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Iranifard E, Ebrahimzadeh Zagami S, Amirian M, Ebrahimipour H, Latifnejad Roudsari R. A systematic review of assisted and third-party reproduction guidelines regarding management and care of donors. Reprod Health 2024; 21:75. [PMID: 38824591 PMCID: PMC11143578 DOI: 10.1186/s12978-024-01804-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/01/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND Gamete and embryo donors face complex challenges affecting their health and quality of life. Healthcare providers need access to well-structured, evidence-based, and needs-based guidance to care for gamete and embryo donors. Therefore, this systematic review aimed to synthesize current assisted and third-party reproduction guidelines regarding management and care of donors. METHODS The databases of ISI, PubMed, Scopus, and websites of organizations related to the assisted reproduction were searched using the keywords of "third party reproduction", "gamete donation", "embryo donation", "guidelines", "committee opinion", and "best practice", without time limit up to July 2023. All the clinical or ethical guidelines and best practice statements regarding management and care for gamete and embryo donors written in the English language were included in the study. Quality assessment was carried using AGREE II tool. Included documents were reviewed and extracted data were narratively synthesized. RESULTS In this systematic review 14 related documents were reviewed of which eight were guidelines, three were practice codes and three were committee opinions. Five documents were developed in the United States, three in Canada, two in the United Kingdom, one in Australia, and one in Australia and New Zealand. Also, two guidelines developed by the European Society of Human Reproduction and Embryology were found. Management and care provided for donors were classified into four categories including screening, counseling, information provision, and ethical considerations. CONCLUSION While the current guidelines include some recommendations regarding the management and care of gamete/embryo donors in screening, counseling, information provision, and ethical considerations, nevertheless some shortcomings need to be addressed including donors' psychosocial needs, long-term effects of donation, donors' follow-up cares, and legal and human rights aspects of donation. Therefore, it is needed to conduct robust and well-designed research studies to fill the knowledge gap about gamete and embryo donors' needs, to inform current practices by developing evidence-based guidelines.
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Affiliation(s)
- Elnaz Iranifard
- Student Research Committee, Mashhad University of Medical Sciences, 9137913199, Mashhad, Iran
| | - Samira Ebrahimzadeh Zagami
- Nursing and Midwifery Care Research Center, Mashad University of Medical Sciences, 9177949025, Mashhad, Iran
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, 9137913199, Iran, Mashhad
| | - Malihe Amirian
- Department of Obstetrics and Gynecology, Fellowship of Infertility, School of Medicine, Milad Infertility Treatment Center of Mashhad, University of Medical Sciences, Mashhad, 9137913316, Iran
| | - Hossein Ebrahimipour
- Department of Health Economics and Management, School of Health, Mashhad University of Medical Sciences, 9196773113, Mashhad, Iran
- Health Sciences Research Center, Torbat Heydarieh University of Medical Sciences, 9519633787, Torbat heydarieh, Iran
| | - Robab Latifnejad Roudsari
- Nursing and Midwifery Care Research Center, Mashad University of Medical Sciences, 9177949025, Mashhad, Iran.
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, 9137913199, Iran, Mashhad.
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Fuchs Weizman N, Yee S, Kazay A, K'Necht E, Kuwar AA, Maltz GM, Librach CL. Non-identified and directed embryo donation: a questionnaire study on donor and recipient perspectives. HUM FERTIL 2023; 26:1417-1428. [PMID: 37497652 DOI: 10.1080/14647273.2023.2238898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 05/25/2023] [Indexed: 07/28/2023]
Abstract
With the growing challenge of abandoned surplus embryos in the ART arena, and the limited traction of embryo donation as a viable embryo disposition choice, it is important to better understand barriers to wider adoption of this opportunity. We aim to learn about perspectives and experience of participants in directed and non-identified embryo donation programmes. This was a longitudinal cohort survey study, of all participants in an embryo donation programme in a single university affiliated clinic between 2016 and 2020. Clinical data were extracted from counselling reports. Based on these data, non-identified online questionnaires were constructed and refined via Delphi procedure for face and content validity. Sixty-five online questionnaires were emailed between March-April 2021. Descriptive statistics, cross-tabulation, Fisher's exact test and t-test were used for analyses. Source of patient awareness, factors influencing the decision-making process, patient perspective and satisfaction were explored. The response rate was 67.2%. Most participants in the non-identified programme learned of it through their treating physicians, whereas most participants in the directed programme learned of it online. The main driver to donate across both cohorts was wanting to give others the opportunity to experience the joy of parenthood. Overall, 45% described moderate to marked difficulty in decision making related to donating their embryos, and this did not differ between cohorts. Non-identified donors reported feeling highly attached to the donated embryos more often than directed donors. Level of satisfaction was higher in the directed donation programme. Participants were more satisfied following directed than non-identified donation, and some even consider their counterparts as extended family. Our findings should be validated in various settings, and on larger samples.
