Donor-linking provisions in New Zealand: counselling roles, concerns and needs.

Donor-linking where those genetically related through donor conception (e.g. donor-conceived persons (DCP), donors and siblings), or recipient parents, search for and connect with each other, is increasingly common, both in identity-release jurisdictions where donors' identifying information may be released to DCP, usually when they become adults - and in anonymous jurisdictions, e.g. as a result of direct-to-consumer DNA testing. In this paper, we explore New Zealand fertility clinic counsellors' views regarding their donor-linking roles and their concerns and needs in relation to current and anticipated service provision. Counsellors believed that fertility service providers had a longer-term responsibility to offer donor-linking services to ensure the wellbeing of all parties affected by donor conception. They perceived their role as complex and multifaceted, encompassing psychoeducation, mediation, advocacy, facilitation, relationship counselling, and therapeutic intervention. They identified significant service provision challenges however, including inadequate staffing, training, time and prioritisation of donor-linking, and inadequate legislative provisions to support practice. Counsellors called for clarity in legislation addressing different contexts of donation and providing measures to ensure the recording of and access to identifying information. They expressed a need for comprehensive, funded donor-linking services, therefore facilitating choice, and services staffed by professionally trained and supported staff.

Reconceptualising the Interest in Knowing One's Origins: A Case for Mandatory Disclosure.

The aim of this article is to make a case for mandatory disclosure in assisted reproduction. This refers to a system whereby those who are born through gamete donation and/or surrogacy would be notified about the manner of their birth and the availability of information about their genetic and/or gestational origins. The article argues that, to date, the law has interpreted an individual's interest in knowing their origins as being predominately about identity. However, the central importance of the principle of autonomy in the conceptualisation of this interest has been overlooked. A reconceptualisation of the interest in knowing one's origins as being concerned predominantly with autonomy provides a justification for mandatory disclosure. It is argued that the interest of individuals born through assisted reproduction in having autonomous choice regarding the significance of information about their origins should be prioritised over the autonomous choices of parents not to disclose to their offspring the manner of their birth.

El interés legítimo de los hijos a conocer el origen biológico en la donación anónima de gametos / The legitimate interest of children to know the biological origin in the anonymous donation of gametes

La diversidad de los modelos de familia, junto al acceso a las técnicas de reproducción humana asistida con contribución de donantes (TRHA-D), está integrada ampliamente en el marco social. El debate actual en la búsqueda del equilibrio entre la libertad y derecho reproductivo, por un lado, y el derecho a conocer los orígenes biológicos como elemento para el bienestar de las personas, por otro, obliga a plantearnos el alcance y pertinencia del anonimato de los donantes de gametos. Debate abierto, asociado al cambio normativo producido en diversos países del entorno, en los que se ha suprimido tal anonimato. La escasez de estudios sobre el tema a nivel nacional, en discordancia con los más numerosos realizados en EEUU y otros países de la UE, reclama que se preste más atención a la cuestión y a la normativa sobre TRHA que, en nuestro país, desde la pionera Ley de 1988 hasta la actual, se han configurado desde la preservación máxima del anonimato de los donantes. Regulación que, junto con la calidad, investigación e innovación nos ha situado entre los países líderes en tratamientos de fertilidad. En este trabajo se analizan algunos aspectos relacionados con el eventual fin del anonimato de las donaciones de gametos. Entre ellos, su motivación y reparos, además de las diferencias existentes entre los distintos tipos de familia y la posible repercusión en el ámbito clínico y de accesibilidad a dicha técnica. Igualmente se analizarán los límites que pueden plantearse para el fin del anonimato en función de la opción reguladora: total, parcial, electiva, con o sin retroactividad, siguiendo modelos de otros países. Finalmente, se abordarán ciertas inquietudes observadas en el ámbito de las TRHA-D, así como su consideración desde la ética y del principio del interés superior del menor o de los hijos nacidos con tales TRHA-D

