Infertility Counseling Research Articles

Revisiting the prevalence of nonclassic congenital adrenal hyperplasia in US Ashkenazi Jews and Caucasians

PurposeNonclassic 21-hydroxylase deficiency, a mild form of congenital adrenal hyperplasia (CAH), is estimated to be the most common autosomal recessive condition, with an especially high prevalence in Ashkenazi Jews (3.7% affected, 30.9% carriers), based on a 1985 HLA-B linkage study of affected families. Affected individuals, especially women, may suffer from hyperandrogenism and infertility. State-of-the-art genetic studies have not been done to confirm these remarkable rates.MethodsCYP21A2 genotyping was performed in 200 unrelated healthy Ashkenazi Jewish subjects and 200 random US Caucasians who did not self-identify as a specific ethnicity using multiplex minisequencing, real-time polymerase chain reaction and junction site analysis.ResultsNonclassic CAH carriership was found similarly in 15% (95% confidence interval (CI): 10.4–20.7) of Ashkenazi Jews and 9.5% (95% CI: 5.8–14.4) of Caucasians (P=0.13). The proportion of Ashkenazi Jewish nonclassic CAH carriers (0.15 versus 0.309, P<0.0001) and disease affected (0.005 versus 0.037, P=0.009) was not as high as previously reported. The estimated prevalence of nonclassic CAH in Caucasians was 1 in 200 (0.5%, 95% CI: 0.01–2.8).ConclusionNonclassic CAH is a common condition, regardless of ethnicity, and should be considered with preconception and infertility counseling.

Polymerase chain reaction identification of &lt;i&gt;Trypanosoma brucei rhodesiense&lt;/i&gt; in wild tsetse flies from Nkhotakota Wildlife Reserve, Malawi

Trypanosoma brucei rhodesiense is the causative agent of acute human African trypanosomiasis. Identification of T. b. rhodesiense in tsetse populations is essential for understanding transmission dynamics, assessng human disease risk, and monitoring spatiotemporal trends and impact of control interventions. Accurate detection and characterisation of trypanosomes in vectors relies on molecular techniques. For the first time in Malawi, a molecular technique has been used to detect trypanosomes in tsetse flies in Nkhotakota Wildlife Reserve. A polymerase chain reaction (PCR) technique was used to identify the serum resistance associated (SRA) gene of T. b. rhodesiense in tsetse flies. Of 257 tsetse flies that were randomly caught, 42 flies were dissected for microscopic examination. The midguts of 206 flies were positive and were individually put in eppendorf tubes containing phosphate-buffered saline (PBS buffer) for DNA extraction. Internal transcribed spacer (ITS)-PCR was first used to isolate all trypanosome species from the flies. TBR PCR was then used to isolate the Trypanozoon group. T. brucei-positive samples were further evaluated by SRA PCR for the presence of the SRA gene. Of 257 flies caught, 185 (72%) were Glossina morsitans morsitans and 72 (28%) were Glossina pallidipes. Three were tenerals and 242 were mature live flies. Of the 242 flies dissected, 206 were positive, representing an 85.1% infection rate. From 206 infected flies, 106 (51.5%) were positive using ITS-PCR, 68 (33.0%) being mixed infections, 18 (8.7%) T. brucei, 9 (4.4%) Trypanosoma vivax, 4 (1.9%) Trypanosoma godfrey, 3 (1.5%) Trypanosoma congolense savanna, 3 (1.5%) Trypanosoma simae, and 1 (0.4%) Trypanosoma simaetsavo. When subjected to TBR PCR, 107(51.9%) were positive for T. brucei. Of the 107 T. brucei-positive samples, 5 (4.7%) were found to have the SRA gene. These results suggest that wild tsetse flies in Malawi are infected with human-infective trypanosomes that put communities around wildlife reserves at risk of human African trypanosomiasis outbreaks. Further studies need to be done to identify sources of blood meals for the flies and for surveillance of communities around wildlife reserves.