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Affiliation(s)
- Noga Fuchs Weizman
- Create Fertility Center, Toronto, Canada
- Lis Maternity and Women's Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Anya Kazay
- Create Fertility Center, Toronto, Canada
| | - Evening K'Necht
- Department of Cognitive Science, Carleton University, Ottawa, Canada
| | - Anushka A Kuwar
- Work-Learn Institute, University of Waterloo, Waterloo, Canada
| | - Gillian M Maltz
- Arts and Science Program, McMaster University, Hamilton, Canada
| | - Clifford L Librach
- Create Fertility Center, Toronto, Canada
- Departments of Obstetrics and Gynecology and of Physiology, University of Toronto, Toronto, Canada
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Indekeu A, Prinsen CFM, Maas AJBM. Lessons from 10 years' experience running the Fiom KID-DNA database, a voluntary DNA-linking register for donor-conceived people and donors in The Netherlands. HUM FERTIL 2023; 26:1164-1172. [PMID: 36373241 DOI: 10.1080/14647273.2022.2144772] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 05/23/2022] [Indexed: 11/16/2022]
Abstract
Worldwide, there is increasing acknowledgment of the importance of getting access to ancestry information. More and more countries facilitate access to this information through law changes and voluntary contact-services. In the Netherlands, the state-funded Fiom KID-DNA database was established in 2010 to facilitate information and/or contact exchange between those people who are genetically related as a result of donor-assisted conception. By the end of 2021, 846 donors and 2355 donor-conceived people are registered in the database. For 25% of the donors a link was found with one or more donor-conceived people, and 39% of the donor-conceived people were linked to a donor-profile. Fiom offers support by professionally qualified staff throughout the entire process from registration to contact to donor-conceived people, donors and their relatives. During the period of more than 10 years several challenges emerged; how does a state-funded DNA database function in the area of commercial DNA databases?; what can be learned from the continuous growing donor-conceived half-siblings networks?; how to deal with malpractices from the past and how to cope with ageing donors?
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Affiliation(s)
| | - Clemens F M Prinsen
- Departments of Pathology and Clinical Chemistry, Canisius-Wilhelmina Hospital, Nijmegen, the Netherlands
- Clinical Chemistry, Canisius-Wilhelmina Hospital, Nijmegen, the Netherlands
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Lou S, Bollerup S, Terkildsen MD, Adrian SW, Pacey A, Pennings G, Vogel I, Skytte AB. Experiences and attitudes of Danish men who were sperm donors more than 10 years ago; a qualitative interview study. PLoS One 2023; 18:e0281022. [PMID: 36791066 PMCID: PMC9931114 DOI: 10.1371/journal.pone.0281022] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 01/12/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND More knowledge about the long-term impact of sperm donation is essential as the donor's attitude towards donation may change over time. Personal and social developments may prompt a rethinking of previous actions and decisions, or even regret. Thus, the aim of this study was to explore the experiences and attitudes of men who were sperm donors more than 10 years ago. METHODS From May to September 2021, semi-structured, qualitative interviews were conducted with 23 former donors (> 10 years since last donation) from Cryos International sperm bank. Two participants were non-anonymous donors and 21 were anonymous. The interviews were conducted by phone or via video (mean 24 minutes). All interviews were recorded, transcribed verbatim and rendered anonymous. Data were analyzed using thematic analysis. RESULTS The analysis showed that most men had been donors for monetary and altruistic purposes, and now considered sperm donation as a closed chapter that was 'unproblematic and in the past'. Most men valued anonymity and emphasized the non-relatedness between donor and donor conceived offspring. Knowledge about recipients and donor offspring was seen as 'damaging' as it could create unwanted feelings of relatedness and responsibility towards them. All men acknowledged donor conceived persons' potential interests in knowing about their genetic heritage in order to understand appearance and personal traits, but also emphasized the donors' rights to anonymity. Potential breach of anonymity was generally considered 'highly problematic' as it was expected to disturb their families and force a relationship on them. CONCLUSION This study reports on former donors who might not have volunteered for research due to lack of interest or protection of privacy. The majority of men valued anonymity and clearly demarcated a line between sperm donation and fatherhood, which was enforced by not knowing about the donor offspring or recipients.
