The (Bio)Medicalisation, Stratification and Racialisation of Reproduction through Matching in UK Egg Donation

The stage of ‘matching’, commonly described as ‘donor selection’, is an integral stage in the egg donation process and refers to the selection of a particular donor for a particular recipient for the purpose of reproduction. Despite the model of clinic-mediated matching being an ‘institutionalised practice’ in the UK much of the literature on egg donation has taken this stage for granted. This study set out to explore the organisation of matching in egg donation in two fertility clinics in South East England. Ethnographic fieldwork was conducted over 2 years and involved observations, in-depth interviews with clinicians and recipients and the collection of matching statistics. Theoretical frameworks of (bio)medicalisation, stratification and racialisation were utilised to understand the matching process, with a particular emphasis on their application in the UK regulated context of egg donation.

In this study ‘matching’ was taken to be a process rather than a single practice of selection, enabling insight into how different sets of aims, activities, decisions, trajectories, roles, tools, constraints, perceptions and interactions at different stages of the matching process combined to result in particular outcomes. Situated within the wider regulatory context of the UK and the immediate clinical contexts in which this research took place this study showed how donor-recipient matching in egg donation simultaneously (bio)medicalised, stratified and racialised reproduction in novel and nuanced ways, particularly through practices of ‘racial matching’ and ‘transracial matching’. Concepts of ‘kinship risk, ‘marked whiteness’ and ‘strategic rationalisation’ were employed to understand the perceptions and practices of clinicians and recipients within the matching process.