Oocyte donors' health before and after their donation-a national Swedish register study

Are Swedish oocyte donors comparable to an age-matched control group of women with regard to medical conditions, drug prescription, and hospitalization both before and up to 15 years after their donation?

Compared with age-matched controls, Swedish oocyte donors exhibited higher outpatient healthcare utilization and medication use, were more frequently diagnosed with genitourinary disorders, and, among donors born in 1973 or later, had mental and nervous disorders.

During the donation process, oocyte donors self-assess their health as good, but longitudinal studies based on objective data are scarce.

Longitudinal study initiated in 2005 following identity-release oocyte donors' health from 1995 until 2023.

In total, 170 women recruited and accepted as identity-release oocyte donors in a non-commercial setting between 2005 and 2008 were included in this national register study. Of these, 21 women were directed donors, donating to a known recipient couple. For each donor, four age-matched controls from the general population were identified to form a control group of 680 women. Data from the National Patient Register, the Prescribed Drug Register, and Cause of Death register were used to obtain information on diagnoses using the ICD classification, medications, and hospitalizations from 1995 until 2018.

Before donation, ∼10% of donors had received specialized healthcare for neoplasms, mental disorders, respiratory disorders, digestive disorders, or skin disorders. Genitourinary disorders were common, with 50% of donors diagnosed prior to donation. With post-donation period included, this proportion increased to almost 80%, which is markedly higher than among controls (58%, P < 0.001). The younger oocyte donors, born from 1973 onwards, were more often than the matched controls diagnosed with mental disorders due to psychoactive substance use, neurotic and stress-related disorders, and behavioural syndromes associated with physiological disturbances (all P < 0.05). Oocyte donors had approximately twice as many outpatient visits compared to the controls, even after excluding visits related to genitourinary disorders (mean number of visits/SD 17.9/20.6 versus 10.1/17.1, P < 0.001). The oocyte donors had also more often received prescribed medications, including systemic hormonal preparations, excluding sex hormones and insulins (73.5% vs 34.7%, P < 0.001) and drugs related to the nervous system (75.9% vs 65.0%, P < 0.012). More than 40% of the oocyte donors had used antidepressants, and 37% had used sedatives. Hospitalization rates did not differ between donors and controls. Directed donors had more outpatient visits than non-directed donors and were also more often treated for anxiety and depression.

National register data.

This study of the health of oocyte donors is limited by the difficulty in retrieving information on primary care from national registers in Sweden. Consequently, a potential underestimation of healthcare use and of health diagnoses must be taken into consideration when interpreting the results.

A society that accepts gamete donation must strive to ensure rigorous medical and psychological assessments. The pre-donation assessment of health status and hereditary disease risk does not appear to reliably identify women with a lower predisposition to future disease or need for medication.

The study was financed by grants from the Swedish state under the agreement between the Swedish government and the county councils, ALF Grants, Region Östergötland, and from the Swedish Research Council (2013-2712; 2021-03174).

None of the authors have any competing interest to report in relation to the current study.

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