Oocyte Donation
What are some of the health risks of in vitro fertilization?
In vitro fertilization is inherently unnatural. It is not natural to have the ovary produce many eggs, and it is not natural to have those eggs be fertilised in the laboratory and for the embryos to be put back. We are naturally concerned, both about whether there are going to be side effects to the women that are taking the fertility medications, as well as potentially to the babies that are born as a result of the fertility technologies. Lots of research has been done into this area. So far, we are very fortunate to be able to say that the risks to the health of the women seem to be minimal, if any. There of course is a risk to any kind of surgical procedure, and poking someone's body with a needle always risks the introduction of infection, or potentially the cause of some bleeding on the side of the needle poke. Complications are relatively rare. So far, there does not appear to be any permanent damage with the use of the fertility medications; there was a series of publications that tried to tie the fertility drugs in with the incidence of ovarian cancer, but those have essentially been disproved by subsequent studies, so that appears not to be a problem. So far, so good. As far as the babies are concerned, there appears to be an association between the use of fertility treatment and certain kinds of abnormalities or certain kinds of developmental abnormalities, but it's not clear whether it's the fertility treatment or the infertility itself, and it's also not clear as to whether this is a serious problem or a minor problem because the babies that are born from infertility are much more likely to be scrutinised than babies that are born after natural conception. The jury's out still on whether we are or are not going to have problems, or an increased risk of problems, in babies born after fertility treatment, but as far as safety to the women that are taking fertility medications and going through the egg retrievals, so far, we cannot identify any specific problems. That's the good news.
What is "oocyte" or "egg donation"?
Egg donation is a treatment which is offered to women who either do not have their own eggs or whose eggs are now not working well enough to produce embryos that are likely to implant. In this case, we use the term "oocyte donation" instead of "egg donation" because it's a fancier term, but, really, it means the same thing; oocyte is just "egg" in Latin. This therapy has been a tremendous help to us for women who are at the upper extreme of age in their mid-forties or late-forties, or even in some cases early ffities, who really would have had no other opportunity to become pregnant. Egg donation may also be applied to young women who have lost their ovaries either because of surgical intervention or because of cancer treatment, or perhaps because they have premature ovarian failure, for whom, ironically, egg donation was first designed. Nowdays, they represent a relatively smaller proportion of the population that is undergoing egg donation and the majority of women having egg donation are those who simply are now in their late forties or early fifties and need egg donation in order to become pregnant.
How do I get donor eggs for in vitro fertilization?
Women who need donor eggs have to find an egg donor. And there's any number of ways of going about this. When we first started doing egg donation, our donation program was entirely non-anonymous. In other words, the egg donors always met the recipients. About half the donors were sisters at that time. The recipients were women with premature ovarian failure, and so they were young, their sisters were young, and it was fairly simple to get their sisters, then, to donate the egg. I still like this as a method. I think it's wonderful to have donation within the family because of course the family tree and the family heritage is maintained that way, never mind that it's cheaper. However, if a woman in her late forties wants to use a donor egg, her sister is very likely to be similar in age to the recipient and therefore also in her forties, and those women do not make very good egg donors even if they are not yet menopausal. And so they very commonly end up having to use an anonymous egg donor, commonly obtained through an egg donor registry, or some donation program where these women register and then go through the ovarian stimulation and the egg retrieval in exchange for some financial payment. The third way to get an egg donor besides using a family member or an anonymous egg donor is to use a friend who may be able to donate. And this, I think, is also a very nice way of going about it. It's cheaper, you know who that person is, you know what to expect from them, and you have some kind of a personal sense of their family heritage which is not quite as easy to obtain in an anonymous egg donor who comes from a registry, although that, of course, is the majority of the egg donation that's being done in this country and the world as in general.
What are the legal rights of egg donors and their recipients?
Egg donation is, as yet, unproven in the courts. In other words, there have not really been enough lawsuits brought forward for there to be a well established case law for egg donors. In general, we anticipate that egg donors are going to follow the same rules as those that were established for sperm donors in the past. There is enough case law to be able to speak about sperm donors. In general, the courts have protected the anonymity of egg donors in the past and we anticipate that the same will be true going forward. Having said that, there are now, of course, Internet groups that are getting together in order to find out half siblings of couples that have used a particular sperm donor or perhaps an egg donor, so that these half siblings can get together. In some cases, egg donors and the children are meeting up on the Internet in order to share stories and get to know one another. It's not clear what's going to happen to the legal protection of egg donors and recipients in an era when actually this kind of openness exists.
