Anonymous Donors Research Articles

Does donor conception violate human dignity?

The moral acceptability of anonymous gamete donation remains contested. Although the view that the value of parent-child relationships should not depend on genetic ties is "nearly axiomatic" among philosophers and bioethicists, one well-known dissenter remains: David Velleman. I argue that most rebuttals to Velleman have simply talked past him because they have failed to understand his fundamental point-that donor conception is a violation of human dignity and as such is wrong even if it does not harm individuals. I challenge Velleman on his own terms by endorsing his metaphysical picture before showing that donor conception is not necessarily a violation of human dignity. I show this by arguing that gamete donation is held to a double standard of self-knowledge. I develop an account of the self that recognizes that certain kinds ofchallenges to one's flourishing can contribute to an individual's strength and self-knowledge. I defend my view against objections that genetic knowledge is categorically different from other ways of knowing oneself and I show that donor conception can respect human dignity as long as it meets certain conditions.

New York MH professionals receive boost with $1M donation towards student loan forgiveness

New York City Mayor Eric Adams and NYC Health + Hospitals announced on July 24 the launch of a new student loan forgiveness program for behavioral health providers, funded by a $1 million contribution from an anonymous donor, New York City news outlets have reported. The new program is designed to help attract and retain doctors, nurse practitioners, and other clinicians who care for New Yorkers with mental health or substance use needs as the U.S. faces a national shortage of mental health professionals.mental health professionals. NYC Health + Hospitals will offer psychiatrists, psychiatric nurse practitioners, psychologists, and licensed clinical social workers between $30,000 and $50,000 of student loan debt relief in exchange for a three‐year commitment to serve the public health system. The news was welcomed by New York State Office of Mental Health Commissioner Dr. Ann Marie T. Sullivan. “The nationwide shortage of health care workers has impacted facilities and providers all across the country, at a time when the stress of the COVID‐19 pandemic has increased the need for services,” she said.

Secrecy & anonymity in donor assisted conception and the right to genetic origins information: The current status in Greece.

When the issue of donor assisted conception arises, two bioethical and legal issues have to be answered. Firstly, when can a donor be considered as a legal parent of a child who claims to have been born through his genetic material? Secondly, should anonymous sperm donation be allowed? In this article, these questions are answered according to Greek Law. Also, the author provides integrated solutions to legal problems.

Gamete Donor Anonymity: What's Privacy Got to Do with It?

In Canada, gamete donor anonymity is tacitly protected in the absence of laws or regulations that explicitly address the topic. This article explores and characterizes the historical and contemporary role of privacy, as a publicly protected legal interest, in the context of gamete donation. Ultimately, this article argues that anonymous gamete donation is not supported by the principle of privacy in Canadian law. The argument proceeds by identifying and exploring three candidate rationales for gamete donors’ interests in privacy as referenced in past and current government reports, legislation, and case law, but ultimately reveals them as wanting and unfounded from a legal standpoint. The implication of this is that the protection of donor anonymity cannot find support in appeals to donors’ privacy interests, and that the legal defensibility of the practice — if it can be defended at all — must be found elsewhere.

Anonymous Gamete Donation in Iran: Lineage Revisited

AbstractAssisted reproductive technologies (ARTs) were legitimized in Iran through the rulings (fatwa) of some of the Shia Islamic jurists, who, in allowing third‐party gamete donation, specified that the resulting child will belong to its biological parent from whom it will take its lineage and inherit. However, three decades on and in practice, the recipients of gamete are increasingly resorting to seeking third‐party gamete from anonymous donors, an act which defies the above rulings. Currently, a proposal including legalizing anonymous gamete donation is examined by the parliament and the question of anonymity remains in flux. This article examines the factors leading to the emergence of the preference by both the infertile couples and the practitioners for anonymous donation. It further examines the implications of anonymous gamete donation for lineage and biological relatedness, which form the cornerstone of family and kinship, and which are paramount in Islam and in Iranian culture.

P-722 Ending the anonymity of egg donors in shared donation programs could reduce the number of participants

Abstract Study question Loss of egg donor anonymity could affect shared donation programs in Brazil? Summary answer Yes. Approximately 20% of the women who participated in this study would drop out of the program, especially those with higher incomes. What is known already The Brazilian Federal Council of Medicine seems to be increasingly flexible with regard to maintaining mandatory secrecy on the identity of donors. The resolution regarding assisted reproduction techniques, approved in 2021, concerns the possibility of donation between family members, up to fourth degree relatives. The possibility to know and have access to this identity or even the search for half-brothers can be a reality in many countries for children born through access to reproductive technology but the opinion or behaviour of this population about the presence or absence of anonymity is limited to a few studies. Study design, size, duration Women (n = 800) who applied for enrolment in the shared egg donation program at a private IVF clinic were invited to participate in an electronic survey developed using the online Survio® tool. The invitation to participate was sent by email from June to November 2021. 279 women (34.8%, 20-35 years) responded to the survey. Participants/materials, setting, methods The information was obtained through questioning and gaining information about: socioeconomic profile of the donors, their motives, ambivalence in relation to the sharing of eggs and feelings about a possible end of anonymity. Thereafter, answers given to 10 specific questions were recorded. Furthermore, a correlation analysis was performed to assess the relationship between acceptance of the end of donor anonymity and various study parameters. Main results and the role of chance Approximately 61% of patients would want to become egg donors for two reasons: to reduce IVF costs and to help another woman. However, significantly younger women want to be part of the egg donation program just to reduce their treatment costs (P < 0.05). Approximately 71% of women do not want any contact with the child born from their eggs; 69% of them would not like to meet the recipients and 75% would not like to meet the child, even if only the recipient had become pregnant. If donors lost a child, they would not even want to meet the child who was born with their donated eggs (76%). Most participants also responded that they would be in the program even if the anonymity was not maintained (80%). However, women with higher income would drop out of the program if donor anonymity was not maintained (56.3%) compared to women with lower income (13.5%;P < 0.001). Limitations, reasons for caution Confounding variables related to the male partner's opinion cannot be excluded. Studies with larger samples are needed to confirm these findings. Wider implications of the findings A possible end to the anonymity of egg donors in Brazil would pose numerous challenges to the current practice of gamete donation. These concerns give rise to a broad discussion in society about how best to safeguard and promote the interests of donor-conceived children and protect the rights of donors. Trial registration number Not applicable.

O-104 Providing accurate information – impact of ancestry testing

Abstract Providing information to patients and, or donors at the ART clinic is essential but challenging, especially in the case of reproductive donation. Recent developments in direct-to-consumer genetic testing combined with social media have increased the degree of difficulty. Concepts such as donor anonymity, secrecy and disclosure have to be revisited and totally re-thought as the anonymity of donors, their relatives and also of the children born through donation is no longer guaranteed. This potentially has significant effects on everyone involved: to donors who donated under the assumption that their donation was completely anonymous, to recipients who were under the impression that they could keep donor conception a secret and to donor offspring who were unaware of their donor-assisted conception. It is also effectively retrospective affecting everyone who has, is or might participate. Providing the correct information to donors, ART couples and donor-conceived offspring is the key, and advise for such information provision will be presented in line with the recently published ESHRE good practice recommendations for information provision for those involved in reproductive donation. Trial registration number

O-317 Panel discussion: Refugee Embryos: Abandon or Rescue? what policies should nations with third party reproduction programs consider to repatriate the gametes of foreign couples

Abstract Ukraine's large population, low salaries and medical expertise along with being one of just a handful of countries with laws regulating surrogacy for foreigners meant that following South-east Asian governments closure of unregulated surrogacy programs, Ukraine emerged in 2016 as the European hub for affordable surrogacy and Donor IVF programs for heterosexual married couples from around the globe. Thousands of infertile couples utilised Ukraine surrogacy programs over the following six years. When Russia invaded Ukraine in February 2022 it is estimated that over 30,000 embryos and gametes belonging to foreigners were in Ukraine storage facilities. Some of these have been temporarily re-located to safer cities or neighbouring countries. This session discusses the difficulties patients face in finding a new home' for these embryos, given the very limited number of countries with capacity and laws which support surrogacy programs. This discussion also considers the differences in individual countries own laws around the ability to accept embryos where anonymous donors were used and what national regulatory bodies could do to ensure these refugee embryos find safe harbour. Trial registration number