The Effect of the Collaborative Infertility Counseling Model on Coping Strategies in Infertile Women Undergoing In Vitro Fertilization: a Randomized Controlled Trial

Objectives: Infertility is a stressful condition influencing interpersonal and social relationships among infertile couples. Various strategies have been suggested for coping with infertility. This study examined the effect of the collaborative infertility counseling model on coping strategies in infertile women undergoing in vitro fertilization (IVF) in an urban area of Iran. Materials and Methods: This clinical controlled trial was conducted on 60 women with primary infertility selected from Milad Infertility Center in Mashhad, Iran. They were randomly allocated to the intervention and control groups with 29 and 31 samples in each group. The intervention group received individual counseling based on the collaborative reproductive healthcare model. The counseling was provided with the collaboration of a midwife, a gynecologist and a clinical psychologist in 5 sessions during a 2-month period. The control group received only routine care. The fertility problem inventory (FPI) and general health questionnaire were used to measure perceived fertility-related stress and general health, respectively. Moreover, the ways of coping-revised questionnaire was used to collect data regarding the women’s coping strategies at the beginning of the study and at the day of the embryo transfer. The student t test, Fisher exact test, Mann-Whitney U test and analysis of variance (ANOVA) were used for data analysis. Results: A statistically significant difference was reported between the two groups in terms of problem-focused coping strategies (P = 0.037). However, no statistically significant difference was reported between the groups with regard to emotion-focused coping strategies (P = 0.947). There were statistically significant differences between the 2 groups in the mean scores of seeking social support (P = 0.022) and planful problem-solving strategies (P = 0.045) as the subscales of problem-focused coping strategies. Conclusion: The collaborative reproductive healthcare model promoted the use of problem-focused coping strategies. Therefore, the use of collaborative counseling approaches by healthcare professionals is suggested for assisting infertile women to cope with infertility. © 2018 The Author (s).

Referral to infertility counseling in cancer patients undergoing chemotherapy.

220 Background: Reproductive concerns in survivorship are associated with distress, depression and anxiety. Patients who receive pretreatment fertility counseling report a better quality of life after treatment. Despite this, only about 50% of patients in studies recall discussion of fertility issues prior to chemotherapy. Methods: A retrospective review was conducted to evaluate discussion of fertility in patients ages 19-35 seen at the University of Alabama at Birmingham Hematology/Oncology clinic from 1/1/15-12/31/15. Patients who never received therapy that could alter their childbearing potential were excluded. Patients’ sex, age at diagnosis, type of cancer, documented discussion of fertility implications prior to therapy, and referral to Reproductive Endocrinology (REI) were documented. Rates of discussion of fertility risks and rate of referral were determined. Results: Fifty-four patients met inclusion criteria for the study. 46.3% were female. 30 patients (55.6%) had a hematologic malignancy and 24 patients (44.4%) had a solid tumor malignancy. Documentation of fertility risk was seen in 33.3% of patients with 29.2% referred to REI. Seven (24.1%) patients had hematologic malignancies and eight (33.3%) had solid tumors were referred to REI. Of the 25 female patients, only five (16.7%) were referred to REI, whereas another five patients could have been deemed not suitable for referral due to previous surgery or metastatic disease making the appropriate referral rate of 25%. Of the 29 male patients, nine were referred to REI, one had semen analysis without REI referral, and one refused REI evaluation making overall referral rate 34.5%. 35 of the 54 patients received their initial chemotherapy at our facility, and of those 34.3% were referred to REI. Conclusions: Despite guidelines recommending discussion of fertility risks with all patients of child-bearing age prior to chemotherapy, less than half of patients at our institution are referred to REI. [Table: see text]

不妊症の心身カウンセリング : 看護職の立場から(ワークショップ : 女性の心身カウンセリング : 実践とシステム化)( 第32回日本女性心身医学会学術集会報告)

不妊症の心身カウンセリング : 看護職の立場から(ワークショップ : 女性の心身カウンセリング : 実践とシステム化)( 第32回日本女性心身医学会学術集会報告)

Offering the full range of contraceptive options: a survey of interest in vasectomy training in the US family planning community

ObjectiveTo assess current practices regarding female and male sterilization counseling and provision, as well as determine interest in providing vasectomy among family planning specialists. MethodsMembers of the US-based network of family planning fellowship physicians (current fellows, graduates and faculty) received a Web-based survey from November 2015 through January 2016 regarding current sterilization preferences and practices, as well as interest in obtaining training in vasectomy counseling and procedure. ResultsNearly 60% (n=178/302) of family planning fellowship providers responded to the survey. While 62% (111/178) of respondents reported counseling their patients about vasectomy at least most of the time and 57% (102/178) recommended vasectomy over female sterilization, few (8/178; 4 trained in family medicine and 4 trained in obstetrics and gynecology) had performed a vasectomy in the last year. Nearly 90% (158/178) of respondents were somewhat or very interested in receiving training on vasectomy counseling; 58% (103/178) desired procedural training. Desire for training was associated with being male and receiving residency training in family medicine. ConclusionsFew family planning fellowship physicians provide vasectomy, and the majority expressed being at least somewhat interested in receiving further training. ImplicationsVasectomy is more effective, safer and less expensive than female sterilization but is less common than female sterilization. One barrier to vasectomy access is the low number of vasectomy providers. Creating a structured vasectomy training program through the family planning fellowship may help to increase the number of vasectomy providers.

