P-492 Providing implications counselling to SA anonymous oocyte donors donating to Australian recipients raising Australian DCC in an open- donor-identity context?

Abstract

Abstract Study question How do counsellors manage mismatched expectations of stakeholders involved in cross-border oocyte donation between Australia and South Africa with different socio-legal frameworks regarding donor anonymity? Summary answer Cross-border oocyte donation can produce mismatched expectations due to different socio-legal frameworks around donor anonymity between two countries. Counsellors should alert stakeholders to these implications What is known already The demand for oocyte donation in Australia exceeds supply, influencing Australian women to undertake cross-border oocyte donation in South Africa. In Australia, oocyte donation is altruistic and open identity with guaranteed identity release. Conversely, South African oocyte donors are compensated and anonymous. The widespread utilisation of direct to consumer (DTC) ancestry DNA testing and internet-based forums to assist in the interpretation of these results has enabled recipients and donor conceived people (DCPs) to learn the identity of previously anonymous gamete donors. To better prepare stakeholders, some regulatory authorities require counsellors to discuss these implications with donors and recipients. Study design, size, duration Semi-structured in-depth interviews (lasting 45-60 mins) were conducted via zoom and in person in 2022 and 2023. The study included 9 South African infertility counsellors, 16 South African oocyte donors and 12 Australian recipients of cross-border oocyte donation in South Africa. Interviews were recorded and transcribed and transcripts were coded using NVivo software. Data were analysed using thematic analysis Participants/materials, setting, methods Infertility counsellors (9) were recruited through networks of SA fertility professionals. Research participant Australian recipients (12) were recruited through a Facebook peer fertility forum for recipients planning or having completed oocyte donation in SA. Research participant SA oocyte donors were recruited through Facebook advertisements and through snowball sampling resulting from recruitment advertisements placed in clinics and oocyte donor agencies Main results and the role of chance South African oocyte donors anticipated that they would remain anonymous. Some indicated that they would be open to contact should the legal framework in South Africa allow it. As Australian recipients were not required to undergo implications counselling with South African counsellors, the South African counsellors were not aware that recipients pursued the identity of their donors. The counsellors did not alert South African oocyte donors that Australian recipients and DCPs may engage in measures to determine their identity, including via DTC DNA testing and online sleuthing through forums. The Australian recipients believed donor conceived children had a right to know the donor’s identity and donor siblings’ identity, with some wanting early contact. Some recipients took steps to determine their donor’s identity and/or to discover whether their donor conceived children had donor siblings. They suggested that their children could pursue DNA testing in the future, if they wanted to know about their genetic origins. Limitations, reasons for caution The study findings are from 9 SA counsellors, 16 SA oocyte donors and 12 Australian recipients who agreed to be interviewed. They may not represent the views of all stakeholders involved in cross-border oocyte donation between Australia and South Africa. Wider implications of the findings Stakeholders involved in cross-border oocyte donation between anonymous donor and open identity settings should receive implications counselling to avoid a mismatch in the consequences of donor-conception. Trial registration number not applicable