Table 2. Categories of Qualitative Data: Challenges and Problems Related to Egg, Sperm, and Embryo Donation .

Category	Merged or Highest Frequency Codes
Outcomes and consequences of assisted reproductive treatment (ART)	Autism
	Cancer
	Genetic diseases
	Possible marriage of siblings
	Embryo anomalies
	Return of the donated child
	Genetic transmission of addiction
	Disruption of the gender ratio
	Death or psychological trauma of the donor
	Deterioration of the country's international image
	An increase in pregnancy complications such as preeclampsia and neonatal complications such as prematurity in cases of embryo donation
Religious challenges regarding assisted reproduction	Lack of global agreement on embryo, sperm, and egg donation
	Disagreement between Shiites and Sunnis regarding the donation of embryos, sperm, and eggs
The big challenge: sperm donation	Repeated sperm donation by any donor (third parent)
	The risk of inbreeding due to the possible marriage of offspring resulting from the donation of the third parent
	The possibility of transmission of genetic and infectious diseases through sperm
	The necessity of keeping the information related to the donation confidential and not disclosing it to anyone other than the person receiving the donation
Donor-related challenge: the mental health challenge	The possibility of serious mental disorders in the donor and their transmission to the fetus
The challenge of inheritance, lineage, and identity	Seeking to identify biological parents for inheritance and financial support.
	The desire to identify biological parents to understand his true identity
	The epidemic of children's doubts about their genetic origin
Lack of national law and protocol	Lack of law and protocol regarding permitted activities and how to perform them in infertility centers
	Parallel work of infertility centers regarding the method of donation due to not having the same protocol
The brokerage market for egg and sperm donation	The business of donating sperm and eggs due to lack of supervision by the Ministry of Health
	The unnecessary use of assisted reproductive methods as a result of indiscriminate expansion of infertility centers.
General challenges of infertility treatment	Lack of a unified protocol among infertility centers.
	Absence of a registry system
	Lack of necessary facilities in government centers to introduce the donor to the patient.
	Absence of jurisprudence and moral advisor
	Charging excessive fees from liaisons while failing to monitor private center operations.