Ovarian Hyperstimulation Syndrome – It’s Time to Reverse the Trend
By Dr. Geeta Nargund | BioNews | Dec. 5, 2016
In this commentary, Dr. Geeta Nargund at CREATE Fertility, discusses the increase in ovarian hyperstimulation syndrome (OHSS) reported by fertility clinics in the United Kingdom.
In the author’s opinion, a report published by the Human Fertilization and Embryology Authority (HFEA) “obfuscates” real data – a 40 percent rise in hospital admissions with severe OHSS. She suggests the HFEA prioritize this “alarming statistic” and focus on reversing the trend, offering the following recommendations: a reduced dose of stimulation followed by GnRH agonist to trigger ovulation, with an option of cryopreservation of all embryos; and abandoning the use of the “long downregulation” protocol, employed in many IVF treatment cycles, and a switch to antagonist cycles.
In line with others in the field, Nargund also emphasizes the need for informed consent – placing the responsibility for this on providers – and rigorous documentation of the effects of stimulation protocols (including 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 report come from the 458 U.S. fertility clinics in operation in 2014. It is organized into the following sections.
- 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.”
This position paper by the National Perinatal Association addresses the ethical use of assisted reproductive technologies. It emphasizes reducing disparities in care provided to mothers and children and makes helpful recommendations, including: single embryo transfers, counseling from a multi-disciplinary team, informed consent prior to treatment, and access to comprehensive obstetric care during and after treatment.
Read the full document >
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.
Others members of the 1000+ strong We Are Egg Donors network have also shared their stories. In a candid photo essay, Christine, a first time egg donor, walks us through every step of her egg retrieval journey. In an interview describing efforts to access her medical records from the clinic, Rae cautions that egg providers may not be protected by HIPAA (the United States legislation that provides data privacy and security provisions for safeguarding medical information). Lauren shares their experience of stigma, as a queer egg provider navigating a heteronormative medical space, while Carter shares her own as an egg provider within and for someone in her family.
We Are Egg Donors invites other egg providers to share their stories and welcomes them into the network.
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 provides a comparison between the experience of an egg provider who did not suffer any complications as a result of the process with another woman who was diagnosed with stage 4 metastatic breast cancer after 10 rounds of egg retrieval.
It includes interviews with noted experts, including Timothy R. B. Johnson, 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 a voluntary database called the Infertility Family Research Registry.
Read the full article >
Perinatal Risks Associated with Assisted Reproductive Technology
The American College of Obstetricians and Gynecologists | Committee Opinion Number 671 | September 2016
Perinatal risks that may be associated with assisted reproductive technology (ART) and ovulation induction include multifetal gestations, prematurity, low birth weight, small for gestational age, perinatal mortality, cesarean delivery, placenta previa, abruptio placentae, preeclampsia, and birth defects. Although these risks are much higher in multifetal gestations, even singletons achieved with ART and ovulation induction may be at higher risk than singletons from naturally occurring pregnancies.
ACOG’s report recognizes the importance of ARTs for infertile couples but, in the spirit of informed consent, it provides a comprehensive outline of related perinatal risks.
To promote optimal outcomes, ACOG suggests that patients receive counseling and a thorough medical evaluation; and that obstetrician–gynecologists and other health care providers address maternal health problems or health conditions before initiating treatment and, when proceeding, make every appropriate effort to achieve a singleton gestation.
Read the full report >
More ART than Science
Reproductive Health Technologies Project | 2016
This report provides an overview of recent scientific literature on the long-term health effects of ovarian stimulation and egg retrieval, a specific component of ART used during in vitro fertilization (IVF), egg donation, and egg freezing. It is not a complete literature review but, as described, “an overall assessment of what is and what is not currently known, followed by recommendations for how to improve the information available about this aspect of reproductive health care.”
This paper builds on work the Reproductive Health Technologies Project began in 2003, when the organization convened leaders from reproductive health, rights, and justice organizations and women’s health advocacy organizations to consider issues related to ARTs and emerging technologies.
Shortly after that convening, RHTP produced a white paper about ovarian stimulation and egg retrieval. This report provides an update to reflect the additional knowledge gained from the research that has taken place since RHTP’s earlier exploration of the field.
Read the full report >
A Call for Protecting the Health of Women Who Donate Their Eggs
By Judy Norsigian and Timothy R.B. Johnson, M.D | WBUR Boston | March 28, 2016
This opinion piece, published on WBUR’s CommonHealth Blog, outlines the authors’ key concerns related to egg retrieval, both for infertility treatment and research.
It includes a call for action – to gather better data on the risks – and provides additional resources for readers interested in learning about the issues and joining the efforts of organizations working on behalf of egg providers. This includes the Dartmouth, N.H.-based Infertility Family Research Registry, which is a voluntary registry set up to understand the health and well being of individuals and families created by ARTs and We Are Egg Donors, which provides a space for egg providers to talk about – and build community around – their experiences with egg retrieval.
Read the full commentary >
Timothy R.B. Johnson, M.D., is chair of obstetrics and gynecology at the University of Michigan, Ann Arbor. Judy Norsigian is co-founder and past executive director of Our Bodies Ourselves.
The Politics of Women’s Eggs
By Diane Tober | Undark | June 10, 2016
A curious battle is being waged over women’s bodies in the state of California. It’s not, as one might expect, the ongoing fight over women’s rights to abortion, which I fully support. Rather, the dispute involves a woman’s right to donate her eggs for use in scientific research — and to be compensated for it.
In this essay, Diane Tober, a medical anthropologist, documentary filmmaker, and assistant professor at the University of California’s Institute for Health and Aging, discusses the implications of egg retrieval (for infertility treatment and research) on the health of egg providers, and plots a timeline for pending legislation in California.
She concludes with recommendations to reduce health risks and track long-term safety data. Read the full essay >
Plus: Learn more about Tober’s documentary “The Perfect Donor.” This film is the culmination of Tober’s conversations with women on, among other things, their health after egg retrieval and their experiences with medical providers during the process. From the film’s website:
The Perfect Donor intends to provide information to all the players in the world of egg donation–the donors, physicians, agents, intended parents, and others–so that those women who do decide to provide eggs to help another person create a family receive the best of care and have their voices heard. By hearing other women’s stories, both good and bad, this film will provide more information to women considering egg donation before deciding to proceed. It will also help fertility practitioners take steps to increase safety and informed consent for egg providers, and educate intended parents on what to look out for when pursuing egg donation to complete their families.
Should Young Women Sell Their Eggs?
By Donna De La Cruz | The New York Times | Oct. 20, 2016
Part of a series to help readers “navigate life’s opportunities and challenges,” this article starts with a reference to Justin Griffin and her experience as an egg provider. It provides information on the health risks and links to a number of other useful resources – including the New York State Department of Health website, which covers the egg retrieval process and outcomes in detail, and community based group We Are Egg Donors, which provides spaces for egg providers to connect and act around their experiences.
Read the full article >
An additional resource is the Dartmouth, N.H.-based Infertility Family Research Registry. This is a voluntary registry set up to understand the health and well being of individuals and families created by ARTs – and all egg providers are invited to participate.