Introduction <p>An increasing number of single women are actively choosing to become mothers without the involvement of a male partner in high-income countries, turning to donor insemination instead. While progress has been made in reducing inequalities in access to Assisted Reproductive Technologies (ART), disparities persist. Single women’s access to fertility treatment is still frequently contested, often due to concerns about child welfare.</p> Objective and rationale <p>The aim of this systematic review was to integrate and critically examine the current body of knowledge about the demographic characteristics, motivations and experiences of single mothers through ART with gamete donation, and to provide insight into the mother–child relationship.</p> Search methods <p>A comprehensive literature search of empirical research conducted in single women without a partner during at least 6 months prior to receiving assisted reproductive treatment with gamete donation was conducted across PubMed, Embase, CINAHL, PsycINFO, Web of Science, and Scopus up to December 2024. English-language, peer-reviewed articles were screened for eligibility. </p> Outcomes <p>A total of 26 studies were analyzed, revealing consistent demographic patterns: single mothers by choice (SMC) are typically well-educated, financially independent women in their late 30s. Motherhood is often a long-standing personal goal, pursued independently due to the absence of a suitable partner and concerns about declining fertility. The decision is portrayed as both pragmatic and empowered, reflecting broader societal shifts in family formation. SMC benefit from considerable support within their social networks and when healthcare systems acknowledge their distinct circumstances and tailor support accordingly. Findings consistently report high levels of maternal well-being and satisfaction, strong mother–child bonds and positive child developmental outcomes. While some variation exists in attitudes toward donor identity, most mothers embrace openness. Limited data from non-European contexts constrains the generalizability of findings.</p> Wider implications <p>This review shows that although legal, ethical, and cultural frameworks significantly shape access and experiences, SMC tend to share similar profiles and motivations. These findings challenge traditional family structures as the evidence supports intentional single motherhood as a valid and successful family model and advocates for greater recognition of reproductive autonomy and family diversity.</p>