of their donation and a similar number in the volunteer group held no objection to the recipients knowing their name whilst only 40% held the same view in the patient donor group (17/20 versus 6/15 P less than 0.02). The feelings of the groups was also different in relation to their desire to know if a child was born from their eggs. Eighty five per cent in the volunteer group (17/20) would like to know the outcome and only 40% (6/15) of the patient donor would want to know the outcome, P less than 0.02. Although greater than 50% in both groups experienced side effects, 60% of volunteers and 90% of patient donors expressed a willingness to donate eggs again.(ABSTRACT TRUNCATED AT 250 WORDS)     

Ethics and Society: Current attitudes towards egg donation among men and women

Recent widespread concern has led to legislation in the UK preventingthe use of fetal ovarian tissue for the treatment of infertilewomen. This questionnaire-based study aimed to assess the attitudesof both fertile and infertile men and women as well as egg donorsand recipients towards the use of donated eggs for treatment,diagnosis and research. Fertile individuals were significantlyless aware of egg donation but the majority in both the fertileand the infertile groups approved the use of eggs for research(89 and 95% of women and 88 and 92% of men respectively) andtreatment (similar percentages). However, fetal sources of oocyteswere acceptable to only 15% of women in the fertile, 21% inthe infertile, 35% in the recipient and 19% in the donor groups.Cadaveric sources of oocytes were slightly more acceptable (28%fertile, 28% infertile, 50% recipient and 42% donors). Boththese sources of oocytes were slightly more acceptable to men.Education had little influence on attitudes, although men andwomen of tertiary education level said they would be less likelyto have gamete donation themselves. Thus there would appearto be widespread approval for the use of donor eggs in researchand treatment but not if the source of eggs is fetal or cadaveric.     

Attitudes of Turkish anatomists toward cadaver donation

There is an insufficient number of cadavers in anatomy education in Turkey. This is because of decreased number of unclaimed bodies and very few cadaver donations. Increasing the number of cadaver donation is one of the probable solutions. Although anatomists encourage people to donate bodies, the attitudes of anatomists toward donating their own bodies for dissection is not well known. In this study, the attitudes of Turkish anatomists toward cadaver donation were evaluated. The questionnaires were sent to the anatomists in Turkey by mail and E-mail. Eighty-three anatomists replied to the questionnaire. The main solutions proposed for cadaver insufficiency included increasing the supply of unclaimed bodies (77.1%) and increasing body donation (78.3%). Further, 51.8% of the respondents thought that increasing body donation was a long-term solution. The general belief (83.1%) was that a campaign would help to increase body donation and 47% of respondents were willing to participate in such a campaign. Of the 83 anatomists, 20.5% of the respondents donated their organs and 49.4% were planning to donate them. Further, 15.7% were planning to donate their bodies; however, 63.9% did not consider donating. The main reasons of the respondents to object the donation were: to be dissected by a colleague (15.7%), the unacceptability of donation by family (26.5%), psychological reasons (43.4%), the anxiety of disrespectful behavior to cadavers (26.5%), and religious beliefs (3.6%). Although the majority of the respondents objected to donating their bodies due to psychological reasons, body donation was proposed as the main solution of cadaver insufficiency.     

Subsidised oocyte donation in Israel (1998-2000): results, costs and lessons

BACKGROUND: Israeli law stipulates that all women aged 45-51 who need oocyte donation are entitled to as many donations as necessary, up to the birth of one child. Only oocytes donated by women who themselves are undergoing assisted reproduction are allowed. The government subsidizes all oocyte donation cycles through the medical insurer of the recipient, whether or not the procedure is performed in a public or private institution. The aim of the present study was to investigate the success of oocyte donation cycles in Israel for the period 1998-2000 and to estimate costs and pregnancy rates. METHODS: Data were derived from the Dan District Registry of the General Health Services (Sheirutei Bri'ut Clalit), the largest medical insurer in Israel. RESULTS: 171 women underwent 254 oocyte donation cycles within these 3 years, and 45 babies were born, for a positive outcome of 17.7%. Average annual cycle cost was US$1742 and average annual cost per patient, US$2521. The total annual cost for the district accounted for only 0.05% of the budget. CONCLUSIONS: These findings suggest that IVF with donated oocytes is relatively efficient and that government funding of oocyte donation cycles ensures a reasonable cost.     

