{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T23:59:03Z","timestamp":1790985543566,"version":"4.1.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011925","name":"ESHRE","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>STUDY QUESTION<\/jats:title>\n                    <jats:p>How should the number of offspring per gamete donor be regulated at an international level?<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SUMMARY ANSWER<\/jats:title>\n                    <jats:p>The European Society of Human Reproduction and Embryology (ESHRE) recommends introducing a European Union (EU)-wide limit on the number of families per gamete donor, starting at 50 families and gradually reducing it to a maximum of 15 families or lower, supported by an EU-wide donor registry to monitor compliance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>WHAT IS KNOWN ALREADY<\/jats:title>\n                    <jats:p>Most European countries impose national limits on the number of offspring or families per donor, but these limits vary widely and are not always enforced. Cross-border movement of patients and the export of donor gametes between countries mean that large donor sibling groups can still emerge despite these restrictions. What matters to donor-conceived people is the total number of donor siblings, regardless of which country they are in, making a transnational limit the only relevant mechanism that can address this issue.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>STUDY DESIGN, SIZE, DURATION<\/jats:title>\n                    <jats:p>This position paper sets out principles relevant to international donor offspring limits and the position and policy recommendations of ESHRE, focusing on the EU level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PARTICIPANTS\/MATERIALS, SETTING, METHODS<\/jats:title>\n                    <jats:p>This ESHRE position paper was developed by a multidisciplinary expert working group. Recommendations are supported by data from the literature, where available. The first version was published for stakeholder review in November 2025, with 45 completed review forms received from organizations representing donor-conceived people, families built through donor conception and infertility patients, national fertility societies, researchers, professionals from different disciplines, and gamete banks. The paper was then revised on the basis of the stakeholder review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MAIN RESULTS AND THE ROLE OF CHANCE<\/jats:title>\n                    <jats:p>ESHRE considers that the wellbeing of donor-conceived people should have the highest priority when determining limits, while also balancing the wellbeing of prospective parents. Limits should be set for the number of families rather than individual children. ESHRE proposes a phased introduction starting at 50 families per donor, being reduced to a maximum of 15 families or lower, alongside a 20-year cap on distributing gametes to new families after the first donation. National limits should still be upheld where they are lower, and donors should be able to set their own lower personal limit. Compliance should be monitored through an EU-wide donor registry or, failing that, national registries, with gamete banks (including non-EU banks exporting into the EU) obliged to enforce the limit, donors required to declare all previous donations, and families counted as potential live births unless confirmed otherwise.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LIMITATIONS, REASONS FOR CAUTION<\/jats:title>\n                    <jats:p>The evidence base on the psychosocial impact of large donor sibling groups is small and developing, and definitive evidence of harm is limited. Research on the preferences of donor-conceived people, donors, and recipients regarding offspring limits is scarce and inconclusive. These recommendations therefore take a precautionary approach, and the proposed 15-family limit should be reviewed in light of developing knowledge during the transition period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>WIDER IMPLICATIONS OF THE FINDINGS<\/jats:title>\n                    <jats:p>An EU-wide limit would represent a feasible first step towards an international limit. An EU-wide donor registry could potentially serve secondary purposes such as supporting tracing in case of the diagnosis of a serious genetic condition and giving access to information to donors and donor-conceived people.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>FUNDING<\/jats:title>\n                    <jats:p>Support for the working group was provided by ESHRE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCLOSURES<\/jats:title>\n                    <jats:p>L.F. and C.C.-J. report travel support from ESHRE. D.P.B. reports speakers' fees from Merck, Ferring, Gedeon Richter and MSD, travel support from ESHRE, and a position as the president of the Croatian Society for Gynaecological Endocrinology and Human Reproduction. A.A. reports speakers\u2019 fees from Merck Healthcare KGaA and Ferring, travel support from ESHRE, passive shareholder interest in Inception Midco 1. S.\u00e0 r.l., membership in a subgroup of the European Medical Devices Coordination Group, and a position as vice chair of the EXPAMED panel on obstetrics, gynaecology and reproductive medicine. G.N. reports speakers\u2019 fees from Gedeon-Richter and Organon, travel support from ESHRE, and a position as past chairman and member of the Executive Committee of the Bulgarian Association for Human Reproductive Embryology. P.T. reports speakers\u2019 fees and travel support from Ferring and Gedeon Richter and a position as a board member on the Arbeitskreis donogene Insemination. J.K.