O-205 Application of a single “Universal warming protocol” for vitrified donor oocytes: A prospective, multicenter study

Abstract Study question Is it possible to use different commercial thawing kits with donor oocytes that have been vitrified with a Kitazato vitrification kit? Summary answer The Omni thawing kit showed higher survival rates of donor oocytes. However, fertilization, blastulation, and chemical pregnancy rates were similar in all three thawing kits. What is known already Vitrification is the best method for cryopreserving metaphase II (M2) oocytes and blastocysts. Oocyte vitrification and subsequent thawing is performed with the use of different commercial kits. Currently, the thawing kit usually corresponds to the same provider as the vitrification kit used. However, this may create issues when using cryopreserved oocytes among different clinics with different vitrification kits and, furthermore, not all lab professionals are accustomed to using other commercial kits. Using a “single warming protocol” would provide a solution to these drawbacks and would improve the compatibility of exchanging gametes and embryos among collaborating centers. Study design, size, duration This is a longitudinal, comparative and prospective study conducted between January 2017 and December 2020 at four different IVF private centers. Overall, we vitrified a total number of oocytes (n = 2172) with a single Kitazato commercial vitrification kit at a Spanish Egg Bank, and three independent IVF centers used different thawing kits (Kitazato, Irvine or Omni) as a warming protocol. Participants/materials, setting, methods The study included oocytes from altruistic anonymous egg donors aged 18-35 years, subject to the rigorous standards to become an oocyte donor. The primary outcome was survival and fertilization rate; secondary outcomes included blastulation rate, and chemical pregnancy rate. Main results and the role of chance A total of 2172 M2 oocytes were retrieved and subsequently vitrified using the Kitazato protocol and the Cryotop device. All vitrified donor M2 oocytes were thawed at independent assisted reproduction centers using the following thawing kits: Omni Vitrolife (n = 655), Kitazato (n = 1021), and Irvine (n = 496). Oocytes thawed using the Omni kit had a 94% (617/655) survival rate and a 73% fertilization rate. Kitazato thawing kits had an 86% (877/1021) survival rate and a 77% fertilization rate. Lastly, Irvine thawing kits had an 85% (423/496) survival rate and a 74% fertilization rate. Survival rate results were statistically significant among different thawing kits (P-Value = <0.01). Fertilization rates were not statistically significant. Blastulation rates with Omni, Kitazato and Irvine thawing kits were 57%, 52%, and 58%, respectively (Not statistically significant). Lastly, chemical pregnancy (HCG-Beta positive) rates with Omni, Kitazato and Irvine thawing kits, results were 65%, 54%, and 76%, respectively (Not statistically significant). Limitations, reasons for caution The study was carried out in centers with long experience collaborating together, but many different professionals intervened in the process, without the same conditions in all labs. Wider implications of the findings With increasing requirements for cryopreserved oocytes due to the difficulties of donor-recipient synchronization, popularization of treatments from abroad, and the need to import or send donor oocytes for recipient phenotypes, it has become of paramount importance to use a single universal warming protocol irrespective of cryopreservation kits. Trial registration number NOT APPLICABBLE

O-081 Brad Pitt or the Next Door Neighbor?

