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BACKGROUND: Disclosure of donor conception has been advocated in several jurisdictions in recent years, especially in those that practice identity-release donation. However, research on disclosure decisions has not been consolidated systematically in the last 10 years to review if parents are telling and what factors may be impacting their decisions. OBJECTIVE AND RATIONALE: Are parents disclosing to their donor-conceived children, and what factors have influenced their disclosure decisions across different contexts and family forms in the last 10 years? SEARCH METHODS: A bibliographic search of English-language, peer-reviewed journal articles published between 2012 and 2022 from seven databases was undertaken. References cited in included articles were manually scrutinized to identify additional references and references that cited the included articles were also manually searched. Inclusion criteria were articles focused on parents (including heterosexual, single mothers by choice, same-sex couples, and transsexual) of donor-conceived persons in both jurisdictions with or without identity-release provisions. Studies focused solely on surrogacy, donors, donor-conceived persons, or medical/fertility staff were excluded as were studies where it was not possible to extract donor-recipient parents' data separately. Both quantitative and qualitative studies were included. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed and Joanna Briggs Institute Critical Appraisal Tools for Systematic Reviews were used to assess article quality and bias. OUTCOMES: Thirty-seven articles met the inclusion criteria representing 34 studies and 4248 parents (including heterosexual, single, same-sex, and transsexual parents although the majority were heterosexual) from countries with anonymous donation and those with identity-release provisions or who had subsequently enacted these provisions (Australia, Belgium, Finland, France, Hong Kong, Middle East, Spain, Sweden, the UK, and the USA) A general trend towards disclosure was noted across these groups of parents with most disclosing to their donor-conceived children before the age of 10 years. Further, the majority of those who had not yet told, reported planning to disclose, although delayed decisions were also associated with lower disclosure overall. Same-sex and single parents were more likely to disclose than heterosexual parents. There was recognition of disclosure as a process involving ongoing conversations and that decisions were impacted by multiple interacting intrapersonal, interpersonal, and external contextual and social factors. Methodological limitations, such as the different population groups and contexts from which participants were drawn (including that those parents who choose not to disclose may be less likely to participate in research), are acknowledged in integrating findings. WIDER IMPLICATIONS: This review has reinforced the need for a theoretical model to explain parents' disclosure decisions and research exploring the role of legislative provisions, culture, and donor/family type in decision-making. Greater ongoing access to psychological support around disclosure may be important to promote parent and family well-being.

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Se deberán equilibrar todos los intereses en juego para garantizar el derecho a la identidad genética de los menores nacidos por reproducción asistida heteróloga. Los donantes deberían hacer prevalecer este derecho frente a su intimidad, derivada del anonimato de la donación, lo que conllevaría su eliminación. El derecho a conocer la verdad biológica no es una obligación, sino fruto del ejercicio de la autonomía personal. Sin embargo, se requiere que sean los padres los que informen a sus hijos del uso que hicieron de las técnicas de la reproducción asistida para la concepción. Sin olvidarnos de la necesaria intervención del Estado y de las clínicas que deben actuar como garantes de este derecho, haciendo prevalecer la verdad genética.(AU)

All the interests at stake must be balanced to guarantee the right to genetic identity of minors born through heterologous assisted reproduction. Donors should make this right prevail over their privacy, derived from the anonymity of the donation, which would lead to its elimination. The right to know the biological truth is not an obligation, but the result of the exercise of personal autonomy. However, parents are required to inform their children of the use they made of assisted reproductive techniques for conception. Without forgetting the necessary intervention of the State and the clinics that must act as guarantors of this right, making genetic truth prevail(AU)

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The article argues that altruistic giving based on anonymity, which is expected to promote social solidarity and block trade in human body parts, is conceptually defective and practically unproductive. It needs to be replaced by a more adequate notion which responds to the human practices of giving and receiving. The argument starts with identification of the main characteristics of the anonymous altruistic donation: social separation of the organ donor (or donor family) from the recipient, their mutual replaceability, non-obligatoriness of donation, and non-obligatoriness of reciprocation on the recipient's part. Since these characteristics are also central to typical market relations, anonymous altruistic donation not only cannot promote solidarity but may encourage proposals for (regulated) markets of transplantable organs. Thus, transplant ethics needs to be reframed. It needs to be rooted in, rather than promote, the practices of giving and receiving known to human societies. As the basis for such reframing, the idea of sharing in another's misfortune is proposed. It relies on the human practices of giving and receiving and, with appropriate regulatory safeguards, can provide a better conceptual basis for blocking commercial exchanges of human body parts.

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Purpose: The aim of this study is to evaluate the health of oocyte donors and explain how they regard their experience in the long-term. Materials and methods: This is a cross-sectional study in a single fertility centre that consists of a telephone interview guided by a semi-structured questionnaire covering several aspects of reproductive health and personal experience. Results: At the time of interview, 84 out of 121 women (69%) had children while 64 (53%) were already mothers at the time of their donation. Of the 38 women achieving a pregnancy after donation, five reported six pregnancy complications. Two out of 121 (2%) women reported being in menopause (aged 41 and 45). Twenty-three women (19%) reported gynaecological issues and eight (7%) reported fertility problems, although only four consulted a specialist. Most of women highlighted positive feelings about their donation (113, 93%) and 155 (97%) would recommend donating. Less than half (53, 44%) mentioned some negative aspects, mainly related to physical discomfort: injections (20,17%), pain (17, 14%), and side effects of ovarian stimulation (10, 8%). Conclusion: The impact of donation on women's life was mostly favourable, with the majority of participants reporting positive aspects and recommending donation, although some negative feelings as physical discomfort also arose. Therefore, more comfortable stimulation protocols could be developed.

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