Infertility Counseling

ABSTRACTInfertility, whether reasons known or unexplained, has been shown to cause a high amount of stress for people who receive this diagnosis. Increased emotional stress can lead to more of a decreased chance of conception, along with other medical problems. Around the world infertility counseling is becoming a new focus for medical professionals to work combined with fertility treatments and help couples conceive. Couples using medicines to help with conception, undergoing intrauterine insemination, andin vitrofertilization who have added counseling to treatment have shown an increase in conception rates.How to cite this articleLaisure BN. Infertility Counseling. Int J Infertil Fetal Med 2017;8(1):32-35.

Long-term outcome of ovarian function in women with intermittent premature ovarian insufficiency.

Spontaneous resumption of ovarian function is not a rare phenomenon in patients with premature ovarian insufficiency (POI). The outcome of this resumption is not known. To describe the outcome following the resumption of ovarian function in POI patients. Cross-sectional study. University medical centre. Cumulative incidence of ovarian function resumption and risk factors arresting this resumption during follow-up were determined in a large cohort of POI women. Five hundred and seven patients were included in the study, with a follow-up of 3·44 ± 4·05 years (0-29). Of these, 117 (23%) had features of ovarian function resumption. The cumulative incidence of pregnancy was 3·5% among the whole cohort and 15·3% among patients with resumption of ovarian function. Fifty-five patients (47%) experienced an arrest of their resumption during the follow-up period. In univariate analysis, high FSH and DHEA levels at initial evaluation were risk factors for the arrest of the resumption of ovarian function. In multivariate analysis, high FSH levels at the initial evaluation [1·89 (1·10-3·23), P = 0·03] and older age at diagnosis [1·53 (1·01-2·33), P = 0·04] were risk factors for the arrest of this resumption. Resumption of ovarian function is not a rare or brief phenomenon in POI women. The identification of predictive factors of this resumption, as well as its duration, increases our knowledge of the natural history of POI, and will improve the medical management, especially infertility counselling of these patients.

Impact of Affordable Care Act coverage expansion on women's reproductive preventive services in the United States

IntroductionThe Affordable Care Act (ACA) expansion mandated the private health plans to cover women's preventive services starting August 2012. With limited and contradictory evidence, this study intends to assess the impact of ACA on the utilization rates and the cost burden of women's reproductive preventive service. MethodsA pre-post analysis was conducted using a nationally representative sample of females (aged 15–44years, n=4397) participating in the 2011–2013 National Survey of Family Growth. The utilization rates and cost burdens were compared for six services using bivariate and multivariable logistic regression models. ResultsAfter the ACA expansion, there wasn't a significant increase in the utilization rates of birth control/prescription (33.7% vs. 30.7%), birth control counseling (17.7% vs. 16.9%), sterilization counseling (3.3% vs. 3.5%), STI counsel/test/treat (15% vs. 14.6%) and HIV screening (24.1% vs. 23.1%). Respondents paying through insurance increased after ACA, but out-of-pocket spending (cost-sharing) didn't decrease for respondents. Type of insurance was an important predictor of utilization rates with publicly insured having significantly higher Odds Ratio (OR) or likelihood of receiving birth control counseling (OR:1.71), sterilization counseling (OR:2.67), STI counsel/test/treat (OR:1.54) and HIV screening (OR:1.69) compared to privately insured. ConclusionsThe early-on impact of ACA expansion on utilization rates of women's reproductive preventive services didn't appear to be significant. Private health plans, however, might have expanded their coverage but burden of cost sharing still existed. Future research should evaluate the long term impact of ACA expansion on women's health and the economic gains.

The effect of obesity on intraoperative complication rates with hysteroscopic compared to laparoscopic sterilization: a retrospective cohort study.

