retrieval surgery. Finally, Dr. Cataldo said, since the data involve mainly women who have had fertility problems, it can be expected that the rate of infection among egg donors will be lower than has been seen in the published studies. All of this implies that there is little potential risk of future fertility being threatened in egg donors by infection or bleeding accompanying the retrieval surgery.

The second potential pathway to fertility risk begins with the trauma applied to the ovary by having a needle thrust through its surface. It has been suggested that this trauma could lead to the development of anti-ovary antibodies, and, indeed, several studies have found that women who have undergone oocyte retrievals have a greater prevalence of antibodies to ovarian tissue than those who have not undergone the surgery.

Furthermore, antibodies to ovarian antigens have been shown to be associated with IVF failures and with women having multiple attempts at IVF—a situation that, again, implies that they have had previous failures. It is possible, Dr. Cataldo said, that somehow these antibodies may interfere with sperm binding with or penetrating the oocyte and thus make it harder to fertilize the egg, but there is no evidence that this actually happens. It is difficult to know whether antibodies formed in one IVF cycle have anything to do with the failure of subsequent IVF attempts, or even if the antibodies play any role at all in infertility.

“So both of these potential avenues for risk related to oocyte retrieval have question marks associated with every step of the way,” Dr. Cataldo concluded. And whatever risk there may be for women undergoing IVF, the risk would be expected to be somewhat lower in healthy women donating eggs for research.

SUMMARY: WHAT WE KNOW ABOUT THE RISKS OF EGG RETRIEVAL

Once hormone treatment has led the ovaries to create a large number of antral follicles ready to ovulate, a surgeon must retrieve the eggs from the follicles by putting a needle through the wall of the vagina into the ovary and using the needle to aspirate the individual follicles. This surgery must be done with anesthesia, and there are a number of health risks that accompany the surgery and the anesthesia.

The statistics on egg retrieval surgery indicate that the risks of complication are relatively low. One study of several hundred thousand surgeries found, for example, that vaginal bleeding occurred in 0.07 percent



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement