A mixed-methods systematic review of the attitudes, experiences, motivations and disclosure decisions among recipients of donor spermatozoa.

Sperm donation offers a parenthood option for fertility patients, including azoospermic men, single women and same-sex female couples. Despite increasing use of donor spermatozoa, and change in demographics of recipients, the psychological impact of being a recipient of donor spermatozoa has not been reported extensively. The objective of this study was to investigate the psychosocial impact of being a recipient of donor spermatozoa. The attitudes, treatment experiences and disclosure decisions among recipients of donor spermatozoa were investigated. Secondary aims included exploration of pursuing cross-border reproductive care (CBRC) for treatment with donor spermatozoa. A systematic search, following the PRISMA guidelines, of two computerized databases with no time restriction was conducted. Data were extracted using thematic analysis. Heterosexual couples, same-sex female couples and single women were included. Actual recipients harboured positive attitudes with little regret. Earlier studies found greater levels of secrecy, whereas recent studies reported greater openness. Attitudes towards donors were unique to individual groups. Although the need for psychological support for fertility patients is well established, this was not universally implemented. With significant change in demographics, individualized counselling is essential to address the psychosocial needs of recipients. Lack of standardization of guidelines and laws is leading to CBRC, which may reduce the quality of care.