Elective egg freezers' disposition decisions pathways

What are the significant decision-making pathways for oocyte disposition outcomes for elective egg freezers?

Observational cross-sectional study undertaken between May and November 2023. Questions were derived from the Prototype Willingness Model with six additional theoretical constructs informed from qualitative research and analysed using structured equation modelling. Patients (n = 175, aged ≥18 years, living in Australia) had electively frozen their eggs with at least one currently in storage. Primary outcomes were willingness to donate to friends or family members; a couple advertising online for an egg donor; an egg bank/fertility clinic; research; or discard or reclaim the eggs.

Each outcome had a distinct decision pathway. All variables were significant for at least one outcome. The models accounted for a substantial variance in willingness to donate (from 45% [research] to 75% [egg bank/fertility clinic]. Across all outcomes, a positive attitude was the strongest enabling factor. Attitude was informed by factors such as concern about other people raising their donor child; desire to meet recipient; empathy; and concern for wellbeing of donor child, depending on the outcome choice. When donating to research, what others thought of their choice was a significant enabler. Feeling favourably towards the typical woman who chooses to discard their eggs was an enabling factor for discarding eggs.

As disposition decisions are individual and personal, the study highlights the importance of counselling for elective egg freezers when considering disposition options. The development of support tools is recommended to help patients navigate this complex decision.