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Affiliation(s)
- Stina Lou
- DEFACTUM–Public Health Research, Central Denmark Region, Aarhus, Denmark
- Department of Clinical Medicine, Center for Fetal Diagnostics, Aarhus University, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- * E-mail:
| | - Stina Bollerup
- DEFACTUM–Public Health Research, Central Denmark Region, Aarhus, Denmark
| | - Morten Deleuran Terkildsen
- DEFACTUM–Public Health Research, Central Denmark Region, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Allan Pacey
- Department of Oncology and Metabolism, The Medical School, The University of Sheffield, Sheffield, United Kingdom
| | - Guido Pennings
- Department of Philosophy and Moral Science, Bioethics Institute Ghent (BIG), Ghent University, Gent, Belgium
| | - Ida Vogel
- Department of Clinical Medicine, Center for Fetal Diagnostics, Aarhus University, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
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Kirkman-Brown J, Calhaz-Jorge C, Dancet EAF, Lundin K, Martins M, Tilleman K, Thorn P, Vermeulen N, Frith L. OUP accepted manuscript. Hum Reprod Open 2022; 2022:hoac001. [PMID: 35178481 PMCID: PMC8847071 DOI: 10.1093/hropen/hoac001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 12/14/2021] [Indexed: 11/26/2022] Open
Abstract
STUDY QUESTION What information and support should be offered to donors, intended parents and donor-conceived people, in general and in consideration of the availability of direct-to-consumer genetic testing and matching services? SUMMARY ANSWER For donors, intended parents and donor-conceived offspring, recommendations are made that cover information needs and informed consent, psychosocial implications and disclosure. WHAT IS KNOWN ALREADY Trends indicate that the use of donor-assisted conception is growing and guidance is needed to help these recipients/intended parents, the donors and offspring, navigate the rapidly changing environment in which donor-assisted conception takes place. STUDY DESIGN, SIZE, DURATION A working group (WG) collaborated on writing recommendations based, where available, on evidence collected from a literature search and expert opinion. Draft recommendations were published for stakeholder review and adapted where relevant based on the comments received. PARTICIPANTS/MATERIALS, SETTING, METHODS Papers retrieved from PUBMED were included from 1 January 2014 up to 31 August 2020, focusing on studies published since direct-to-consumer genetic testing has become more widespread and accessible. The current paper is limited to reproductive donation performed in medically assisted reproduction (MAR) centres (and gamete banks): donation outside the medical context was not considered. MAIN RESULTS AND THE ROLE OF CHANCE In total, 32 recommendations were made for information provision and support to donors, 32 for intended parents and 27 for donor-conceived offspring requesting information/support. LIMITATIONS, REASONS FOR CAUTION The available evidence in the area of reproductive donation is limited and diverse with regards to the context and types of donation. General conclusions and recommendations are largely based on expert opinion and may need to be adapted in light of future research. WIDER IMPLICATIONS OF THE FINDINGS These recommendations provide guidance to MAR centres and gamete banks on good practice in information provision and support but should also be considered by regulatory bodies and policymakers at a national and international level to guide regulatory and legislative efforts towards the protection of donors and donor-conceived offspring. STUDY FUNDING/COMPETING INTEREST(S) The development of this good practice paper was funded by European Society of Human Reproduction and Embryology (ESHRE), covering expenses associated with the WG meetings, the literature searches and dissemination. The WG members did not receive any payment. The authors have no conflicts of interest to declare. DISCLAIMER This document represents the views of ESHRE, which are the result of consensus between the relevant ESHRE stakeholders and where relevant based on the scientific evidence available at the time of preparation. The recommendations should be used for informational and educational purposes. They should not be interpreted as setting a standard of care, or be deemed inclusive of all proper methods of care nor exclusive of other methods of care reasonably directed to obtaining the same results. They do not replace the need for application of clinical judgement to each individual presentation, nor variations based on locality and facility type. †ESHRE pages content is not externally peer reviewed. The manuscript has been approved by the Executive Committee of ESHRE.
