Oocyte donors' motivations for donation and expectations about post-donation contact with donor-conceived individuals: a systematic review.

BACKGROUND: Oocyte donation has been increasingly used in ARTs in recent years. Previous reviews have generally reported positive donor attitudes towards oocyte donation; however, they have not focused on expectations regarding outcomes and potential future contact with donor-conceived offspring. Addressing this gap is critical in light of ongoing ethical, cultural, and legal debates surrounding donor anonymity, financial compensation, and the rights of donor-conceived individuals. OBJECTIVE AND RATIONALE: The systematic review focused on oocyte donors' motivations and expectations on future contact with donor-conceived offspring. This review synthesizes existing empirical evidence to provide a comprehensive overview of donors' perspectives across different sociocultural and legislative contexts. SEARCH METHODS: This systematic review was conducted in accordance with the PRISMA guidelines. A comprehensive search was conducted in May 2024 and updated in September 2025 across PubMed, Embase, PsycINFO, and Web of Science. Search terms were iteratively developed and refined based on preliminary literature reviews and expert consultation. The search strategy identified peer-reviewed empirical research focusing on oocyte donors' attitudes, experiences, or demographic characteristics in any donation context. Grey literature and non-empirical publications were excluded. A total of 37 studies met the inclusion criteria. Data were extracted manually and analysed using a thematic narrative synthesis. Quality appraisal using the Joanna Briggs Institute checklists confirmed that all included studies met minimum methodological quality standards, reducing the risk of significant bias in the synthesis. OUTCOMES: From 9809 records initially identified, and following title and abstract screening, 233 full-text articles were assessed for eligibility. Of these, 37 studies were included. Findings were organized into three overarching themes: motivations for donation, perspectives on anonymity and disclosure, and expectations towards future contact with donor-conceived offspring. Donors were primarily motivated by altruism and financial need, with varying motivations across different sociocultural contexts. Variations were observed in perspectives on anonymity, disclosure, and expectations about future contact, reflecting the influence of legal frameworks, cultural norms, and regulatory backgrounds. Donors in identity-release jurisdictions expressed greater openness to disclosure, while those in anonymous systems emphasized privacy. Although variations in sampling methods, compensation models, and sociocultural contexts may complicate comparisons, the observed patterns were consistent across multiple independent studies, suggesting that these findings are not due to chance but may reflect cross-contextual differences in donor experiences and attitudes. WIDER IMPLICATIONS: This review provides cross-cultural insights into donors' attitudes towards disclosure and future contacts with donor-conceived offspring, highlighting the need for more tailored education and informed consent practices to ensure donors understand the long-term implications of their decisions and receive adequate support throughout the donation process and beyond. For clinicians and policymakers, these results underscore the need to balance donor autonomy and the welfare of donor-conceived families. Further research, particularly longitudinal and cross-jurisdictional studies, is needed to better understand how donors' perspectives evolve over time and to inform evidence-based policy and clinical practice in an era of changing donor anonymity regulations. REGISTRATION NUMBER: CRD42024560246.