Acceptability of an injectable male contraceptive regimen of norethisterone enanthate and testosterone undecanoate for men

BACKGROUND: We assessed attitudes towards and acceptability of male hormonal contraception among volunteers participating in a clinical trial of a prototype regimen, consisting of progestin and testosterone injections. METHODS: After completing screening, eligible men were randomly assigned to the no-treatment group (n = 40) or to receive injections of norethisterone enanthate and testosterone undecanoate or placebo at different intervals (n = 50) according to a blocked randomization list. They underwent self-administered questionnaires. RESULTS: The average age of the participants was approximately 28 years; most were involved in a stable relationship and had no children. Ninety-two percentage of the respondents thought that men and women should share responsibility for contraception and 75% said they would try a hormonal contraceptive if available. At the end of the treatment phase, 66% of the participants said that they would use such a method, and most rated its acceptability very highly; none reported it to be unacceptable. The injections themselves were indicated as the biggest disadvantage. No significant changes in sexual function or mood states were detected among the men who underwent hormone injections. CONCLUSIONS: The contraceptive tested in this study was well accepted by the participants over the course of 1 year.     

Characterization of potential oocyte donors in Sweden

BACKGROUND: Oocyte donation has been permitted by Swedish legislation since January 2003. While donors are anonymous to the receiving couple, offspring have the legal right to receive identifying information about the donor when they reach adult age. Our aim was to investigate factors of potential importance for women's willingness to donate oocytes. METHOD: A questionnaire regarding attitudes towards oocyte donation was sent to a randomized sample of 1000 women aged 25-35 years (73% response). RESULTS: Seventeen percent would consider donating oocytes, whereas 39% opposed this, and 44% were doubtful. Potential donors were less likely to have children of their own and thought the genetic link was of less importance. Potential donors would feel happy about helping a childless couple, and 38% would be glad to be contacted by the offspring. Factors that would increase women's willingness to donate were being able to talk to experienced donors, proximity to the clinic and availability of counselling. CONCLUSION: The results indicate considerable interest in donating oocytes among a subset of women in Sweden. Potential donors associated donation with altruistic motives. The issue of offspring's right to know about their origin appears to be complicated. This suggests that information about the consequences of donation is of great importance.     

Comparison of attitudes of donors and recipients to oocyte donation.

The attitudes of volunteer donors and recipients undergoing treatment in an ovum donation programme were studied in order to assess both the psychological and psycho-social aspects of the procedure. A questionnaire was sent to 35 donors and 60 recipients. All donations were unpaid. Fifty-eight were anonymous donations and three were known. Eighty-six per cent of recipients and 74% of donors had told at least one person other than their partner. Eighty per cent of donors and 66% of recipients agreed that donors should not be paid. Sixty-three per cent of donors would donate if the recipient was told their name but only 26% of recipients would accept if the donor was given their name. Seventy per cent of the donors would donate to someone they knew but would rather donate anonymously. Ninety per cent of recipients were strongly against the donor contacting the child later in life but 54% of donors had no objection to the child contacting them. Eighty-six per cent of recipients and 56% of donors felt that if they had been born from a donated oocyte, they would not want to know.     

Ethics and society: Attitudes of parents of young children to sperm donation--implications for donor recruitment

An anonymous questionnaire was circulated to parents of youngchildren to survey exposure to publicity about and attitudesto sperm donation (n = 192 couples; 50% response rate). Of thosesurveyed, 55% of men and women had seen or heard of the needfor sperm donors; for 26% of couples, one or both partners hadconsidered donation, and among half of those (13% of total)no objections to donating were raised. However, only two menhad approached the clinic as donors. Objections to donationcentred mainly on discomfort at having children outside theirfamily, worry about future contact with donor insemination children,and worry about incest. Women were three times as likely toraise these objections as men. Of all respondents, 20% thoughta donor should be used for only one recipient couple, while50% suggested three or fewer families. Overall, 41% rated havingnon-identifying information about the recipient couple(s) asan important aspect of sperm donation, although only 9% of menand 17% of women considered personal contact important. Whilemany people are aware of and receptive to the idea of beingdonors, very few act. Many would prefer that their spermatozoawere used for only one or a few couples about whom they hadsome information.     

