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Assessing the Medical Risks of Human Oocyte Donation for Stem Cell Research: Workshop Report
nation for research. For one thing, Dr. 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.
In addition, the available data come primarily from Caucasian women in middle to upper socioeconomic groups, because they are the women most likely to be able to pay for IVF on their own. Since fertility treatment is generally not covered, or not covered fully, by medical insurance, women in lower economic brackets are less often able to afford such treatments and so make up a relatively small percentage of women in IVF programs. But the pool of research donors is likely to be significantly broader than just Caucasian women in middle to upper socioeconomic groups, and it is difficult to infer just what potential risks these research donors may face when the only available data are from a collection of women who differ from them in age, race, and socioeconomic status.
One other complicating factor is that the potential risks from hormone therapy, from surgery, and from anesthesia seem to have been changing over the past 20 years. “Many of these risks,” Dr. Giudice said, “seem to have been greater early in the process of in vitro fertilization than they are currently.” The reason would seem to lie in the increasing experience that reproductive specialists have been accumulating, she said. By doing procedures over and over again, doctors hone their skills and learn to avoid certain mistakes, leading to a decline in potential risk. This decline is good news, of course, but it adds to the uncertainty about exactly what potential risks egg donors face now.
The bottom line is that there is a great deal of uncertainty about the potential risks of oocyte donation for research. David Guzick, dean of the University of Rochester School of Medicine and Dentistry, made this point when discussing the future fertility of egg donors:
“What we know about future fertility in connection with oocyte donation is really only by inference,” he said. “What were presented [at the workshop] were data on general IVF patients and a much smaller amount of data on donors. We learned that the incidence of infection, the incidence of adhesions, and the incidence of general surgical problems is