Oocyte donors' physical outcomes and psychosocial experiences: a mixed-methods study.

IF 6.6 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Fertility and sterility Pub Date : 2025-01-13 DOI:10.1016/j.fertnstert.2024.12.019
Kirby Adlam, Mary Dawn Koenig, Crystal L Patil, Alana Steffen, Sana Salih, Wendy Kramer, Patricia E Hershberger
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Abstract

Objective: To expand knowledge on physical outcomes and psychosocial experiences of oocyte donors after donation across 3 age cohorts.

Design: Cross-sectional mixed-methods survey.

Patients: A total of 363 participants (ages: 22-71 years, M = 38.8) recruited from Donor Sibling Registry and Facebook groups donated an average of 3.3 times, with 77.1% using nonidentified donation. Most were White (92.8%) and over half (59%) were married at the time of survey. Average length of time from initial donation to study participation was 13.75 years.

Exposure: Previous oocyte donation.

Main outcome measures: Self-reported physical outcomes and psychological experiences after donation.

Results: Most donors (89.5%) completing the online survey (N = 363) reported a positive overall experience. Self-reported physical outcomes, including changes to menstrual cycles, ovulation, or fertility, were reported by 21% of participants after donation. Many (41.4%) reported procedural pain, and 10.5% reported ovarian hyperstimulation syndrome. Anxiety (25.8%) and depression (23.2%) were the most common self-reported diagnoses. Validated measures (Patient Reported Outcomes Measurement Information System Bank V1.0 Depression, Patient Reported Outcomes Measurement Information System Bank V1.0 Anxiety) were used to assess mild or greater anxiety and depression (25.1% and 17.6%, respectively; t-score ≥55). Participants screened clinically significant rates of alcohol/drug misuse (11.5%; ≥2 Cut down, Annoyed, Guilty, Eye opener-Adapted to Include Drugs), with 50% of those reporting depressive symptoms. Anonymity was the most common qualitative response for reported emotional distress (17%) and regret (20%). Most participants (94.3%) reported no contact by clinics for medical updates after donation, despite 25% reporting they had changes in their health to communicate. Participants' open-ended responses detailed the 3 most important concerns: improved communication with clinics; desire for less anonymity; and more information on long-term donor health outcomes.

Conclusion: Most participants felt their oocyte donation experience was positive despite reported pain, menstrual cycle changes, and emotional distress. Depression and anxiety were the most common self-reported diagnoses. Depression rated higher than the national prevalence. Elevated Cut down, Annoyed, Guilty, Eye opener-Adapted to Include Drugs was associated with depression, indicating the importance of screening oocyte donors for mental health and drug/alcohol misuse. Concerns included lack of communication after procedure and lack of information provided on long-term health outcomes. Clinicians can incorporate these findings when counseling this population.

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卵母细胞捐献者的生理结果和社会心理经历:一项混合方法研究。
目的:扩大对3个年龄组的卵母细胞捐献者捐献后的生理结局和心理经历的了解。设计:横断面混合方法调查。患者:共有363名参与者(年龄:22-71岁,M = 38.8)从Donor Sibling Registry和Facebook群组中招募,平均捐赠3.3次,其中77.1%使用未识别的捐赠。大多数是白人(92.8%),超过一半(59%)的人在调查时已婚。从首次捐赠到参与研究的平均时间为13.75年。暴露:既往卵母细胞捐赠。主要结果测量:捐献后自我报告的身体结果和心理体验。结果:完成在线调查(N = 363)的大多数捐赠者(89.5%)报告了积极的总体体验。21%的参与者在捐赠后报告了自我报告的身体结果,包括月经周期、排卵或生育能力的变化。许多(41.4%)报告手术疼痛,10.5%报告卵巢过度刺激综合征。焦虑(25.8%)和抑郁(23.2%)是最常见的自我报告诊断。经验证的测量方法(患者报告结果测量信息系统银行V1.0抑郁,患者报告结果测量信息系统银行V1.0焦虑)用于评估轻度或重度焦虑和抑郁(分别为25.1%和17.6%;t指数≥55)。参与者筛选了具有临床意义的酒精/药物滥用率(11.5%;≥2个抑郁、烦恼、内疚、睁眼(包括药物),其中50%的人报告抑郁症状。对于报告的情绪困扰(17%)和后悔(20%),匿名是最常见的定性回答。大多数参与者(94.3%)报告在捐赠后没有与诊所联系以了解医疗更新,尽管25%的参与者报告他们的健康状况发生了变化。参与者的开放式回答详细说明了三个最重要的问题:改善与诊所的沟通;渴望更少的匿名;以及更多关于捐赠者长期健康结果的信息。结论:尽管报告了疼痛、月经周期变化和情绪困扰,但大多数参与者认为他们的卵母细胞捐赠经历是积极的。抑郁和焦虑是最常见的自我诊断。抑郁症的发病率高于全国的发病率。情绪低落、烦恼、内疚、睁眼——适应药物——与抑郁症有关,这表明筛选卵子捐献者对精神健康和药物/酒精滥用的重要性。令人关切的问题包括手术后缺乏沟通和缺乏关于长期健康结果的信息。临床医生在对这一人群进行咨询时可以将这些发现纳入其中。
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来源期刊
Fertility and sterility
Fertility and sterility 医学-妇产科学
CiteScore
11.30
自引率
6.00%
发文量
1446
审稿时长
31 days
期刊介绍: Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.
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