Diane Beeson and Abby Lippman, based at California State University and McGill University, Montreal respectively, report on medical risks and ethical problems associated with collection of human oocytes (eggs) during IVF practice from donors who give them to other women who desperately want a child. Doubts are emerging about donating oocytes in this manner, even when recipients use them to establish a pregnancy. Their article Egg harvesting for stem cell research: medical risks and ethical problems is published in the journal Reproductive BioMedicine Online [www.rbmonline.com/Article/2503 – e-pub ahead of print 14 August 2006].
Widely practised in IVF, but not yet proven to be fully safe, various hormones are given to donors to stimulate several eggs to develop. Using ultrasound, ripe oocytes are then aspirated from within their follicles. The oocytes are often donated free, although the HFEA has given permission for donors to receive some compensation via discounts for their own IVF treatment. In one case reported, the donor oocytes were needed for stem cell research, which makes ethicists even more furious about ‘selling’ human oocytes.
It is hard to separate ethically this decision from giving direct payments to donors, or from fertilizing the eggs and then giving them away for research. In all these examples, many donors might have suffered from mild symptoms of ovarian hyperstimulation, among other disorders, without their knowledge.
Recent research has stressed the risks of using hormonal stimulants to induce follicle growth and ovulation in women. Surprisingly, Beeson and Lippman claim that pharmaceutical companies have not been compelled to submit their information on the risks of such forms of ovulation induction to the US Food and Drug Administration. Claims are made of 25 deaths among donors, although this requires verification. Claims that cancers may be induced in some patients have been questioned or denied, although an increase arose in another study on >3500 women donors, and critics stress that many of these studies had short-term follow-ups in only a few women. These patients were among the first to attempt IVF, and their risks of tumours are now emerging and will be analysed in the near future.
IVF children have not yet displayed such anomalies, though significant abnormalities are reported in offspring of mice following similar treatments. These investigating authors nevertheless cited earlier reports on anomalies, including cancers, in offspring of women receiving exogenous hormones, perhaps due to the release of steroids. In view of all these known and unknown risks to women donors, these authors refer to organizations established to protect women undergoing IVF and other ovarian treatments. It is one thing, however, to raise a fuss about uncertain risks but quite another to gain hard data from the complex reports emerging in the world of assisted human conception.
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