Egg Donation Risks and Benefits Reported
According to a study that examines the long-term effects of egg donation, women who choose to donate eggs to help infertile couples should be aware of both the psychological and physical risks associated with the procedure.
Women should also know that there is little data available to assess whether donating eggs when they are young has any effect on fertility later in life, experts say.
A new study in the journal Fertility and Sterility found that almost one in five women reported lasting psychological effects as a result of egg donation - some positive and some negative.
Some women felt a sense of pride in helping an infertile couple, while others developed concerns about the people who were raising their genetic offspring.
Still, two-thirds of women who donated eggs reported satisfaction with the process, the study reveals.
"Women need to look at the risk involved very carefully, and pay attention to what they're being told about risks, not just to what they're being offered to do it," says study author Nancy Kenney, Ph.D., at the University of Washington in Seattle.
The egg donation process is not as tightly regulated by the US government compared to other countries such as western European and Canada.
For example, in the United Kingdom, egg donation is viewed in the same manner as organ donation, and is done without compensation to the woman providing the eggs.
The US egg donation process was evaluated by researchers by compiling information using a questionnaire. A total of 80 women who had donated their eggs at least once and were an average age of 31 were the participants in the study.
The researchers focused on findings out what the women experienced during the process, what motivated the women to donate, and if they were aware of the risks when they donated. The study also questioned how the women felt about their donation decision several years after the procedure.
The results of the study indicated that both altruism and money motivated the women to donate their eggs.
More than 30 percent of the women surveyed said altruism alone motivated them to donate their eggs, while fewer than 20 percent were motivated solely by cash. About 40 percent of the women said both altruism and the promise of money motivated them.
The study found that women who donated eggs received an average of about $4,000 each time they donated. Although a set number of eggs are not harvested during each donation, Dr. Kenney says a typical donation may number in the teens.
When asked about the physical risks of the donation process, many women felt the risks involved were minor, and 20 percent did not recall being made aware of any physical risks, such as ovarian hyper-stimulation due to hormone injections, or infection.
Dr. Kenney points out that this does not necessarily mean the women were not told of the risks; it may simply be that they did not recall the risks.
"Often risk is not as meaningful to the young," says Dr. Kenney.
Women who reported physical problems with donation cited bloating, pain, and cramping, ovarian hyperstimulation, mood changes, and irritability, as well as weight gain or loss, as common complaints.
Several women contended they had suffered infertility, decreased fertility, or damage to their ovaries, the study authors say.
The survey also found that 70 percent of the women donated eggs more than once, with most repeat donors undergoing the procedure two or three times. In fact, one woman donated eggs nine times.
In addition, 45 percent of the women were students when they first donated, and most of the donations took place in California (23), Massachusetts (seven), New York (seven), Washington (seven) and New Jersey (seven).
Dr. Harry Lieman, at the Montefiore Institute for Reproductive Medicine and Health in New York City, says his clinic's own consent form is about 12 to 13 pages long, and that women are definitely informed of both potential physical and psychological risks.
Both Dr. Kenney and Dr. Lieman expressed concern that there are not really any long-term studies on the effects of egg donation on the donor's fertility. This may remain a concern because the process is generally anonymous in the US and there is no registry of health information from women who have donated their eggs.
Still, most women who went through the donation process were happy with the experience, the new study finds.
Dr. Lieman says women donating eggs should know there definitely is a "positive side" to donation, and that these women are doing something special to help infertile couples. "They're bringing a whole world to these couples."
For more information consult MUSC MED-U-NURSE or your physician.
Once a diagnosis of infertility is made, the specialist can work with you to determine the course of treatment. Most infertility cases are treated with conventional therapies, such as drug treatment or surgical repair of reproductive abnormalities. Depending on the cause of infertility, there are many options to offer an infertile couple.
Types of treatments for women may include the following:
These medications help regulate the timing of ovulation and stimulate the development and release of mature eggs. They can also help correct hormonal problems that can affect the lining of the uterus as it prepares to receive a fertilized egg. Ovulation medications can stimulate more than one egg to be released which increases the possibility of having twins and other multiples. Some of the common ovulation medications include clomiphene citrate, and human menopausal gonadotropins - medications containing follicle-stimulating hormone (FSH) and luteinizing hormone (LH)
For some conditions, including low sperm count and cervical mucus problems, a procedure that places specially washed and prepared sperm directly into the uterus through a small catheter (flexible tube) helps increase the chances for conception. This procedure is often used in combination with ovulation medications.
Surgery may be used to treat or repair a condition that is causing infertility such as fallopian tube blockage, or endometriosis. A common surgical procedure often used as part of the diagnostic workup of infertility is the laparoscopy. In a laparoscopy, a small telescope inserted into the abdominal or pelvic cavity allows internal organs to be visualized. Some procedures to treat infertility can be performed using instruments inserted through the laparoscope.
assisted reproductive technology (ART)
For some couples, more extensive treatment is needed. With most forms of ART, the sperm and egg are united in the laboratory and the fertilized egg is returned to the woman's uterus where it can implant and develop.
Although ART procedures are often costly, many are being used with success. These include the following:
in vitro fertilization (IVF)
- involves extracting a woman's eggs, fertilizing the eggs in the laboratory with sperm, and then transferring the resulting embryo(s) into the woman's uterus through the cervix (embryo transfer) where it can develop. Most couples transfer two embryos; however, more may be transferred in certain cases. IVF is the most common form of ART and it is often the treatment of choice for a woman with blocked, severely damaged, or absent fallopian tubes. IVF is also used for infertility caused by endometriosis or male factor infertility. IVF is sometimes used to treat couples with long-term unexplained infertility who have not been able to conceive with other infertility treatments.
intracytoplasmic sperm injection (ICSI)
- a procedure in which a single sperm is injected directly into an egg; this procedure is most commonly used to help with male factor infertility problems.
gamete intrafallopian transfer (GIFT)
- involves using a fiber-optic instrument called a laparoscope to guide the transfer of unfertilized eggs and sperm into the woman's fallopian tubes through small incisions in her abdomen. GIFT is only used in women with healthy fallopian tubes.
zygote intrafallopian transfer (ZIFT)
- involves fertilizing a woman's eggs in the laboratory and then using a laparoscope to guide the transfer of the fertilized eggs (zygotes) into her fallopian tubes. ZIFT is only used in women with healthy fallopian tubes.
- involves an embryo formed from the egg of one woman (the donor) being transferred to another woman who is unable to conceive with her own eggs (the recipient). The donor relinquishes all parental rights to any resulting offspring. ART using donor eggs is much more common among older women than among younger women. The likelihood of a fertilized egg implanting is related to the age of the woman who produced the egg. Egg donors are typically in their 20s or early 30s.
- a procedure in which embryos are preserved through freezing (cryopreservation) for transfer at a later date. This procedure is often used when an IVF cycle produces more embryos than can be transferred at one time. The remaining embryos can be transferred in a future cycle if the woman does not become pregnant.
For more information consult MUSC MED-U-NURSE or your physician.