<p>Attitudes toward oocyte donation in Iran are deeply shaped by sociocultural forces, including concepts of lineage, stigma, privacy, and gendered expectations. Evidence from western Iran remains limited. This study examined attitudes toward oocyte donation and their sociocultural determinants among infertility patients. This cross-sectional survey was conducted among 171 infertile men and women attending a public infertility center in western Iran. Data were collected using a validated 52-item multidimensional attitude questionnaire distributed as a self-administered paper survey in a clinical setting. Multivariable linear regression was used to assess associations between sociodemographic characteristics and attitude domains. Participants demonstrated generally positive attitudes toward oocyte donation (mean = 177.21 ± 26.15). However, clear sociocultural patterns emerged, with strong endorsement of donor–recipient anonymity, secrecy from others, and non-disclosure to the future child, reflecting concerns related to lineage and social judgment. Higher male educational level was significantly associated with stronger support for anonymity, while female education showed a modest association with disclosure-related attitudes. Attitudes toward oocyte donation in western Iran are shaped primarily by sociocultural expectations surrounding privacy, secrecy, and lineage rather than clinical characteristics. These findings highlight the importance of culturally sensitive counseling and education strategies in donor-assisted reproduction programs.</p>