BackgroundSurgical sterilization is a common method of contraception. There have been few studies evaluating the effect of obesity on procedural complications with either laparoscopic or hysteroscopic methods of sterilization. The purpose of this study was to compare the incidence of intraoperative complications of hysteroscopic tubal occlusion with laparoscopic tubal ligation among obese and nonobese women.MethodsThis retrospective cohort study compared women undergoing interval laparoscopic or hysteroscopic sterilization in the operating room between September 2009 and December 2011 at a single hospital. Serious complications included: unintended surgery, uterine perforation, anaphylaxis, blood transfusion, infection requiring antibiotics, hospital admission, fluid overload, myocardial infarction, and venous thromboembolism. Post-operative events included: nausea/vomiting, doctor evaluation or additional pain medication required in the recovery room, and emergency department visit within 2 weeks of surgery. The association between sterilization type and incidence of complications was examined overall, separately by BMI group, and also among patients who received general anesthesia.ResultsA total of 433 laparoscopic and 277 hysteroscopic procedures were reviewed. The BMI distribution of the sample was 35 % normal weight, 31 % overweight, and 34 % obese which is comparable to the general US female population. No life-threatening events were identified. Serious complications were similar with 20 (4.6 %) in the laparoscopic group and 11 (4.0 %) in the hysteroscopic group (p = 0.9). The most common serious complications were bleeding from the tube, cervical laceration, and uterine perforation. Although not statistically significant, women with a BMI of 30 or greater had only 1 (1 %) serious complication in the hysteroscopic group compared to 7 (5.2 %) in the laparoscopic group. Postoperative events were increased in the laparoscopic group (16.2 %) compared to the hysteroscopic group (6.9 %), especially among overweight and obese women (p <0.01). Failure to complete the intended bilateral occlusion occurred for 14 women in the hysteroscopic group compared to just one woman in the laparoscopic group (p <0.001).ConclusionBoth laparoscopic and hysteroscopic tubal sterilization are safe with few serious complications based on these data. No cases of laparotomy, blood transfusion, or life-threatening events were identified. There was no difference in serious complication rate by sterilization method. Overweight and obese women were no more likely to experience a serious complication with either method than women with a BMI <25. There were fewer postoperative events (p <0.01) with hysteroscopic sterilization, but far fewer failed laparoscopic procedures (p <0.001). These study findings can be used to enhance sterilization counseling.

Association between infertility factors and non-physical partner abuse in infertile couples.

Background:Infertility predisposes the couples to mental and psychological problems such as anxiety, depression, anger, and partner abuse. This study aimed to investigate the association between infertility factors and the non-physical abuse between infertile spouses.Materials and Methods:This is a descriptive cross-sectional study conducted on 262 infertile couples (131 female and 131 male), selected through convenient sampling, who referred to infertility centers in Isfahan. Data were collected by Partner Abuse Scale: Non-physical (PASNP), designed to measure the non-physical abuse experienced in relationship with partner and Non-physical Abuse of Partner Scale (NPAPS), designed to measure the non-physical abuse delivered upon the partner. All data were analyzed through SPSS version 16.Results:Mean scores of NPAPS were 23.1% and 21.3% in men and women, respectively. Mean scores of PASNP were 13.8% and 20.3% among men and women, respectively. There was a significant difference in the mean scores of perceived non-physical partner abuse between men and women (P < 0.001). There was also a significant difference in the mean scores of perceived non-physical partner abuse and factor of infertility (P < 0.01).Conclusions:Perceived non-physical abuse and delivered non-physical abuse upon the partner were low among infertile couples. Women had a higher perception of abuse when the cause of infertility was female factor, compared to men. However, special attention should be paid to infertile couples. Marital counseling, besides infertility counseling, should be conducted for these couples.

As both person and a professional: cultivating compassion satisfaction among healthcare practitioners specialized in assisted reproductive technologies (ART)