-B. reports speakers\u2019 fees from Ferring, IBSA, Merck and CooperSurgical, travel support from Merck and ESHRE, an associate editor position for the journal Andrology, and a position as chair of the scientific advisory committee of the Association for Reproductive and Clinical Scientists (ARCS). The remaining authors (J.T. and N.V.) have nothing to declare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>TRIAL REGISTRATION NUMBER<\/jats:title>\n                    <jats:p>n\/a.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/humrep\/deag108","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T07:02:10Z","timestamp":1783494130000},"page":"1270-1276","source":"Crossref","is-referenced-by-count":4,"title":["ESHRE position paper: international limits on the number of offspring per gamete donor"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8506-0699","authenticated-orcid":false,"given":"Lucy","family":"Frith","sequence":"first","affiliation":[{"name":"Centre for Social Ethics & Policy, Department of Law, School of Social Sciences, University of Manchester , Manchester,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0883-7372","authenticated-orcid":false,"given":"Johanna","family":"Tassot","sequence":"additional","affiliation":[{"name":"European Society of Human Reproduction and Embryology, Central Office , Strombeek-Bever,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5074-912X","authenticated-orcid":false,"given":"Aisling","family":"Ahlstrom","sequence":"additional","affiliation":[{"name":"IVIRMA Global Research Alliance, Livio Gothenburg , Gothenburg,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3412-8024","authenticated-orcid":false,"given":"Dinka Pavi\u010di\u0107","family":"Baldani","sequence":"additional","affiliation":[{"name":"University Clinical Hospital Zagreb, School of Medicine, University of Zagreb , Zagreb,","place":["Croatia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2941-113X","authenticated-orcid":false,"given":"Carlos","family":"Calhaz-Jorge","sequence":"additional","affiliation":[{"name":"Universidade de Lisboa Obstetrics and Gynaecology Department, Faculdade de Medicina, , Lisbon,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5847-5402","authenticated-orcid":false,"given":"Gueorgui","family":"Nikolov","sequence":"additional","affiliation":[{"name":"ReproBioMed Medical Centre , Sofia,","place":["Bulgaria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7107-630X","authenticated-orcid":false,"given":"Petra","family":"Thorn","sequence":"additional","affiliation":[{"name":"Private Practice , Moerfelden,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8046-6799","authenticated-orcid":false,"given":"Nathalie","family":"Vermeulen","sequence":"additional","affiliation":[{"name":"European Society of Human Reproduction and Embryology, Central Office , Strombeek-Bever,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2833-8970","authenticated-orcid":false,"given":"Jackson","family":"Kirkman-Brown","sequence":"additional","affiliation":[{"name":"Centre for Human Reproductive Science, School of Medical Sciences, College of Medicine & Health, University of Birmingham , Birmingham,","place":["UK"]},{"name":"Birmingham Women\u2019s Fertility Centre, Birmingham Women\u2019s Hospital, Edgbaston , Birmingham,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"2026080301513784600_deag108-B1","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1057\/s41292-021-00259-z","article-title":"The ongoing work of kinship among donor half-siblings in The Netherlands","volume":"18","author":"Bolt","year":"2023","journal-title":"Biosocieties"},{"key":"2026080301513784600_deag108-B2","author":"Conrad","year":"2025"},{"key":"2026080301513784600_deag108-B3","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.rbms.2015.10.001","article-title":"Emerging models for facilitating contact between people genetically related through donor conception: a preliminary analysis and discussion","volume":"1","author":"Crawshaw","year":"2015","journal-title":"Reprod Biomed Soc Online"},{"key":"2026080301513784600_deag108-B4","article-title":"You feel a bit mass-produced\u2019: donor-conceived people on the export of UK sperm","volume-title":"The Guardian","author":"Devlin","year":"2024"},{"key":"2026080301513784600_deag108-B5","author":"Donor Conceived UK. Some of the challenges of being Donor Conceived\u2026,","year":"2025"},{"key":"2026080301513784600_deag108-B6","author":"Dutch court orders sperm donor to stop after 550 children","year":"2023"},{"key":"2026080301513784600_deag108-B7","doi-asserted-by":"crossref","first-page":"hoac001","DOI":"10.1093\/hropen\/hoac001","article-title":"Good practice recommendations for information provision for those involved in reproductive donation\u2020","volume":"2022","author":"ESHRE Working Group on Reproductive Donation;","year":"2022","journal-title":"Hum Reprod Open"},{"key":"2026080301513784600_deag108-B8","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.1093\/humrep\/deae163","article-title":"Survey on ART and IUI: legislation, regulation, funding, and registries in European countries\u2014an update","volume":"39","author":"European IVF-Monitoring Consortium (EIM) for the European Society of Human Reproduction and Embryology (ESHRE)","year":"2024","journal-title":"Hum Reprod"},{"key":"2026080301513784600_deag108-B9","author":"European Sperm Bank"},{"key":"2026080301513784600_deag108-B10","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1057\/s41292-017-0063-2","article-title":"Searching for \u2018relations\u2019 using a DNA linking register by adults conceived following sperm donation","volume":"13","author":"Frith","year":"2018","journal-title":"Biosocieties"},{"key":"2026080301513784600_deag108-B11","doi-asserted-by":"crossref","first-page":"103421","DOI":"10.1016\/j.rbmo.2023.103421","article-title":"Direct-to-consumer genetic testing and the changing landscape of gamete donor conception: key issues for practitioners and