Assessing the Medical Risks of Human Oocyte Donation for Stem Cell Research Workshop Report (2007) / Chapter Skim
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5 Directions for the Future
5 Directions for the Future
Pages 51-60
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From page 51... ...
Although more than a million IVF cycles have been performed in the United States over the past 20 years, and although there are registries that keep track of the various reproductive outcomes, such as the number of eggs retrieved and the number of children born, there are no registries that track the health of the people who have taken part. Without such registries to draw from, most of the studies of the health outcomes of IVF have been anecdotal or have focused on relatively small groups of people.
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From page 52... ...
Giudice pointed out, the available data come primarily from IVF patients and not from healthy subjects, yet it is healthy women and not those coping with infertility who will be donating eggs for research. This raises the possibility, for example, that the existing data will overstate the potential risks for healthy donors, given that IVF patients may be more likely to have a variety of conditions, such as pelvic adhesions and polycystic ovary syndrome, that increase the odds of complications from the ovarian stimulation or the retrieval surgery.
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From page 53... ...
Doctors and medical researchers should be able to offer concrete answers to some questions: Does ovarian stimulation increase a woman's lifetime risk of uterine cancer? What effect does a history of pelvic inflammatory disease have on a woman's risk factors for retrieval surgery?
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From page 54... ...
Of course, physicians try not to subject any of their patients to unnecessary risks, but because research donors represent a special situation -- women who are undergoing a procedure not for their own benefit but for the benefit of others -- the workshop participants said that even greater care should be taken to make sure that these donors do not pay for their altruism with their own health. "We absolutely want to minimize risk for our reproductive donors," said Dr.
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From page 55... ...
There are two basic ways to minimize potential risk to egg donors. The first is to identify which potential donors have particular risk factors and to exclude them from the donor pool, since they have a higher than normal risk for complications.
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From page 56... ...
Only one out of eight women who had been interested enough to contact the program, get a questionnaire, fill it out, and return it actually ended up donating eggs. This exclusionary approach can be applied to lessen any of the major potential risks from oocyte donation.
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From page 57... ...
In theory, this technique can be applied to any of the potential risks of oocyte donation, but the workshop participants focused on its application to one potential risk in particular: the development of ovarian hyperstimulation syndrome caused by hormones used to stimulate the ovaries to produce more eggs. PREVENTING OVARIAN HYPERSTIMULATION SYNDROME Of all the risks facing women undergoing in vitro fertilization, the most common and the most threatening is ovarian hyperstimulation syndrome (OHSS)
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From page 58... ...
As Dr. Rosenwaks explained, the development of ovarian hyperstimulation syndrome depends on a large number of follicles in the ovary being exposed to human chorionic gonadotropin (hCG)
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From page 59... ...
ALTERNATIVE SOURCES FOR OOCYTES Given that there is always going to be some potential risk to egg donation, it makes sense to look for alternate sources of eggs -- sources that do not rely on the traditional process of ovary stimulation and surgical retrieval that was developed for in vitro fertilization. The workshop participants discussed several of these alternatives.
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From page 60... ...
So women who might otherwise be excluded from donating their eggs for research -- such as women with polycystic-appearing ovaries -- could in this way provide eggs without the potential risks that would accompany such a donation done via the usual path. Finally, there was some discussion about the possibility of retrieving oocytes from cadavers in much the same way that organs are now retrieved from the bodies of people who have signed organ donation cards.
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