Abstract Study question Can we identify the preferences of sperm recipients regarding traits of the ideal sperm donor? Summary answer According to our questionnaire, patients’ priority was a “healthy child” but they were also trying to assemble “the perfect looking child”. What is known already Recruiting sperm donors is tedious and time consuming. Literature is scarce on the factors guiding women when choosing a donor. Increasing knowledge regarding these factors could assist in the recruitment process. In certain countries sperm donation is anonymous. The shared information about the donors is limited and includes basic physical traits (hair, eye color, skin complexion, height) in addition to religion, education, and occupation. Single women are free of social constraints when choosing an anonymous donor, shedding a light on what are the most critical elements. Study design, size, duration An anonymous questionnaire was developed to explore sperm recipients’ preferences in choosing a sperm donor. The respondents were asked to describe themselves and choose the traits of the ideal donor from a structured list in the questionnaire. Patients were asked to rank the importance of a list of traits. Participants/materials, setting, methods Sixty four patients completed the questionnaire. The data was statistically analyzed. Main results and the role of chance Eighty percent of participants are single women. 45% of the participants are 35-40 years old. Most of them have an academic degree (70%) and grew up in the city (77%). 74% of our patients have dark hair and 67% have brown eyes. We compared the traits of the recipients to the traits of the hypothetical ideal donor. Interestingly, recipients did not desire a donor that looks like them overcoming the natural instinctive desire to have a child that looks like you. Even though the average recipient at our unit does not have a fair appearance, the ideal donor of 73% of the recipients is light haired with blue/green colored eyes. The average height of the women was 166cm±6 while the average height of the ideal donor was 178cm±6. Still, when ranking the importance of traits; 89% ranked genetic testing as most important in their selection and 67% ranked the staff's impression of the donor as very important. Recipients with an academic degree ranked education as important compared with non-academic recipients. Limitations, reasons for caution Preference in choosing a sperm donor may be influenced by local factors and might not generally applicable Wider implications of the findings Recruitment of sperm donors is an ongoing process demanding commitment between the medical staff and the donors. It requires a psychologic evaluation, serologic and genetic testing and repeated sperm sampling. Knowing factors that guide women when choosing a sperm donor may precise the recruitment process of donors. Trial registration number None

Parent-initiated posthumous-assisted reproduction revisited in light of the interest in genetic origins

A rich literature in bioethics argues against the use of anonymous gamete donation in the name of the ‘interest in knowing one’s genetic origins’. This interest stems from medical as...

Singapore needs to update regulation of frozen egg donation after permitting social egg freezing.

With social egg freezing being permitted in Singapore, there is expected to be an accumulated surplus of unused frozen eggs (vitrified oocytes) available for donation in coming years. A comprehensive update of current healthcare regulations pertaining to frozen egg donation is needed to resolve various pertinent ethical issues. In particular, the issue of egg donor anonymity should be addressed, together with the lack of sharing of medical and family information about the donor to prospective recipient patients and donor-conceived offspring. Rigorous and comprehensive genetic testing of prospective egg donors must be mandated to protect the welfare of recipient patients. Older women above 35years of age should be required to have at least one child, before being allowed to donate their unused frozen eggs, to prevent any future regret and psychological problems of remaining childless, while being unsure of whether they have an unknown genetic offspring out there. New regulations drafted to address these ethical issues must also prevent potential conflicts of interests. For example, fertility doctors soliciting and encouraging former patients to donate their unused frozen eggs face an obvious conflict of interest, because additional medical fees will be earned by performing the egg donation procedure on other patients. A centralized donor registry should be established by the Singapore government to oversee the distribution and allocation of donated unused frozen eggs to infertile IVF patients. Such a registry could also facilitate sharing of vital health information about the donor to recipient patients and donor-conceived offspring.

Editor.ial board info.docx AJOL Journal Information Form-AJTCCM.docx

South African (SA) gamete banks and gamete donation agencies do not offer open-identity donors, as it is generally believed that donor anonymity is a legal requirement in SA. However, analysis of SA statutory instruments and case law shows that this belief is mistaken, and that gamete donation in SA can be anywhere on the spectrum between anonymous and known. Accordingly, open-identity gamete donation would be lawful in SA and can be offered to the public by SA gamete banks and gamete donation agencies.

