1. "Just Another Form of Giving Back": Motivations, Awareness, and Attitudes of Potential Oocyte Donors at Orientation Lindsay B. Gezinski, PhD, MA, MSW Sharvari Karandikar, PhD, MSW James R. Carter, MPH Presented at the American Public Health Association Annual Meeting – New Orleans, LA November 19, 2014

2. Presenter Disclosures (1) The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: Lindsay Gezinski “ No relationships to disclose ”

3. Literature Review In vitro fertilization (IVF) techniques have a played widespread role in the range of available fertility treatments in the United States (Kenney & McGowan, 2008). Through IVF, women are able to donate eggs to infertile women who cannot produce viable eggs (Winter & Daniluk, 2004). Egg donation involves administering drugs and injections such as Lupron to potential donors for producing eggs/oocytes. Egg donation unlike sperm donation requires longer commitments from donors and may have lasting side effects (Kenney & McGowan, 2008). Very little is known about the motivations and experiences of women who donate eggs.

4. Purpose of the Study 1.To understand women’s motivations to donate oocytes. 2.To assess awareness and knowledge of egg donation prior to entry into the oocyte donation program. 3.To explore attitudes toward oocyte donation.

5. Methodology 92 prospective oocyte donors completed the questionnaire prior to orientation at one fertility clinic located in the Midwest. The survey instrument took approximately 15 minutes to complete and consisted of 37 items. Data was collected from August 2011 to August 2012. Responses were entered in SPSS. Descriptive and inferential statistics were used to analyze the data. Textual analysis was used to identify themes for open-ended survey items.

6. Results: Description of Sample n (%)Mean (Range) Age (years)25.6 (21-32) Number of Children0.7 (1-4) Race African American13 (14.4) Asian1 (1.1) White68 (75.6) Multi-Racial8 (8.9) Education High School Diploma/GED12 (13.0) Some College35 (38) Associate’s Degree11 (12.0) Bachelor’s Degree28 (30.4) Master’s Degree4 (4.3) PhD or Professional Degree2 (2.2) Currently a Student No55 (60.4) Yes, part-time13 (14.3) Yes, full-time23 (25.3)

7. n (%) Occupation No Answer17 (18.5) Service23 (25.0) Administrative13 (14.1) Labor6 (6.5) Home-Based2 (2.2) Technically Skilled29 (31.5) Student2 (2.2) Married or Committed Relationship Yes59 (64.1) No33 (35.9) First Learned No Answer18 (19.6) Friend28 (30.4) Relative4 (4.3) Agency2 (2.2) Electronic Medium38 (41.3) Educational System2 (2.2) Results: Description of Sample

8. Motivations Approximately 98 percent of participants ranked “helping others to have children” as significant to their decision. 81.32 percent indicated that the offer of payment was significant to their decision to donate oocytes. Level of payment was reported as: – “Just about right” by 89.0 percent – “Too much” by 7.7 percent – “Too little” by 2.2 percent

9. Altruistic Motivation 89 percent of participants indicated their aspiration to help infertile couples. – “[I] feel that it would be good contribution to deserving folks. also donate blood regularly. I guess its [sic] just another form of giving back.” 20 percent reported personal exposure to acquaintance, friend, or family member who had struggled with infertility. – “good friend and sister have a lot of problems having a child. my friend went through a successful egg donation which motivated me to donate for people like her!”

10. Financial Motivation 48.35 percent of participants wrote about financial need as a motivator. Participants stated that compensation would be used for school loans and tuition, medical debt, and to buy a house. – "feels comfortable with procdure [sic] and is small investment of time for the financial compensation awarded."

11. Pass on Genetic Material 23.08 percent indicated desire to pass on their genetic material, because they either had no desire to have children themselves or they were done having their own children. "As a student pursuing a professional degree and an extremely career-motivated person, I'm not certain that having my own children will be part of my future. That being said, I'd like to contribute to the next generation."

12. Awareness of Physical & Psychological Risks 67 percent indicated awareness of physical risks. 65.48 percent reported the perceived severity of physical risks as somewhat minor to very minor. Mothers were less aware (χ 2 =24.806, df=2, p=.000) Educated were more aware (χ 2 =9.643, df=2, p=.008) 54 percent indicated awareness of psychological risks. 69.51 percent reported the perceived severity of psychological risks as somewhat minor to very minor. Mothers were less aware (χ 2 =9.475, df=2, p=.009)

13. Information-Giving Attitudes 81.1 percent agreed that "the recipients should receive some information about the donor. While 28.1 percent of participants felt that "offspring should receive some information about the donor as a mature adult", approximately 23 percent disagreed with this statement and close to half were 'neutral'. Significant differences between mothers and childless adults – “ Donor should be informed if the donation results in a child” – “It is in the best interest of the child…to learn (as an adult) the identity of the donor”

14. Limitations Participants may have completed the questionnaire in a manner that they felt would be desirable to the clinic. This study has limited generalizability, because this study sampled women at one fertility clinic only. – This study cannot be generalized to the larger population of oocyte donors. Cross-sectional nature of research study is a limitation, as women’s attitudes may change over time.

15. Implications For Practice – Fertility clinics should tailor orientation differently for different groups. For Policy – Policy should be developed to ensure all parties are protected at sufficient levels. For Research – Longitudinal research is needed that examines psychological and health consequences post-donation.

16. Contact Information Lindsay Gezinski, Ph.D. – lindsay.gezinski@utah.edu lindsay.gezinski@utah.edu Sharvari Karandikar, Ph.D. – karandikar-chheda.1@osu.edu karandikar-chheda.1@osu.edu Thank You!