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Between the many ethical questions that are still in debate around gamete donation, the authors analyse some of them including why oocyte and sperm donation are experienced very differently by couples, despite their apparent similarity, and stress the ethical impact of the difficulties of donor recruitment in all oocyte donation programs. The various types of donors (occasional, relational, IVF patient, and professional) are described with their motivations, resistances, advantages and disadvantages. The contradictory consequences with free or paid donation and the particular risks of oocyte donation (in comparison to sperm donation), both for the donor as for the recipient, are highlighted. The paper also examines the actual debate of gamete donors'' CMV serology status, as well as the question of eventual quarantine of donated oocytes. The problem of maintaining anonymity is then analysed in ethical terms but also in terms of technical efficacy. A strategy which, due to the decision of retaining anonymity, increases treatment efficacy by avoiding wastage of oocytes offered as a donation, is described. The pregnancy rate per donor oocyte pickup rises from 35% to 99% using this strategy, significantly reducing shortage. [Copyright &y& Elsevier]