Anonymous gamete donation and Article 8 of the European Convention on Human Rights: The case for incompatibility

It has long been suggested that anonymous gamete donation may breach the rights of donor-conceived persons under Article 8 of the European Convention on Human Rights (ECHRs). However, this has never been definitively addressed by the European Court of Human Rights (ECtHRs). The purpose of this article is to comprehensively set out the argument that anonymous gamete donation constitutes an unjustifiable interference with Article 8 ECHR. The article analyses the rich jurisprudence of the ECtHR on the right to identity in the fields of paternity and anonymous birth, and argues that the right has a ‘tracing’ element and a ‘recognition’ element, both of which are engaged in the anonymous donation context. It is argued that despite the absence of consensus across the Member States, proper analysis of the application of Article 8 should conclude that regimes that permit anonymous donation fail to strike a fair balance between competing rights and interests.

Dark Money in Congressional House Elections

The deregulation in campaign finance, stemming from the 2010 United States Supreme Court decision in Citizens United v. Federal Election Commission, has led to nonprofit organizations with anonymous donors spending on advertisements targeting candidates. I study the effects of this “dark money” 501(c)(4) nonprofit spending on election outcomes in US Congressional House elections. Since 501(c)(4)s are not legally required to disclose spending to the Federal Election Commission, I use advertising data to measure their behavior. I estimate a model of the voter’s candidate choice, which is influenced by the spending of different groups. I find that 501(c)(4)s do not have significant effects on candidate vote share when accounting for the spending of candidates, parties, PACs, and Super PACs.

Myeloproliferative neoplasms – a global view

Myeloproliferative neoplasms – a global view

Anonymity: What does it mean and why is it important to anonymous living liver donors?

Anonymous living organ donation has recently become more common in select transplantation programs, with donors voluntarily offering a kidney or a lobe of their liver to those in need. These anonymous donations may be directed to a specific recipient or nondirected, and anonymity may be one way or reciprocal. Given their unique situation, we interviewed a cohort of anonymous living liver donors and explored their opinions surrounding anonymity and its implications in living liver donation. A total of 26 anonymous donors completed a semistructured qualitative interview consisting of questions regarding their experiences as a living liver donor. The interviews were audio-recorded, transcribed, and analyzed for common themes, specifically those pertaining to the donor's perceptions and experiences with anonymity. Five main themes related to anonymity were identified: (1) the moral importance of an unencumbered gift, (2) wanting internal satisfaction rather than seeking external accolades, (3) anonymity as a protection against potential negative outcomes in the recipient, (4) feelings of ambivalence toward meeting the recipient, and (5) concerns about negative perceptions among their own friends and family. These insights into the range of donors' attitudes toward anonymity will help improve awareness and provide the best possible mental and physical care for the anonymous donor.

Eosinophil-mediated suppression and anti–IL-5 enhancement of plasmacytoid dendritic cell interferon responses in asthma

Virus-induced IFN-α secretion by plasmacytoid dendritic cells (pDCs) is negatively impacted by IgE and has been linked to asthma exacerbations. Eosinophils, another contributor to type 2 inflammation, are also associated with asthma severity. We sought to investigate the impact of eosinophils on pDC antiviral interferon responses and determine whether anti-IL-5/5Rα therapy enhances pDC antiviral function. Blood pDCs purified from anonymous donors were stimulated invitro with rhinovirus (RV)-16 in the presence or absence of eosinophils/eosinophil supernatants. IFN-α was measured in supernatants and RNA collected for bulk RNA-sequencing. Next, purified pDCs from 8 individuals with moderate to severe asthma, treated or not treated with anti-IL-5/5Rα therapy, were cultured exvivo with or without RV; IFN-α secretion and differential gene expression analysis were compared between groups. Exposure to either eosinophils or eosinophil supernatants inhibited RV-induced pDC IFN-α secretion in a dose-dependent manner and did not impact pDC viability. Eosinophil-derived neurotoxin and TGF-β partially recapitulated pDC IFN-α inhibition. Transcriptome analysis revealed global repression of pDC interferon response patterns by eosinophils, most notably in basal expression of interferon-stimulated genes. Increased RV-induced IFN-α secretion and transcription as well as increased basal interferon-stimulated gene expression was detected in pDCs from participants treated with anti-IL-5/5Rα therapy. Our findings highlight a novel mechanism through which type 2 inflammation regulates pDC IFN-α responses relevant to RV respiratory infections in the context of eosinophilic airway disease, suggesting a potential mechanism through which eosinophil-depleting therapies may reduce severity of RV illnesses.

