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欧洲11个国家卵母细胞捐赠者的社会人口学特征、生育相关特征及动机

Socio-demographic and fertility-related characteristics and motivations of oocyte donors in eleven European countries.

作者信息

Pennings G, de Mouzon J, Shenfield F, Ferraretti A P, Mardesic T, Ruiz A, Goossens V

机构信息

Bioethics Institute Ghent (BIG), Ghent University, Blandijnberg 2, B-9000 Ghent, Belgium.

出版信息

Hum Reprod. 2014 May;29(5):1076-89. doi: 10.1093/humrep/deu048. Epub 2014 Mar 13.

DOI:10.1093/humrep/deu048
PMID:24626802
Abstract

STUDY QUESTION

Do the socio-demographic and fertility-related characteristics and motivations of oocyte donors differ in European countries?

SUMMARY ANSWER

The socio-demographic and fertility-related characteristics and motivations of oocyte donors differ considerably across countries.

WHAT IS KNOWN ALREADY

There have been no other international studies comparing the characteristics of oocyte donors. Regarding their motivations, most studies indicate mixed motives.

STUDY DESIGN, SIZE, DURATION: The proposed study was a transversal epidemiological study. Data were collected from 63 voluntarily participating assisted reproduction technology centres practising oocyte donation in 11 European countries (Belgium, Czech Republic, Finland, France, Greece, Poland, Portugal, Russia, Spain, UK and Ukraine). The survey was conducted between September 2011 and June 2012 and ran for 1-6 calendar months depending on the number of cycles of oocyte donation performed at the centre. The sample size was computed in order to allow an estimate of the percentage of a relatively rare characteristic (∼2%) with a precision (95% confidence interval) of 1%. The calculation gave 1118 donors.

PARTICIPANTS/MATERIALS, SETTING, METHODS: In total, 1423 forms were obtained from oocyte donors. All consecutive donors in these centres filled out an anonymous questionnaire when they started their hormonal stimulation, asking for their socio-demographic and fertility-related characteristics, their motivations and compensation. Population characteristics were described and compared by country of donation. Motives for donation and mean amount of money were compared between countries and according to the donors characteristics.

MAIN RESULTS AND THE ROLE OF CHANCE

The socio-demographic and fertility-related characteristics and motivations of oocyte donors varied enormously across European countries. The number of received forms corresponded with a participation rate of 61.9% of the cycles performed by the participating centres. Mean age was 27.4 years. About 49% of donors were fully employed, 16% unemployed and 15% student. The motivation in the total group of donors was 47.8% pure altruism, 33.9% altruism and financial, 10.8% pure financial, 5.9% altruism and own treatment and finally 2% own treatment only. About 15% of the donors were egg sharers (patient donors), mainly from the UK and Poland. Women were donating for the first time in 55.4% of cases, for the second time in 20.3% and for the third time in 12.8%. The motivation to donate was significantly related to being of foreign origin (P < 0.01), age (P < 0.001), living in couple or not (P < 0.01), level of education (P < 0.001) and number of donations (P < 0.001). The amount of compensation differed considerably between centres and/or countries. The general donor profile in this study was a well-educated, 27-year-old woman living with her partner and child who mainly donated to help others.

LIMITATIONS, REASONS FOR CAUTION: The selection of clinics in some countries and the limited participation rate may have led to a bias in donor characteristics. A possible effect of social desirability in the answers by the donors should be taken into account.

WIDER IMPLICATIONS OF THE FINDINGS

The diversity of the donor population reflects the differences in European legislation (for example, on anonymity and payment) and economic circumstances. The differences in systems of reimbursement/payment demonstrate the need to have a thorough discussion on the specific meaning of these terms.

STUDY FUNDING/COMPETING INTEREST(S): The study was funded by the European Society for Human Reproduction and Embryology. The authors declare no conflicting interests.

摘要

研究问题

欧洲各国卵母细胞捐赠者的社会人口统计学特征、生育相关特征及动机是否存在差异?

简要回答

各国卵母细胞捐赠者的社会人口统计学特征、生育相关特征及动机存在显著差异。

已知信息

此前尚无其他国际研究对卵母细胞捐赠者的特征进行比较。关于其动机,大多数研究表明动机复杂多样。

研究设计、规模、持续时间:本拟进行的研究为横向流行病学研究。数据收集自11个欧洲国家(比利时、捷克共和国、芬兰、法国、希腊、波兰、葡萄牙、俄罗斯、西班牙、英国和乌克兰)的63个自愿参与的实施卵母细胞捐赠的辅助生殖技术中心。调查于2011年9月至2012年6月进行,根据中心进行的卵母细胞捐赠周期数量,持续1 - 6个日历月。计算样本量是为了能够以1%的精度(95%置信区间)估计一种相对罕见特征(约2%)的百分比。计算得出需要1118名捐赠者。

参与者/材料、环境、方法:共获得1423份卵母细胞捐赠者的表格。这些中心的所有连续捐赠者在开始激素刺激时填写一份匿名问卷,询问其社会人口统计学特征、生育相关特征、动机及补偿情况。按捐赠国家描述并比较人口特征。比较各国之间以及根据捐赠者特征的捐赠动机和平均金额。

主要结果及机遇的作用

欧洲各国卵母细胞捐赠者的社会人口统计学特征、生育相关特征及动机差异极大。收到的表格数量对应参与中心所进行周期的61.9%的参与率。平均年龄为27.4岁。约49%的捐赠者为全职工作,16%失业,15%为学生。捐赠者总体中的动机为47.8%纯粹利他主义,33.9%利他主义与经济因素并存,10.8%纯粹经济因素,5.9%利他主义与自身治疗需求并存,最后2%仅为自身治疗需求。约15%的捐赠者为卵子共享者(患者捐赠者),主要来自英国和波兰。55.4%的情况是女性首次捐赠,20.3%为第二次捐赠,12.8%为第三次捐赠。捐赠动机与外国血统(P < 0.01)、年龄(P < 0.001)、是否同居(P < 0.01)、教育水平(P < 0.001)及捐赠次数(P < 0.001)显著相关。各中心和/或国家之间的补偿金额差异很大。本研究中捐赠者的总体概况是一位受过良好教育、27岁、与伴侣及孩子同住且主要为帮助他人而捐赠的女性。

局限性、谨慎原因:一些国家诊所的选择以及有限的参与率可能导致捐赠者特征存在偏差。应考虑到捐赠者回答中社会期望可能产生的影响。

研究结果的更广泛影响

捐赠者群体的多样性反映了欧洲立法(例如关于匿名性和报酬方面)及经济状况的差异。报销/支付体系的差异表明有必要对这些术语的具体含义进行深入讨论。

研究资金/利益冲突:本研究由欧洲人类生殖与胚胎学会资助。作者声明无利益冲突。

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