Healthcare practitioners in ART setting work under high pressure environment with heavy caseloads and patients facing a lot uncertainty and uncontrollability. This study aims at evaluating a professional development program which was develop to cultivate compassion satisfaction (CS), which refers to the pleasure derived from doing health care work effectively, and enhancing their ability to receive gratification from caregiving. This is a quasi-experimental study. Twenty-five healthcare practitioners from 11 licensed ART clinics in Hong Kong, including obstetricians and gynecologists, nurses, social workers and embryologists, attended a professional training course on infertility counseling. Effectiveness of the program was evaluated before and after the implementation of the program. The professional development program was composed of nine three-hour weekly sessions, including components such as self-reflective activities, mindfulness, compassionate meditation and personal reflection on vulnerabilities and resilience, life and death, as well as pain and suffering. All of them were invited to complete a self-administered questionnaire before (T0) and after (T1) the course, which contained Professional Quality of Life (ProQol) measuring CS, compassion fatigue (CF), and other validated measures related to psychological wellbeing. Participants showed significant improvement in CS after attending the course (Pre-course: 33.94 + 4.4; Post-course: 36.35 + 3.82, t=-3.29, p<0.001). There was no significant change in the subscales of Burnout and Secondary Trauma. Moreover, healthcare practitioners who were younger in age, worked longer in medical field (t=-5.196, p<0.035) but shorter in ART setting (t=-3.042,p<0.014) showed greater difference. In addition, those who were with lower educational level (t=-3.45,p<0.014) and had religious belief (t=-7.071,p<0.002) also showed significant improvement in CS. The professional quality of life among healthcare practitioners comprises of both CS and CF. Although no significant change was found in CF, the program could still enhance CS among healthcare practitioners in ART setting. Regarding CF being the emphasis of many researches, enhancing CS involved in caring thus provides a positive aspect in cultivating job satisfaction and positive feelings in healthcare profession. Apart from preventing burnout, it can shed light on how to enhance the quality of human services in the field of ART. Therefore, CS should be taken into consideration in professional training on infertility counseling.

Treatment decision after IVF implantation cycle failure: Chinese female patients’ preferred role in decision making and its effects on decisional regret and psychological well-being

istered questionnaire before (T0) and after (T1) the course, which contained Professional Quality of Life (ProQol) measuring CS, compassion fatigue (CF), and other validated measures related to psychological wellbeing. RESULTS: Participants showed significant improvement in CS after attending the course (Pre-course: 33.94 + 4.4; Post-course: 36.35 + 3.82, t1⁄4-3.29, p<0.001). There was no significant change in the subscales of Burnout and Secondary Trauma. Moreover, healthcare practitioners who were younger in age, worked longer in medical field (t1⁄4-5.196, p<0.035) but shorter in ART setting (t1⁄4-3.042,p<0.014) showed greater difference. In addition, those who were with lower educational level (t1⁄43.45,p<0.014) and had religious belief (t1⁄4-7.071,p<0.002) also showed significant improvement in CS. CONCLUSIONS: The professional quality of life among healthcare practitioners comprises of both CS and CF. Although no significant change was found in CF, the program could still enhance CS among healthcare practitioners in ART setting. Regarding CF being the emphasis of many researches, enhancing CS involved in caring thus provides a positive aspect in cultivating job satisfaction and positive feelings in healthcare profession. Apart from preventing burnout, it can shed light on how to enhance the quality of human services in the field of ART. Therefore, CS should be taken into consideration in professional training on infertility counseling.

The role of counselling in the management of patients with infertility

Key content Infertility is a complex state. In addition to the medical causes and implications of involuntary childlessness, there is interplay between several psychosocial and emotional factors. Along with advances in infertility treatment options, clinicians should also focus on patients’ changing psychosocial needs. The counselling service plays a major complementary role in providing holistic patient‐centred care by multidisciplinary staff in fertility clinics. This article provides a general introduction to the role of counselling in the UK, within the context of fertility treatment. Counselling aims to explore, understand, resolve and more effectively deal with the issues arising from infertility and related treatments. Learning objectives Role of the independent infertility counselling practitioner and the counselling service. Counselling in relation to specific aspects of infertility/assisted reproductive technology. Eligibility criteria for individuals carrying out infertility counselling. The role of guidelines in addressing and promoting the use of specialist fertility counselling skills. Ethical issues Ensuring all legal implications for the patient, the practitioner and the fertility clinic are addressed. Ensuring specialist, professional competence regarding the training and practice of the infertility counselling practitioner. Development of counselling guidelines by professional bodies.

British Infertility Counselling Association

The British Infertility Counselling Association (BICA) is the only professional association in the UK for infertility counsellors. We represent the interests, views and needs of members actively involved in infertility...

Current Jewish perspectives on maternal identity

Infertility counseling is a specialized field that will continue to grow in coming years as the impact of infertility and its treatment is documented more in terms of emotional, physical, social and life consequences. We report here on more recent developments in halakha (Jewish law and ethics) that are of importance to Orthodox Jewish infertile couple considering donor gametes or surrogacy. Counselors should anticipate issues that may arise in the future and assist couples in their efforts to address them. Good medical practice values the importance of understanding the patient’s individual concerns and values, including the complex psychological, sociological and cultural context in which they experience their infertility. Good counseling anticipates and addresses future problems about which patients might not currently be aware, and requires up-to-date authoritative information.