stakeholders","volume":"48","author":"Gilman","year":"2024","journal-title":"Reprod Biomed Online"},{"key":"2026080301513784600_deag108-B12","doi-asserted-by":"crossref","first-page":"2002","DOI":"10.3390\/ijerph19042002","article-title":"Sociological accounts of donor siblings\u2019 experiences: their importance for self-identity and new kinship relations","volume":"19","author":"Hertz","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"2026080301513784600_deag108-B13","author":"Human Fertilisation and Embryology Authority"},{"key":"2026080301513784600_deag108-B14","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1080\/14647273.2021.1872804","article-title":"Meeting multiple same-donor offspring: psychosocial challenges","volume":"25","author":"Indekeu","year":"2022","journal-title":"Hum Fertil (Camb)"},{"key":"2026080301513784600_deag108-B15","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.xfnr.2021.01.003","article-title":"Factors associated with searching for people related through donor conception among donor-conceived people, parents, and donors: a systematic review","volume":"2","author":"Indekeu","year":"2021","journal-title":"F&S Reviews"},{"key":"2026080301513784600_deag108-B16","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/j.rbmo.2010.01.001","article-title":"Experiences of offspring searching for and contacting their donor siblings and donor","volume":"20","author":"Jadva","year":"2010","journal-title":"Reprod Biomed Online"},{"key":"2026080301513784600_deag108-B17","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1016\/j.rbmo.2015.01.018","article-title":"Evolving minimum standards in responsible international sperm donor offspring quota","volume":"30","author":"Janssens","year":"2015","journal-title":"Reprod Biomed Online"},{"key":"2026080301513784600_deag108-B18","author":"Kramer","year":"2024"},{"key":"2026080301513784600_deag108-B19","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1186\/s12958-025-01418-8","article-title":"Egg donors\u2019 attitudes toward identifiability, offspring information, and genetic testing","volume":"23","author":"Lassen","year":"2025","journal-title":"Reprod Biol Endocrinol"},{"key":"2026080301513784600_deag108-B20","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1093\/jlb\/lsv045","article-title":"Gamete donor anonymity and limits on numbers of offspring: the views of three stakeholders","volume":"3","author":"Nelson","year":"2016","journal-title":"J Law Biosci"},{"key":"2026080301513784600_deag108-B21","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1016\/j.rbmo.2021.06.025","article-title":"Attitudes of sperm donors towards offspring, identity release and extended genetic screening","volume":"43","author":"Pennings","year":"2021","journal-title":"Reprod Biomed Online"},{"key":"2026080301513784600_deag108-B22","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1111\/chso.12158","article-title":"Adolescents conceived through donor insemination in mother-headed families: a qualitative study of motivations and experiences of contacting and meeting same-donor offspring","volume":"31","author":"Persaud","year":"2017","journal-title":"Child Soc"},{"key":"2026080301513784600_deag108-B23","first-page":"257","article-title":"Donor-conceived children looking for their sperm donor: what do they want to know?","volume":"5","author":"Ravelingien","year":"2013","journal-title":"Facts Views Vis Obgyn"},{"key":"2026080301513784600_deag108-B24","doi-asserted-by":"crossref","first-page":"hoaa057","DOI":"10.1093\/hropen\/hoaa057","article-title":"Finding people like me: contact among young adults who share an open-identity sperm donor","volume":"2020","author":"Scheib","year":"2020","journal-title":"Hum Reprod Open"},{"key":"2026080301513784600_deag108-B25","author":"Spenderkinder","year":"2021"},{"key":"2026080301513784600_deag108-B26","author":"Swedish National Council on Medical Ethics; Danish Council on Ethics; Finnish National Advisory Board on Social Welfare and Health Care Ethics; Norwegian Biotechnology Advisory Board","year":"2025"},{"key":"2026080301513784600_deag108-B27","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1111\/aogs.12395","article-title":"Oocyte and sperm donors\u2019 opinions on the acceptable number of offspring","volume":"93","author":"Sydsj\u00f6","year":"2014","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2026080301513784600_deag108-B28","doi-asserted-by":"crossref","first-page":"2038","DOI":"10.1093\/humrep\/deaf179","article-title":"ART in Europe, 2020: results generated from European Registries by ESHRE\u2020","volume":"40","author":"The European IVF Monitoring Consortium for the European Society of Human Reproduction Embryology","year":"2025","journal-title":"Hum Reprod"},{"key":"2026080301513784600_deag108-B29","first-page":"57","article-title":"Artificial insemination with donor sperm (AID): heterogeneity in sperm banking facilities in a single country (Belgium)","volume":"6","author":"Thijssen","year":"2014","journal-title":"Facts Views Vis Obgyn"}],"container-title":["Human Reproduction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/humrep\/article-pdf\/41\/8\/1270\/68706576\/deag108.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/humrep\/article-pdf\/41\/8\/1270\/68706576\/deag108.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T05:51:46Z","timestamp":1785736306000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/humrep\/article\/41\/8\/1270\/8726004"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,8]]},"references-count":29,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,7,8]]},"published-print":{"date-parts":[[2026,8,1]]}},"URL":"https:\/\/doi.org\/10.1093\/humrep\/deag108","relation":{},"ISSN":["0268-1161","1460-2350"],"issn-type":[{"value":"0268-1161","type":"print"},{"value":"1460-2350","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,8]]},"published":{"date-parts":[[2026,7,8]]}}}