A new study in the Journal of the American Medical Association by Kawwass et al. uses Centers for Disease Control and Prevention (CDC) data to show that the number of IVF cycles using third-party eggs is rapidly increasing, and leading to higher "success rates." Significantly, the authors’ criterion of "success" is a full-term singleton birth. It is heartening that researchers in the fertility field are so explicitly acknowledging that multiple pregnancies and premature births are not results to be celebrated, since they carry notable risks for babies and mothers.
The JAMA study actually shows that while more women are getting pregnant using IVF with other women’s eggs, more people fail than succeed at going home with a baby in a given IVF cycle. But you’d never know that from the headlines of most of the news stories reporting on the study, like the Associated Press’ Donor Egg Pregnancies on the Rise or the Philadelphia Inquirer’s Donor Eggs Increasingly Used for IVF, With Rising Success.
Nor would you learn by reading most news articles about the risks of egg retrieval, or the appalling lack of follow-up studies on the health of egg providers. An exception is this story by Melissa Dahl, which states that “some doctors and advocates worry that too little is known about the long-term health and psychological impacts on the egg donors themselves” and quotes We Are Egg Donors co-founder Raquel Cool.
"I think in the 30 years that donor eggs have been used, that very few questions have been asked toward us donors about how we feel about the experience….It’s sort of dizzying and it can be very, very isolating."
Perhaps it’s unfair to blame the news media – or for that matter the authors of the JAMA study – for not including information about the effects of egg retrieval on young women who sell their eggs. After all, the study was based on CDC data, and while CDC collects data on how many eggs are retrieved from third-party providers, and how many pregnancies result from them, it gathers no information at all about what happens to the egg providers themselves. In other words, CDC data can tell us a fair amount about what the title of the JAMA study terms "Trends and Outcomes for Donor Oocyte Cycles," but nothing about the outcomes for the women who are the source of those "donor oocytes."
Another set of numbers in the JAMA study gives the number of eggs retrieved per IVF cycle. In 40.3% of the egg retrieval cycles performed on "oocyte donors," more than 21 eggs were retrieved. For women having eggs retrieved for their own use – "Patients Using Nondonor (Autologous) Oocytes" – 13.1% of the cycles produced more than 21 eggs. These are large numbers. In fact, a study presented at the annual meeting of the American Society for Reproductive Medicine that was held last week (see "ASRM Meeting: What to Know"), showed than retrieving more than 15 "leads to increased risk of complications."
The study’s authors might have remarked on this finding, or mentioned the lack of data about health outcomes for "donors," but did not. However, their article was accompanied by an editorial that did make the latter point, in clear terms.
Dr. Evan Myers, a professor in the department of obstetrics and gynecology at Duke University Medical Center, stated that current data "have an important limitation—no data on health outcomes in donors." He continued:
"Donors are at risk for all of the complications associated with ovulation induction, including the potentially life-threatening ovarian hyperstimulation syndrome. In addition, there is uncertainty about longer-term issues such as effects on the donor’s own fertility or the need to inform recipients about the discovery of health issues not known at the time of donation. Current evidence on donor outcomes is limited to single centers or to small samples susceptible to selection bias…."
"More complete data on both short- and long-term outcomes of donation are needed so donors can make truly informed choices and, once those data are available, mechanisms can be put in place to ensure that the donor recruitment and consent process at clinics is conducted according to the highest ethical standards."'s