title: Investigating psychosocial attitudes, motivations and experiences of oocyte donors, recipients and egg sharers: a systematic review.
abstract: The donation of oocytes has been made feasible as a result of in vitro fertilization (IVF). This treatment offers an answer for infertile women with ovarian conditions, such as primary ovarian insufficiency. Demand for oocyte donors has been on the rise globally, with infertile couples, as well as gay men, increasingly using it as a means to found their families. With an acute shortage of oocyte donors globally, the psychosocial aspects behind oocyte donation are important for fertility clinics to understand. This paper aims primarily to provide an up-to-date systematic review of the psychosocial aspects of oocyte donation from the point of view of oocyte donors and recipients and egg sharers. Its secondary aims are to explore the motives and experiences of donors as well as attitudes towards donor anonymity and disclosure. An emphasis has been placed on the analysis of donors in the UK. No review has analysed together the aforementioned donor groups along with recipient group.
  
  
  
  A systematic search of English peer-reviewed journals of four computerized databases was undertaken, with no time restriction set for publications.
  
  
  
  There were 62 studies which met the inclusion criteria and were included in the systematic review. Attitudes towards donation were positive from both a donor oocyte and recipient point of view, with medical procedures being well tolerated and excellent post-donation satisfaction among all donor groups. There were distinct differences between the different donor groups and recipients in motivation for oocyte donation and decisions for disclosure. Attitudes towards anonymity issues were reassuring with a significant proportion of donors of all types willing to donate as identifiable donors. However, there were methodological limitations identified in the studies reviewed.
  
  
  
  This review successfully explored the important psychosocial aspects of oocyte donation. In general terms the attitudes and feeling of patients involved from all sides of the donation process were extremely positive. A number of key and consistent issues emerged which demonstrated differences and similarities between the different donor groups, as well as a greater understanding of the recipient. With regard to psychosocial well-being, the results were reassuring throughout all donor groups, especially the egg share donors. Although it seems the 2005 legislative changes in the UK have not caused the anticipated dramatic decrease in gamete donation, oocyte donation still falls far short of demand. The UK has an increasing population of patients from different ethnic backgrounds and same sex relationships seeking oocyte donation, with very few studies including these groups of patients. An increased number of well-designed studies looking into the psychological issues surrounding gamete donation of different patient groups, could allow more directed assessment and counselling of oocyte donors and recipients, with a resulting increase in donor recruitment.
authors.affiliation: Division of Surgery and Cancer, Institute of Developmental Reproductive & Developmental Biology, Imperial College London, Chelsea and Westminster Hospital Campus, 369 Fulham Road, London, UK tjb101@doctors.org.uk.
authors.forename: Timothy
authors.initials: T
authors.lastname: Bracewell-Milnes
authors.affiliation: Division of Surgery and Cancer, Institute of Reproductive & Developmental Biology, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, UK.
authors.forename: Srdjan
authors.initials: S
authors.lastname: Saso
authors.affiliation: The Lister Hospital, Chelsea Bridge Road, London, UK.
authors.forename: Shabana
authors.initials: S
authors.lastname: Bora
authors.affiliation: Obstetrics & Gynecology, Faculty of Medicine, Women's Health Centre, Assiut University, Assiut, Egypt.
authors.forename: Alaa M
authors.initials: AM
authors.lastname: Ismail
authors.affiliation: Division of Surgery and Cancer, Institute of Reproductive & Developmental Biology, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, UK.
authors.forename: Maya
authors.initials: M
authors.lastname: Al-Memar
authors.affiliation: Obstetrics & Gynecology, Faculty of Medicine, Women's Health Centre, Assiut University, Assiut, Egypt.
authors.forename: Ali Hasan
authors.initials: AH
authors.lastname: Hamed
authors.affiliation: The Lister Hospital, Chelsea, London, UK.
authors.forename: Hossam
authors.initials: H
authors.lastname: Abdalla
authors.affiliation: The Lister Hospital, Chelsea, London, UK.
authors.forename: Meen-Yau
authors.initials: MY
authors.lastname: Thum
mesh_terms: D030881:Disclosure; D005260:Female; D005307:Fertilization in Vitro / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007247:Infertility, Female / Q000523:psychology*; D018587:Oocyte Donation / Q000331:legislation & jurisprudence / Q000523:psychology*; D009865:Oocytes; D014019:Tissue Donors / Q000523:psychology* / Q000706:statistics & numerical data; D009927:Tissue and Organ Procurement
keywords: artificial reproductive technologies; infertility; oocyte donation; surrogate donation; systematic review