Ms. Wing’s cancer might have been completely unrelated to her egg donations. But provided that Ms. Wing had been a health-conscious younger lady with no household historical past of colon most cancers or genes related to this illness, Dr. Schneider questioned if the in depth hormone remedies her daughter had undergone may need stimulated progress of the most cancers and if different egg donors may additionally be in danger.
Alas, she quickly found, it was inconceivable to know as a result of nobody was retaining monitor of the medical or psychological destiny of egg donors. Once donors stroll out the door, they’re primarily misplaced to medical historical past.
Dr. Schneider started vigorously advocating for institution of an egg donor registry that would profit not solely the hundreds of wholesome younger women whose eggs assist others get pregnant, but in addition the growing number of women who need to postpone pregnancy and select to have their eggs frozen for future use.
But 14 years after her daughter’s demise, there’s nonetheless nobody monitoring the destiny of egg donors. The Centers for Disease Control and Prevention collects info on in vitro fertilization, however not on those that donate their eggs both anonymously or to relations or pals unable to get pregnant with their very own eggs.
There aren’t even dependable knowledge on the variety of egg donors. The greatest statistic I might discover was the number of donor eggs that were used for in vitro fertilization, which elevated to 18,306 in 2010 from 10,801 in 2000.
Fertility clinics and egg-donor businesses promote broadly, particularly on school campuses and even on New York subways, for donors, who’re sometimes paid $5,000 to $10,000 for every donation, much more if the lady satisfies a fertility shopper’s specs. One lady wrote in The Atlantic that she had responded to a suggestion for $25,000 in The Yale Daily News for “a young woman over five feet five, of Jewish heritage, athletic, with a combined SAT score of 1500, and attractive.”
Donor eggs are sometimes used for women in search of being pregnant who might have undergone early menopause, have poor egg high quality, a historical past of genetic illness, a hormonal imbalance, ovaries that fail to reply to stimulation, or are over the age of 40.
“Egg donors are just not on anyone’s radar,” Dr. Schneider, who lives in Tucson and is licensed in inner drugs, habit drugs and ache administration, stated in an interview. “It’s not the same as sperm donation, which doesn’t involve hormone injections or any invasive treatments. In my opinion, egg donors need to be treated like all other organ donors — their health should be monitored.”
What we’ve now are solely anecdotal reviews of women who served as egg donors and later developed most cancers. For instance, 5 years earlier than Ms. Wing’s premature demise, two docs at a London fertility clinic described within the journal Human Reproduction the “tragic case of a young woman who died of cancer of the colon after successfully donating eggs to her younger sister.” They famous that long-term safety concerns about egg donation had been raised within the British Medical Journal (now BMJ) in 1989, given the excessive ranges of hormones administered to donors.
The London docs, Okay.Okay. Ahuja and E.G. Simons of Cromwell Hospital, referred to as upon the British Human Fertilization and Embryology Authority “to confirm that ovarian stimulation in volunteer egg donors does not increase the risk of cancer over and above the background rate.” But this has but to be carried out.
Earlier this yr, in Reproductive Biomedicine Online, Dr. Schneider and two co-authors reported on five cases of breast cancer amongst egg donors, 4 of them women of their 30s and all 5 of whom had no obvious genetic danger for the illness. None of the women had been given any details about long-term dangers of egg donation, as a result of no such info exists.
The authors identified that single instances don’t set up whether or not hormone stimulation of egg donors will increase the danger of varied cancers, and reiterated Dr. Schneider’s earlier pleas for “the necessity to create egg donor registries that may facilitate long-term research on egg donors.”
Similar dangers may additionally exist for women who’re in a position to provide their very own eggs for in vitro fertilization, or I.V.F. They bear the identical hormone remedies as egg donors. However, these women, who’re sometimes older and should have endocrine or different abnormalities, aren’t a dependable group for figuring out long-term dangers for younger, wholesome egg donors.
Dr. Schneider and co-authors expressed concern as properly about one other group of women: these whose eggs are harvested and preserved for their very own future use. They bear the identical hormone remedies, maybe greater than as soon as if not sufficient wholesome eggs are obtained on a primary try. If profitable, egg freezing can allow women to delay being pregnant and stay within the work pressure till properly past regular childbearing years.
Some corporations, together with Apple, Facebook, Google, Intel and Microsoft, now cover the cost of fertility treatments, in some instances together with egg freezing, which may value about $10,000 plus $500 to $1,000 a yr for storage. Facebook, for instance, is claimed to supply a $20,000 egg-freezing benefit for women staff.
But till extra is understood, Dr. Schneider has written, “All women who undergo ovarian stimulation, especially more than once, should be told that their long-term health risks are unknown.”