The Effect of Polycystic Ovarian Syndrome on the Physical Status of Women in Reproductive Age

Objectives: To Assess the Effect of Physical Status of Polycystic Ovarian Syndrome on Women in Reproductive Age,To Find out the Relationship Between Polycystic Ovarian Syndrome and Women's Physical Health (Acne , Hirsutism ,Weight Gain , Irregular Menstrual Period),&amp;To Identify the Association of Physical Status to polycystic ovariansyndrome and Some Socio Demographic Characteristic (Age ,Occupation &amp; Obesity ), and ReproductiveCharacteristic(Gravida ,Para ,Abortion &amp;Menstrual Regularity).Methodology :a descriptive analytical study was conduct on Non-probability (purposive sample) of (100)women whosuffering from polycystic ovarian syndrome in reproductive age in infertility counseling from three hospitals atBaghdad city which include al- yarmouk teaching hospital ,Baghdad teaching hospital , and Kamal Al-SamaraeeHospital/ fertility and IVF at al-karck and al- Russafa sectors . Study implemented for the period of 2nd January 2013to 30April 2013. A questionnaire was used as a tool of data collection to fulfill with objective of the study andconsisted of two parts, including part I 1-socio-demographic characteristic 2- a reproductive information, 3-menstrualcycle information&amp; 4-Previous medical history. And part II includes questions about hormonal and physical status ofpolycystic ovarian syndrome symptoms to women samples. A pilot study was carried out to test the reliability of thequestionnaire and content, and validity was carried out through the 21 experts. Descriptive and inferential statisticalanalyses were used to analyze the data.Results: the results revealed that (83%) of the women in the study group were between the ages of (20-34) years89%) were housewives, (77%) were primary school graduates and (66%) were suffering from low socio-economicstatus, (99%) were suffering from infertility, (88%) suffer from irregular menstrual cycle, (87%) The duration of themenstrual cycle has a (2-7) days, and (51%) suffer from severe pain during menstruation ,(30%) suffer from polycysticovary syndrome in addition to the genetic percentage sisters infected during the study identified it (22%).Recommendations: The study recommended the development of programs and awareness sessions for diseasepolycystic ovarian syndrome for women living with for the purpose of learn how to deal with the disease, as well ashow to prevent complications, the development of courses for nurses, especially present in the centers of infertilityawareness and deliver new information about what's new research and methods of treatment and how to deal withpatient

British Infertility Counselling Association

British Infertility Counselling Association

Addressing the particular recordkeeping needs of infertile orthodox Jewish couples considering the use of donated eggs

Infertility counseling is a specialized field that will continue to grow in coming years as the impact of infertility and its treatment is documented more and more in terms of emotional, physical, social and life consequences. Counselors should anticipate issues that may arise in the future and assist couples in their efforts to address them. We report here on recordkeeping issues of possible future concern that should be addressed when Orthodox Jewish couples make use of donor eggs. Good medical practice values the importance of understanding the patient's individual concerns and values, including the complex psychological, sociological and cultural context in which they experience their infertility. Good counseling anticipates and addresses future problems about which patients might not currently be aware.

Family building using donated gametes and embryos in the UK: Recommendations for policy and practice on behalf of the British Infertility Counselling Association and the British Fertility Society in collaboration with the Association of Clinical Embryologists and the Royal College of Nurses Fertility Nurses Forum

The UK Department of Health's consultation on the future of the Human Fertilisation and Embryology Authority (HFEA) presented an opportunity to review current practice in relation to donor conception (DC) and make recommendations for improving services to those seeking fertility treatment, to families with donor conceived children and those of donors, and to those seeking later information. The year 2023 marks the start of post-2005 donor conceived adults having statutory access to identifying information about their donor(s); some adults with pre-2005 donors will have access sooner if the donor(s) re-registers as ‘willing to be identified’. This paper examines current practice in UK licensed treatment centres in collecting and disseminating donor information and in supporting donors and prospective parents. Further, it considers current HFEA functions concerning DC including its responsibilities for the Register of Information and Donor Sibling Link and its approach to policy making, regulation and the release of information from these Registers to applicants. Proposals for how these functions could be carried out in the future are set out together with recommendations for national support and intermediary services. The key evidence available to support these recommendations is outlined.