Priorities in accessing gamete donation: what donors and beneficiaries think

The Instituto de Saúde Pública da Universidade do Porto (ISPUP) listened to the opinion of donors and gamete recipients on several topics related to Medically Assisted Procreation (MAP), and found that most participants disagree with the possibility of heterosexual couples and married women having priority in the access to fertility treatments, compared to gay couples and single women, respectively.

The research came about following changes in the law that regulates access to MAP in Portugal, which started to contemplate access to fertility treatments by single women and female couples in 2016. The widening of potential beneficiaries has led to an increase in the demand for gametes – that is, eggs and sperm – donated to MAP techniques.

Taking into account the scarcity of resources and gamete donors to satisfy this increase in demand in the public sector, the establishment of priority criteria for accessing treatments was considered necessary, including, for example, sexual orientation and marital status. ISPUP researchers heard the opinion of donors and beneficiaries involved in the Banco Público de Gâmetas regarding this possible recommendation.

“The Portuguese law of 2016 does not define priority criteria for access to fertility treatments. However, this is an issue that arises, due to the difficulty in meeting all requests. We wanted to understand the opinion of those involved in the process, in order to contribute to the application of participatory recommendations that ensure access to equitable and quality health care”, explains Inês Baía, first author of the study entitled Priority of Access to Fertility Treatments Based on Sexual Orientation and Marital Status: the Views of Gamete Donors and Recipients, coordinated by Susana Silva and Cláudia de Freitas.

Between July 2017 and June 2018, researchers collected the opinion of 171 recipients and 72 donors who had at least one appointment at the Portuguese Public Bank of Gametes.

Most participants disagreed with priority criteria in access to treatments

The research, published in the journal Sexuality Research and Social Policy, available HERE, showed that 60% of study participants disagreed with the possible existence of priority access to treatments by heterosexual couples and married women, compared to homosexual couples and single women, respectively. They are therefore in favor of equitable access to MAP, regardless of sexual orientation and marital status.

However, the study found that male participants were more likely to agree to give priority access to heterosexual couples and married women. Individuals who were married or cohabiting and participants with blue-collar professions were more likely to agree to give priority access to married women.

As Inês Baía explains, “although most individuals agree with equitable access to treatments, we found that heteronormative representations persist, which are particularly visible among men. Likewise, we observed the dominance of marriage in the family institution, which is not as favorable to single women. There is still the idea that these women have less income and weaker social support networks that make it difficult to provide care to a child, which the literature does not always support”.

Therefore, the researchers defend “investment in campaigns that aim to deconstruct misconceptions that still exist regarding the parental capacity and skills of families made up of one or two women”.

For the author, the study emphasizes the importance of being aware of the values, preferences and needs of gamete recipients and donors to support policies and recommendations aimed at promoting the provision of quality, safe and fair reproductive health care.

The Engaged project

The empirical work was developed within the ENGAgED – Bionetworking and citizENship on GAmetE Donation project, coordinated by Susana Silva, and funded by the Foundation for Science and Technology (FCT), which ended in 2019.

Image: Pixabay/RitaE

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