Induction of SARS-CoV-2 neutralizing antibodies by CoronaVac and BNT162b2 vaccines in naïve and previously infected individuals.

SummaryBackgroundA major challenge of the SARS-CoV-2 pandemic is to better define “protective thresholds” to guide the global response. We aimed to characterize the longitudinal dynamics of the antibody responses in naturally infected individuals in Chile and compared them to humoral responses induced after immunization with CoronaVac-based on an inactivated whole virus -or the BNT162b2- based on mRNA-vaccines. We also contrasted them with the respective effectiveness and efficacy data available for both vaccines.MethodsWe determined and compared the longitudinal neutralizing (nAb) and anti-nucleocapsid (anti-N) antibody responses of 74 COVID-19 individuals (37 outpatient and 37 hospitalized) during the acute disease and convalescence. We also assessed the antibody boosting of 36 of these individuals who were immunized after convalescence with either the CoronaVac (n = 30) or the BNT162b2 (n = 6) vaccines. Antibody titres were also measured for 50 naïve individuals immunized with two doses of CoronaVac (n = 35) or BNT162b2 (n = 15) vaccines. The neutralizing level after vaccination was compared to those of convalescent individuals and the predicted efficacy was estimated.FindingsSARS-CoV-2 infection induced robust nAb and anti-N antibody responses lasting >9 months, but showing a rapid nAb decay. After convalescence, nAb titres were significantly boosted by vaccination with CoronaVac or BNT162b2. In naïve individuals, the calculated mean titre induced by two doses of CoronaVac or BNT162b2 was 0·2 times and 5.2 times, respectively, that of convalescent individuals, which has been proposed as threshold of protection. CoronaVac induced no or only modest anti-N antibody responses. Using two proposed logistic models, the predicted efficacy of BNT162b2 was estimated at 97%, in close agreement with phase 3 efficacy studies, while for CoronaVac it was ∼50% corresponding to the lowest range of clinical trials and below the real-life data from Chile (from February 2 through May 1, 2021 during the predominant circulation of the Gamma variant), where the estimated vaccine effectiveness to prevent COVID-19 was 62·8–64·6%.InterpretationThe decay of nAbs titres in previously infected individuals over time indicates that vaccination is needed to boost humoral memory responses. Immunization of naïve individuals with two doses of CoronaVac induced nAbs titres that were significantly lower to that of convalescent patients, and similar to vaccination with one dose of BTN162b2. The real life effectiveness for CoronaVac in Chile was higher than estimated; indicating that lower titres and additional cellular immune responses induced by CoronaVac might afford protection in a highly immunized population. Nevertheless, the lower nAb titre induced by two doses of CoronaVac as compared to the BTN162b2 vaccine in naïve individuals, highlights the need of booster immunizations over time to maintain protective levels of antibody, particularly with the emergence of new SARS-CoV-2 variants.FundingFONDECYT 1161971, 1212023, 1181799, FONDECYT Postdoctorado 3190706 and 3190648, ANID Becas/Doctorado Nacional 21212258, PIA ACT 1408, CONICYT REDES180170, Centro Ciencia & Vida, FB210008, Financiamiento Basal para Centros Científicos y Tecnológicos de Excelencia grants from the Agencia Nacional de Investigación y Desarrollo (ANID) of Chile; NIH-NIAD grants U19AI135972, R01AI132633 and contracts HHSN272201400008C and 75N93019C00051; the JPB Foundation, the Open Philanthropy Project grant 2020-215611 (5384); and by anonymous donors. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Ethnicity shouldn't matter

My name is Anne-Pierre. I am an Aries, but I celebrate my rebirth day in January. In 2022, I happily turned 8 years old since the day of my bone marrow transplantation. I am now in good health thanks to a selfless anonymous donor from Germany. In my misfortune, I have been most fortunate. My friend Tiana was not and it still feels like a punch in the stomach.