The diversity of family models, together with access to donor-contributed assisted human reproduction (TRHA-D) techniques, is widely integrated into the social framework. The current debate in the search for a balance between freedom and reproductive law, on the one hand, and the right to know biological origins as an element for the well-being of people, on the other hand, requires us to consider the scope and relevance of the anonymity of gamete donors. The debate has been opened up with regard to the legal change in different countries around us, in which such anonymity has been suppressed. The scarcity of studies on the subject at the national level, at its discord with the most numerous carried out in the US and other countries of the European Union, calls for more attention to be paid to the issue and to the TRHA regulations than, in our country, since the pioneering 1988 Act to the present, have been configured since the maximum preservation of donor anonymity. This work discusses some aspects related to the eventual end of anonymity of gamete donations. Among them, their motivation and qualms, in addition to the differences between the different types of family and the possible impact on the clinical and accessibility to this technique. The end of anonymity will be analyzed according to the regulatory legislation: total, partial, elective, with or without retroactivity, following models of other countries. Finally, certain concerns seen in the field of TRHA-D will be addressed, as well as their consideration from the ethics and principle of the best interests of the child or children born with such TRHA-D

Mater semper certa est: motherhood is always certain.

The development of oocyte donation has led to a reexamination of the facets of motherhood: the genetic, gestational, and psychosocial contributions. In addition, the practice of oocyte donation has prompted a consideration of the unique psychosocial and legal aspects of this form of family building. In this section of Views and Reviews a summary and discussion of the long-term psychosocial adjustment of oocyte donor-conceived children and their parents is presented. Next, the current permeability around donor anonymity is investigated and questions regarding whether donor anonymity can still exist is discussed. Third, the evolution of oocyte cryopreservation and banking is reviewed and the future of oocyte banking is explored. Finally, as oocyte donation continues to grow and evolve, so too does the legal landscape in which it is practiced. Seminal legal cases are presented to describe the legal landscape that has shaped the practice of oocyte donation.

New realities for the practice of egg donation: a family-building perspective.

The practice of egg donation in the United States has been based on assumptions about secrecy, anonymity, and contact among the parties that require reexamination. This article argues for the need to acknowledge that secrecy and anonymity are no longer viable assumptions and that all parties may have a strong interest in contact and connection. A shift in the narrative for the practice of egg donation from a purely medical perspective to a broader family-building perspective is described. Significant practice changes to accommodate the new realities, rooted in a family-building perspective, are outlined in the arenas of medical record retention, informed consent, recipient and donor preparation and counseling, facilitation of contact among the parties, and outreach to other medical professionals, with the goal of promoting not only healthy pregnancy, but also long-term positive family functioning.

The current status of oocyte banks: domestic and international perspectives.

Two major breakthroughs in the field of assisted reproduction-oocyte donation and oocyte vitrification-have joined forces to create the rapidly emerging phenomenon of commercial egg banks (CEBs). In this review, we examine the history of this concept, the operational models, the geographical variations, and the benefits and pitfalls of CEBs, including the ethical and legal dilemmas arising from gamete mobility. We highlight future directions in the brave new world of third-party reproduction.

Legal principles and seminal legal cases in oocyte donation.

Oocyte donation has played an increasingly important role in assisted reproductive technologies since the early 1980s. Over the past 30 years, unique legal standards have evolved to address issues in the oocyte donation procedure itself as well as the disputes over issues, such as parentage, that inevitably arise with new technologies, particularly for individuals seeking to build nontraditional families. This essay will explore oocyte donation's legal aspects as well as seminal law concerning the procedure, including statutory law (uniform and model provisions and enacted state laws) and selected judicial opinions concerning surrogacy and parentage, testing of oocyte donors, mix-ups of donated oocytes, and donor compensation.

A systematic review investigating psychosocial aspects of egg sharing in the United Kingdom and their potential effects on egg donation numbers.

This review aims to provide an up-to-date knowledge of the psychosocial aspects of egg donation from the perspectives of the egg share donor and their recipient. It explores the motives, experiences and attitudes of egg sharers and their views towards donor anonymity and disclosure. Conclusions are made on how these findings can guide clinical practice and improve egg sharing numbers. A systematic search of peer-reviewed journals of four computerized databases was undertaken. Eleven studies were included in the review. Psychosocial aspects towards donation were positive from the egg share donor and recipient. Concerns raised were whether participating in the egg sharing scheme would impact on their success rates, as well as frustration expressed by a minority regarding the lack of knowledge of egg sharing outside of fertility clinics. The 2005 legislative changes in the UK have not caused the anticipated dramatic decrease in egg donation; however, oocyte donation still falls short of demand. Egg sharing provides a practical option for more patients to access IVF, whilst also providing more donor oocytes. Improved information provision will result in greater awareness of egg sharing, with the potential to recruit more donors and meet the needs of recipients currently on long waiting lists.