LAUSR

Introduction The use of sexual orientation and marital status as criteria for access to fertility treatments varies across countries, being recently discarded in Portugal. This originated a discussion on whether priority should be given to heterosexual married couples when resources are in short supply, causing controversy. Policy and practice aligned with public views are needed to ensure access to equitable and high-quality care. However, the opinions of the key stakeholders involved in gamete donation are rarely addressed. Methods Between July 2017 and June 2018, 171 recipients and 72 donors attending the Portuguese Public Bank of Gametes completed a self-report questionnaire to analyse their opinions about the use of sexual orientation and marital status as priority criteria for accessing fertility treatments, and its associated factors. Results Most participants disagreed with priority of access to fertility treatments by heterosexual couples or by married women (60%). Men and recipients were more likely to agree with priority of access for heterosexual couples. Agreement with priority of access for married women was more frequent among men, participants who were married/cohabiting and those who had lower white-collar or blue-collar occupations. Conclusions Donors and recipients have differing and complex opinions regarding priority of access to fertility treatments based on sexual orientation and marital status. To overturn the heteronormative representations and a marriage hierarchy underlying misconceptions about parenting abilities of same-sex couples and single women, and fears regarding a decrease in the quality of care, it is crucial to implement communication campaigns and surveillance systems. Policy Implications International policy on cross-border reproductive care is needed to promote accountability regarding transnational fertility treatments.