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Affiliation(s)
| | - Jackson Kirkman-Brown
- Centre for Human Reproductive Science, University of Birmingham, IMSR, Birmingham, UK
- Correspondence address. University of Birmingham, IMSR, Birmingham B15 2TT, UK. E-mail: ;
| | | | - Eline A F Dancet
- KU Leuven, Department of Development and Regeneration, Leuven, Belgium
| | - Kersti Lundin
- Department of Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mariana Martins
- University of Porto, Faculty of Psychology and Education Sciences, Porto, Portugal
| | - Kelly Tilleman
- Department for Reproductive Medicine, Universitair Ziekenhuis Gent, Ghent, Belgium
| | - Petra Thorn
- Private Practice, Couple and Family Therapy, Infertility Counseling, Mörfelden, Germany
| | - Nathalie Vermeulen
- European Society of Human Reproduction and Embryology (ESHRE) Central Office, Strombeek-Bever, Belgium
| | - Lucy Frith
- Centre for Social Ethics and Policy, University of Manchester, Manchester, UK
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Akatsuka K, Hatta T, Sawai T, Fujita M. Public attitudes in Japan toward the reproductive use of gametes derived from human-induced pluripotent stem cells. Future Sci OA 2021; 7:FSO754. [PMID: 34840811 PMCID: PMC8609981 DOI: 10.2144/fsoa-2021-0065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/30/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To investigate the interests of the Japanese general public in the reproductive use of in vitro derived (IVD)-gametes. METHODS We conducted an online survey and obtained answers from 3096 respondents. RESULTS More than half of the respondents agreed with the reproductive use of IVD-gametes by infertile heterosexual married couples but disagreed with the same use by unmarried or homosexual individuals. Nearly 70.0% disagreed with the use for designing a baby. DISCUSSION In Japan at present, the use of IVD-gametes that deviate from societal values regarding reproduction and family prescribed by the conventional marriage system is unlikely to be accepted. It is also unlikely to be accepted for non-treatment purposes in reproduction.
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Affiliation(s)
- Kyoko Akatsuka
- Uehiro Research Division for iPS Cell Ethics, Center for iPS Cell Research & Application, Kyoto University, Japan, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Taichi Hatta
- Shizuoka Graduate University of Public Health, Japan, 4-27-2 Kita Ando, Aoi-ku, Shizuoka 420-0881, Japan
| | - Tsutomu Sawai
- Institute for the Advanced Study of Human Biology (WPI-ASHBi), KUIAS Kyoto University, Japan, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Misao Fujita
- Uehiro Research Division for iPS Cell Ethics, Center for iPS Cell Research & Application, Kyoto University, Japan, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
- Institute for the Advanced Study of Human Biology (WPI-ASHBi), KUIAS Kyoto University, Japan, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
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Bolt SH, Notermans C, van Brouwershaven AC, Maas AJBM, Indekeu A. The ongoing work of kinship among donor half-siblings in The Netherlands. BIOSOCIETIES 2021. [DOI: 10.1057/s41292-021-00259-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Affiliation(s)
- Allan A Pacey
- Editor in Chief, Department of Oncology and Metabolism, School of Medicine and Biomedical Sciences, University of Sheffield, The Jessop Wing, Sheffield, S10 2SF, UK
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