Ovarian Hyperstimulation Syndrome – It’s Time to Reverse the Trend
By Dr. Geeta Nargund | BioNews | Dec. 5, 2016
In this commentary, Dr. Geeta Nargund, medical director at CREATE Fertility, discusses the reported “slight increase” in ovarian hyperstimulation syndrome (OHSS) reported by fertility clinics in the United Kingdom in 2015.
In the author’s opinion, the Human Fertilization and Embryology Authority (HFEA) report “obfuscates” the real data – a 40 percent rise in hospital admissions with severe OHSS. She suggests the HFEA put this “alarming statistic on the front page” and discuss methods to “reverse this trend.”
Some of Nargund’s recommendations include:
- Use of a reduced dose of stimulation followed by GnRH agonist to trigger ovulation, with an option of cryopreservation of all embryos.
- Abandoning the use of the “long downregulation” protocol employed in many IVF treatment cycles and changing to antagonist cycles.
- Ceasing long downregulation protocols for those at risk of OHSS.
- Limits on the dose of FSH hormone given to a woman, dependent on her history, her age, BMI, AMH hormone levels, and antral follicle count.
In line with others in the field, the author also emphasizes the need for informed consent, placing the responsibility for this on providers, and the rigorous documentation of the effects of stimulation protocols and the drugs and dosages used. Read the full commentary >
Assisted Reproductive Technology National Summary Report
Centers for Disease Control and Prevention | October 2016
The data for this national report come from the 458 U.S. fertility clinics in operation in 2014 that provided and verified data on the outcomes of all ART cycles started in their clinics. It is organized into short sections, as described below, all of which include helpful visuals for readers.
- Section 1: Information on the different types of ART cycles performed in 2014.
- Section 2: Information on ART cycles that used only fresh non-donor eggs or embryos.
- Section 3: Information on the ART cycles that used only frozen non-donor embryos.
- Section 4: Information on the ART cycles that used only donated eggs or embryos.
- Section 5: Information on trends in the number of ART procedures and measures of success over the past 10 years, from 2005 through 2014.
Read the full report >
Ethical Use of Assisted Reproductive Technologies
National Perinatal Association | December 2015
Professor Michele Goodwin at the University of Minnesota and Judy Norsigian have described the “raw and debilitating physical, emotional and spiritual challenges created by deeply personal and life-altering procedures” experienced by some women seeking ART and support the need for additional regulation. In addition to the invasive processes involved in conception, the ethical quandary created by a recommendation for fetal reduction and the emotional toll on women and couples may be profound and is incompletely studied. Professor Goodwin asserts there is a “much needed public discourse that could also become the clarion call for regulation of a field of medicine that has thus far unsuccessfully regulated itself.”
In this position paper, the National Perinatal Association, whose membership comprises healthcare providers, parents and caregivers, educators and service providers, addresses the ethical use of assisted reproductive technologies.
The paper calls for action on reducing disparities in care provided to mothers and children and makes helpful recommendations: single embryo transfers, counseling from a multi-disciplinary team and informed consent prior to treatment, and access to comprehensive obstetric care during and after treatment. Read the full document >
Responsible Surrogacy is a web-based project created by a group of volunteers in Israel to provide people considering surrogacy with information on the ethical and practical aspects of an arrangement. The information is available in Hebrew and English.
The site is facilitated by intended parents who believe “the ethical responsibility for the surrogacy process lies with the intended parents.” From the About page:
Surrogacy is a difficult process for all involved in many aspects, and it is often initiated after much hardship for the intended parents. For those in need of it, surrogacy is commonly the last hope to raise a family. They reach it exhausted but with a sense of purpose. Perhaps that is why in many cases we have encountered upon building this information center there was a tendency of intended parents to neglect one of the most important points – on the other side of this process is a person.
The website functions like a database, providing information on a range of issues related to the health and well-being of gestational mothers, including the fairness of the contract, monetary and legal considerations, and the woman’s relationship with the intended parents.
The site’s creators believe these and other aspects should be considered irrespective of where an arrangement is formed, but intended parents must also seek current and accurate country-specific information for guidance.
We Are Egg Donors was founded by three egg providers. The platform enables egg providers from more than 12 countries to connect with one another, share their experiences, and access evidence-based research on egg retrieval. We Are Egg Donors operates a Facebook group for approved members and an informative blog.
By sharing our stories, we create a meaningful conversation and advocate for causes that matter to egg donors.
With organizations like Our Bodies Ourselves, We Are Egg Donors is actively calling for long-term studies on the health effects of egg retrieval. Co-founder Raquel Cool has written extensively about her experience for OBOS’s blog.
Do Women Who Donate Their Eggs Run A Health Risk?
By Sandra G. Boodman | The Washington Post | June 20, 2016
A transaction once shrouded in secrecy, the Internet now hosts a thriving and competitive marketplace for donors, largely supplanting leaflets on college bulletin boards and ads in campus newspapers, the traditional methods of recruiting fertile young women. Payment varies, currently starting at about $3,500 per cycle and sometimes exceeding $50,000, depending on the location of the clinic or egg brokerage and the donor’s characteristics. An Ivy League education, Asian descent (there is a paucity of donors), exceptional looks and a previous donation that led to a birth command higher reimbursement.
This article balances the experience of an egg provider who did not suffer any complications as a result of the process with another who was diagnosed with stage 4 metastatic breast cancer after 10 rounds of egg retrieval.
It also includes interviews with noted advocates on the issue, including Timothy R. B. Johnson, the longtime chair of the department of obstetrics and gynecology at the University of Michigan School of Medicine, and Judy Stern, professor of pathology and obstetrics and gynecology at Dartmouth, who oversees the Infertility Family Research Registry, a voluntary database that includes about 70 egg donors. Read the full article >