The personality and motivation of semen donors: a comparison with oocyte donors.

Seventeen consecutively recruited candidates for semen donation were evaluated by a psychologist with testing and a structured interview. Most men (71%) were motivated by financial compensation. Only 29% would donate semen if records were open to potential offspring. Fifty-nine per cent of the men were rated as excellent candidates from a psychological perspective and 35% were rated as acceptable with slight reservations. One was excluded as a donor. Psychological testing revealed mildly abnormal subscale scores for 35% of donors. Forty-seven per cent had histories of minor depressive or anxiety episodes and 35% had had periods of heavy alcohol use. Compared to oocyte donors at the same institution, the men were less altruistic, more affluent, and more likely to have abused alcohol. Women had more traumatic family and reproductive histories. Psychological evaluation can be a valuable tool in gamete donor selection.     

Comparative assessment of pre- and post-donation attitudes towards potential oocyte and embryo disposition and management among ovum donors in an oocyte donation programme

BACKGROUND: In anonymous oocyte donation programmes, the disposition of retrieved oocytes and subsequent embryo management are at the discretion of the IVF programme and the oocyte recipients, as donors waive all rights following their donation. Nonetheless, donors are routinely made aware of ways in which oocytes and resulting embryos may be used and elect to proceed with the process even in the presence of reservations to some clinical scenarios before their donation. The aim of our study was to examine oocyte donors' attitudes to oocyte and embryo disposition and management and how initial reservations change over the course of the donation process. METHODS: Oocyte donors in a university-based IVF programme were asked about their willingness to donate in relation to various clinical scenarios during the initial screening interview and at the post-donation exit interview. Results were tabulated as 'yes' or 'no'. RESULTS: At the pre-donation interview, 72% of donor candidates expressed reservations to one or more clinical scenarios. More reservations were expressed at the post-donation interview compared with the pre-donation interview. The greatest reservations were donating to recipients >50 years of age (P < 0.05). Despite this, 97% of donors were willing to donate again. CONCLUSION: Oocyte donors' attitudes towards various clinical scenarios changed following their donation, reflecting overall greater reservations following the donation process. Although speculative, donors may be more willing to assert their opinions or donor attitudes become more restrictive.     

Public knowledge and attitudes regarding organ and tissue donation: an analysis of the northwest Ohio community

Residents of Ohio, a midwestern state of the United States, were surveyed to determine their knowledge and attitudes toward organ and tissue donation. Sources of information on donation and the role of health care providers were also explored. One thousand participants were randomly selected from northwest Ohio to receive a survey distributed by mail. A total of 383 valid questionnaires were obtained. Respondents were knowledgeable about donation, with a mean correct knowledge score of 86%. However, four questions were answered incorrectly by nearly 25% or more of participants, indicating deficits in the community's knowledge. Over 96% of respondents had favorable attitudes toward donation. Both knowledge and attitudes were positively associated with willingness as well as commitment to donate. Health care providers were infrequently reported as sources of information on donation, yet nearly 60% would like their provider to discuss donation. Misconceptions represent potential barriers to donation. Therefore, public education should focus on the knowledge areas that show deficits. Results of the present study suggest that health care providers can play a critical role in educating patients about donation.     

The role of oocyte donation in women who are unsuccessful with in-vitro fertilization treatment.

Oocyte donation improves the chances of becoming pregnant in some women who are unsuccessful with in-vitro fertilization (IVF) treatment. A total of 119 IVF cycles achieved a pregnancy rate per cycle of 2.5% whereas the same women, when treated with 45 cycles of oocyte donation, achieved a 24.5% pregnancy rate per cycle. To ascertain which women may be helped by oocyte donation, IVF data were analysed according to the outcome of oocyte donation. There was a difference in the number of previous natural conceptions and live births, and in the IVF fertilization rate. There was no difference in the age of the women and the numbers of oocytes collected per cycle of IVF. New criteria are therefore suggested for recommending oocyte donation to women who have previously failed to become pregnant with IVF treatment.