by Diane Tober / Associate Executive Director, Center for Genetics & Society
ABC World News joined other media this week in addressing the astonishing 74 percent rise over the past 10 years in young women providing their eggs so that other women can create families.
Correspondent Cynthia McFadden interviews egg “donors” and fertility practitioners to explore the risks of egg retrieval, and chats with anchor Diane Sawyer about the story. While the segment lets several misleading statements stand, it gets some important things right.
First, the report is clear about the point that young women, primarily college students, are recruited to become egg providers with offers of thousands of dollars (yet use of the term “egg donor” for what is a commercial transaction is misleading). Women who are considered better-looking are typically paid more, as are white and Asian women, and those who have higher SAT scores and/or athletic skills. More money also goes to “proven donors” — women whose eggs have been used by “intended parents” to achieve a successful pregnancy.
The story also correctly reports — and expresses appropriate surprise about — the lack of short- or long-term tracking of egg providers’ health and the fact that there is no national database for egg providers. As Dr. Jennifer Schneider points out in the segment, egg providers are “not considered patients — they’re considered more like vendors.” They essentially disappear as soon as the procedure is done.
Now let’s turn to the inaccuracies in the ABC World News story.
McFadden interviews Dr. Joel Batzofin, a reproductive endocrinologist, who states that although “nothing is risk free,” egg extraction is “essentially risk free.” He describes the short-term complication known as ovarian hyperstimulation syndrome or OHSS as “extremely rare” and says it occurs in less than 1 percent of cases.
Unfortunately, his claim remains unchallenged in the segment, despite emerging evidence that OHSS occurs much more frequently than that. One prospective study analyzed OHSS rates in 339 women who produced more than 20 ovarian follicles. 49 (14 percent) were hospitalized due to OHSS, 13 (3.8 percent) needed intravenous fluids, and 9 (2.7 percent) needed to have fluid drained from their abdomens.
Egg providers are commonly stimulated to produce more than 20 follicles, and therefore appear to be at much higher risk for OHSS than is currently being reported. A recent study in the Journal of the American Medical Association found that more than 21 eggs were retrieved in 40.3 percent of the retrieval cycles performed on “oocyte donors.”
Furthermore, preliminary collaborative research on egg provider experiences by CGS and We Are Egg Donors has found numerous cases of women experiencing OHSS to the point where they are bedridden for a week or more. Even though doctors and clinicians assure egg providers that OHSS is “rare,” no one is surprised when it occurs.
When donors are in pain and bloated to the point where they look six months pregnant — after their eggs have been retrieved — they are told that this is “normal,” and to rest and drink plenty of fluids. These cases are not even diagnosed as OHSS, let alone reported or tracked, so there is no data to substantiate that it only occurs in 1 percent of cases.
The ABC World News segment is equivocal in its discussion of links between egg retrieval and cancer. McFadden reports that “there are no known long-term medical issues for donors,” but goes on immediately to say that this is “a world of difference from saying [that there are] no long-term issues.”
In fact, some data does suggest that the synthetic hormones used in egg retrieval may increase risk of colon, ovarian, uterine and breast cancers, though it is difficult to prove the connection due to the delayed onset of cancers in former egg providers and infertility patients.
One Dutch study published in Human Reproduction by Dr. Flora van Leeuwen followed over 19,000 women for 15 years and found that those who had undergone at least one IVF cycle were approximately twice as likely to suffer ovarian malignancies as women who had not undergone IVF treatment.
So how does the ABC World News report rate overall? We recognize that it is not possible in a three-minute segment to cover the entire gamut of egg retrieval risks and experiences but would have liked to hear a mention of the side effects of Lupron (which is used off-label and has been known to cause strokes and a variety of dangerous side effects) and Clomid (which has been linked to increased cancer risk in women who don’t go on to become pregnant).
We would also have liked to see correspondent McFadden question the claims made by Dr. Batzofin, and point out that he and others in the infertility industry stand to profit from taking eggs from young women.
At the same time, we applaud ABC World News for its clear and explicit call for follow-up studies of egg providers and for a national database to track their short- and long-term health.
Plus: Raquel Cool, co-founder of We Are Egg Donors, explains the need for a group that supports women considering or who have provided eggs for fertility purposes. Also check out this petition (started by OBOS, the Center for Genetics and Society, and other organizations), which calls for a human egg extraction health registry and for warnings on ads and notices seeking egg donors. And read one young woman’s experience as she contemplates donating her eggs.