Understanding Egg Donation: The Give and Take

The latest event from PET (the Progress Educational Trust) brought together clinical, social and lived perspectives on egg donation, exploring the needs and interests of donors, recipients, and donor-conceived people alike.

Sarah Norcross, director of PET, acted as chair and opened the session. Since the first child conceived through egg donation was born in 1983 (see BioNews 1236, 1238 and 1273), egg donation has enabled thousands of people to form families. Norcross also referred to the current Parliamentary inquiry into egg donation and egg freezing (see BioNews 1315a, 1315b and 1321), and noted that the event was taking place on the first day that the Women and Equalities Committee of the UK's House of Commons heard oral evidence in relation to this inquiry.

The first speaker was Dr Jane Stewart, former head of Newcastle Fertility Centre, who provided an overview of the medical risks and safety considerations associated with egg donation. The medications and procedures involved are comparable to those used in IVF treatment. While most side effects of ovarian stimulation and egg retrieval are minor, ovarian hyperstimulation syndrome (OHSS) remains a recognised risk. Although egg donors are often young and have a good ovarian reserve, the fact that they are not planning to become pregnant immediately means their risk of OHSS is generally lower than it would be for IVF patients receiving similar medication.

Dr Stewart explained that other procedural complications are rare. The Human Fertilisation and Embryology Authority (HFEA)'s most recent fertility sector report revealed that 99 percent of 100,000 treatment cycles occurred without incident, and that none of the 65 reported cases of severe OHSS that year involved egg donors (see BioNews 1315c). However, screening may reveal unexpected findings – such as low ovarian reserve or genetic results – which can prevent a prospective donor from proceeding. Addressing egg donors' longer-term concerns, Dr Stewart emphasised that while infection at the time of donation can affect fertility, the risk is small and evidence suggests that the overall long-term impact on donors' physical health is low.

The second speaker – Nicky Hudson, professor of medical sociology at Loughborough University – spoke to the motivations of egg donors. She described how research consistently shows that women's reasoning for donating eggs is often varied and complex. While wanting to help others overcome infertility is often a key factor, motivations are rarely singular, and other motivators – including financial compensation – may also play a part.

Drawing on findings from the EDNA study – which compared egg donation practices in the UK, Belgium and Spain (see BioNews 1145 and 1325) – Professor Hudson illustrated how different regulatory systems shape collective understandings of donation. In Spain, egg donation is often framed as a mutually beneficial exchange, whereas in Belgium it is regarded as similar to tissue donation. By contrast, the UK frames egg donation around contribution to family building. Donor motivations, therefore, vary according to national policies on compensation and anonymity – as well as broader cultural frameworks – and must be understood within these contexts.

Angela Pericleous-Smith, chair of the British Infertility Counselling Association, shifted the discussion towards the role of counselling in egg donation. She encouraged attendees to move beyond viewing egg donation solely as a medical procedure or altruistic act. Instead, she emphasised the relational and emotional dimensions of egg donation, as well as its lifelong implications for donors and their families, for recipients, and for donor-conceived people.

Since the passing of the Human Fertilisation and Embryology Act 1990, the lived realities of donor conception have changed considerably. We have seen the removal of donor anonymity in the Human Fertilisation and Embryology Authority (Disclosure of Donor Information) Regulations 2004 (see BioNews 302), and the rise of direct-to-consumer DNA testing, as well as the advent of social media and various advances in fertility treatment. For Pericleous-Smith, the need for counselling is not in question. Rather, the challenge lies in ensuring that counselling services are accessible, robust and able to keep up with this evolving landscape.

In the context of egg donation, counselling aims to support donors and recipients in making informed decisions, when the consequences are permanent and largely unpredictable. For donors, counselling explores people's feelings and motivations, as well as potential long-term implications for their identity and future relationships. For recipient parents, counselling focuses on emotional preparedness, and encourages early conversations on disclosure and openness. Drawing on scenarios from her clinical practice, Pericleous-Smith invited attendees to consider these situations from the perspective of the donor-conceived child.

Attendees then had the opportunity to hear from Sophie Cook, who was herself conceived with an egg from an anonymous donor. She explained that her experience is unique to her and is not representative of the experiences and views of every donor-conceived person.

Having been told about her origins at a very young age, Cook described growing up with donor conception as an integrated part of her identity. Early disclosure allowed her a sense of autonomy over when, and with whom, she shared her story. Although Cook recounted the impact of this openness and transparency as profound, she noted that parents must also treat donor conception as an ongoing and normalised topic of conversation.

Conceived in 2002, Cook applied at age 18 for non-identifying information from the HFEA. After a year-long wait, she received information including certain physical characteristics of her donor, and including the fact that she had no known donor-conceived (half-) siblings. Cook hasn't prioritised seeking a relationship with her donor, but rather has sought to gain access to her donor's medical history. This reflects wider concerns, among donor-conceived people, that they might transpire to have an inherited genetic condition or predisposition.

Cook also described the challenges of navigating information access, both in relation to the HFEA and in relation to DNA testing. She highlighted the value of organisations such as Donor Conceived UK and the Donor Conception Network, which enable donor-conceived people to navigate information and experiences within an understanding community. Such organisations can be vital in helping donor-conceived people to feel supported, in what can otherwise be an isolating and overwhelming experience. Cook expressed pride in her identity as a donor-conceived person, and gratitude that her experience has been positive.

The final speaker, Mark Hanson – emeritus professor of human development and health at the University of Southampton – rounded out the discussion by exploring whether recipients of donor eggs can shape their children's genome or epigenome. He clarified that while recipients cannot alter the DNA of a donor egg, environmental factors during pregnancy may influence epigenetic processes that affect how genes are expressed.

The idea that non-genetic parents may be able to influence their child's genes in some way has long been of interest to many (see BioNews 519 and 826). While there is some evidence to suggest that assisted conception may result in epigenetic changes within eggs and embryos, it remains unclear whether these changes have lasting health consequences. However, Professor Hanson's own research indicates that maternal lifestyle and diet can result in epigenetic changes that may confer disease risk in later childhood. He encouraged recipients of donor eggs to follow the same health guidance recommended to all women who are, or plan to be, pregnant – maintaining a healthy diet and BMI, exercising regularly, managing stress, and avoiding alcohol, smoking, and drugs.

The session concluded with an audience-driven discussion that prompted attendees and speakers alike to reflect on the need for continued research into medical risks, the adequacy of counselling provision, and the challenges of studying epigenetic effects.

As a person conceived through egg donation who actively advocates for and engages with the donor-conceived community, I can personally vouch for the varied motivations of donors, the undeniable need for counselling, the harms of secrecy, and the comforts of community. Donor conception is inherently emotional and ethically complex. The implications not only bleed into medical, regulatory, and biological considerations, but also splinter into what those varied factors mean for one's identity, family dynamics, and lived experience.

This event not only succeeded in capturing the range of questions and concerns that arise from egg donation but did so in such a way that was educational, insightful and emotionally intelligent.

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PET is grateful to London Egg Bank for supporting this event.

Register for these upcoming PET events:

• Male Infertility: Today's Insights, Tomorrow's Treatments, taking place in Edinburgh on Wednesday 18 March 2026 – register here.