Fertility experts urge the creation of registries to safeguard donor conception practices
However, lack of regulation on donor conception in many countries is exposing those seeking to build families in this way to potential medical, legal and psychosocial ramifications.
Associate Professor Sonja Goedeke, a New Zealand-based clinical psychologist specialising in psychosocial and ethical implications of infertility, has called on policy makers to help those seeking donor conception to make safer choices for themselves, their donors and their potential offspring and families.
Speaking at the 2025 Congress of the Asia Pacific Initiative on Reproduction (ASPIRE) in Singapore, Associate Professor Goedeke said legislation, policies and practices regarding donor conception vary significantly across jurisdictions and anonymous donation remains possible in some countries, including across the Asia Pacific.
"Anonymity can prevent donor conceived people from accessing vital health information and deny them knowledge of their genetic origins," she said. "It may also increase the risk of half-siblings unknowingly forming relationships with each other.
"Internationally, many donor conceived people have emphasised their desire for and right to access information about the donor."
Associate Professor Goedeke said limited local access to egg, sperm and embryo donors may be one of the key drivers in so-called cross-border reproduction. "However, this may present significant risks including unspecified donor limits leading to potentially large numbers of siblings," she explained.
"Unified legislation is required to set up central donor registries for each country and enforce limits around the number of donor-conceived people born from one donor to reduce the risk of consanguineous relationships and the psychological impact of discovering an unlimited number of potential siblings.
"Proper record keeping would allow central donor registries to share information with each other and ensure those seeking and providing donor conception can operate in a more regulated, safer environment."
Associate Professor Goedeke is from the Department of Psychology and Neuroscience at the Auckland University of Technology, and she is the Co-Chair of the ASPIRE Special Interest Group on Psychology and Counselling.
She said unregulated donor conception raised potential legal issues surrounding parentage, access rights to offspring and responsibilities for financial child support.
"Significant advances in science that have allowed families to be created using donated gametes have also advanced the growing availability of direct-to-consumer DNA testing," Associate Professor Goedeke explained. "This, coupled with a growing recognition of the rights and needs of donor-conceived people has driven a shift toward greater openness.
"DNA testing has become commonplace among people who suspect they were donor conceived and so true donor anonymity is no longer guaranteed. DNA samples may allow the tracing of anonymous donors and donor conceived people and access to medical and genetic data.
"Donor conceived people have the right to develop and conserve mutually agreeable relationships with biological, social and gestational families regardless of when or where they were born.
"But DNA testing for biological links can also have its downsides. In an unsupported environment, it can be challenging to negotiate outreach to individuals who may be previously unknown genetic relatives. Individuals to whom they outreach may not be anticipating contact, or genetic siblings may not be aware of their own donor conception, so responses may become psychologically confronting.
"Donor conception is a growing trend that is becoming more complex, so guidance is needed to help the recipients/parents, donors and donor conceived people to navigate the rapidly changing landscape in assisted reproduction. Donor conception is not just a treatment to help individuals conceive. It is a form of family building with long-term implications for all involved."
Associate Professor Goedeke said donor registries, donor limits, support for parents to disclose and access to properly recorded information were required to ensure ethical donor conception. This includes an understanding of complex cultural and religious contexts.
"Policy makers and health care professionals have a duty to ensure that adequate support provisions are in place to promote the health and well-being of all parties affected by donor conception," she said. "Qualified counsellors in clinical settings can provide psychosocial and decision-making support, education and advocacy and, if sought, help manage linking between donors, parents, children and siblings."
More than 2,000 experts in fertility health are attending the ASPIRE Congress at the Suntec Convention and Exhibition Centre in Singapore. For more information, go to www.aspire2025.com
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