Concerns with educating the public about donating and receiving gametes

Educating the public about donating and receiving gametes (i.e., oocytes and sperm) is needed to increase public awareness, decrease stigmatisation, improve donor recruitment and ensure the continuous replenishment of public banks of gametes [1]. Why is it relevant? Because demand for assisted reproductive technology (ART) treatments with donated gametes has increased in many countries, while huge shortages in gametes supply persist. But how to educate the public? Using people-centred communication campaigns. Communication campaigns are strategies to inform, influence or shape attitudes, decisions or behaviours among patients or the public in a certain period of time [2]. They have been acknowledged to enable systems facing transitions (e.g., shortage of gamete donors, prevention of age-related fertility decline and shift from anonymous to open donation) to prompt public and patient involvement in health governance and to improve the responsiveness of the care provided. However, some public communication campaigns have been criticised for failing to give due consideration to the perceptions and needs of the populations targeted, and for lacking adequate evaluation of their implementation and effectiveness. Do these concerns impact on gamete donation? Yes. There is a scarcity of guidelines to help develop people-centred communication campaigns, i.e., campaigns that are responsive to key stakeholders’ values, preferences and needs. To help fill this gap, we assessed gamete donors’ and recipients’ perceptions about and experiences with publicly funded communication campaigns on gamete donation implemented over the last three years in Portugal (e.g., launch of the first web page about gamete donation hosted by the National Health Service website; dissemination of flyers and posters appealing to the donation) through a mixed-methods study [3]. Portugal is in a transition phase from anonymous donation to an open-identity regime, and gamete donors are recompensed for loss of earnings and inconvenience through a fixed sum of money. Between July 2017 and June 2018, 72 gamete donors and 177 recipients recruited at the Portuguese Public Bank of Gametes completed self-report questionnaires, and semistructured qualitative interviews were later conducted with a subsample of 16 donors and 13 recipients. Our study results offer several insights that can be used to overcome existing concerns with public campaigns about gamete donation that may apply across different jurisdictions. First, there is a need to invest in campaign dissemination through diverse and accessible settings and channels that go beyond health-related sites or universities. Communication campaigns about gamete donation are mostly targeted at specific populations (e.g., health care users or college students). This can alienate the general public who may feel the issue as a distant and unrelated concern. The implementation of a joint communication campaign strategy would thus benefit from being mindful of a wide audience, while considering two particular targets: older married men who have children, who show increased motivation to donate gametes based on altruism and the positive experience of fathering a child; and health professionals working outside reproductive medicine, whose involvement in communication campaigns is crucial but has been limited by reduced knowledge about infertility and gamete donation. In addition, communication channels and settings need to be adjusted to the distinct but complementary intended effects of gamete donation campaigns, which include reducing the stigma associated with donor conception and improving the recruitment of donors. TV seems to be an effective channel to disseminate contents related with donor recruitment and to improve awareness about gamete donation among the general population (e.g., using personal testimonies of recipients, donors and health professionals). Dissemination at universities should be mainly used for campaigns aiming to recruit young adults as gamete donors. Students correspond to a desirable profile of more educated and healthy citizens, who are at the ‘adequate’ reproductive age and for whom payment can be a high motivation. Finally, the telling of first-hand stories and face-to-face interaction can improve communication among the stakeholders involved in gamete donation. Hearing personal experiences at workshops, university seminars and other public events promote recognition of similarity, which is fundamental to motivate solidarity and raise awareness about the negative effects of stigmatisation. We call for the inclusion of recommendations on educating the public about donating and receiving gametes in general guidelines for psychosocial care in infertility and ART, namely investment in communication campaigns’ dissemination through diverse and accessible channels, including non-health related settings, aimed at the wider public; adjusting the communication channels and settings to the intended effects of the campaigns; and involving health professionals and using real-life testimonies.