Gamete donation is widely practiced globally and demand is increasing, driven by rising infertility and diversification of family structures. In 2018, ICMART reported 212,631 cycles of oocyte donation in 59 countries and 82,365 IUI sperm donor cycles in 39 countries (Baker et al., 2025). However, estimating the number of donor-conceived births is challenging due to absence of dedicated international registries and to cross border reproductive care. According to the 2025 IFFS Triennial report, 41 of 75 countries taking part in the survey reported the existence of regulations regarding donor anonymity. While historically many countries supported anonymous donation to protect all parties involved, recent advocacy campaigns led by donor-conceived persons (DCPs) have prompted legislative changes in several jurisdictions. This move has complex ethical, legal, social, and practical implications. Unconditional abolition of donor anonymity is an oversimplified approach that fails to consider the diverse range of rights and instances of all categories of stakeholders involved, which include donors, recipients, DCPs, families of origin, IVF clinics, and broader societal contexts. While the desire of some DCPs to know genetic origins can be legitimate and is often supported by human-rights frameworks, making it a universal right may have unintended and underestimated consequences for other groups. For example, removing anonymity might dissuade potential donors, with subsequent donor shortage, reduced gamete supply and longer waiting time for treatments. Other potential concerns related to indiscriminate abolition of donor anonymity entail ethical and legal issues related to privacy, data protection and the risk of sensitive genetic and health information being misused or disclosed improperly. From a social point of view, emphasizing the prevalence of genetics as key determinant of identity could diminish nonbiological family relationships. In conclusion, policies on donor anonymity should pursue a balanced approach reflecting cultural and regulatory diversity, rather than endorsing indiscriminate abolition as a universal solution.

Serena Sgargi obtained her BA from Bologna University, Italy. She has been working in the field of Reproductive Medicine and ART for 16 years, during which she has primarily been involved in communication, event organization, educational activities, and relationships with national and international scientific societies.