of the women, intestinal injuries in 0.001 percent, and peritonitis in 0.005 percent. Only 0.002—or 2 in every 100,000—had complications that required surgery to correct.

Complications due to infection are rare as well. Although a 1993 study found 9 patients out of 1,000 had pelvic abscesses that needed to be treated, that seems to have been due to a failure to consistently use aseptic techniques. A later study in which aseptic techniques were used found no abscesses that required treatment.

Ovarian torsion is another rare complication in women undergoing IVF—about 0.13 percent of the time, according to one study. According to Dr. Cataldo, this complication seems mainly due to the softening of the ligaments that occurs during pregnancy. Dr. Rosenwaks added that it can also occur due to hyperstimulation, even in the absence of pregnancy.

Various factors increase the risk of complications from retrieval surgery, including previous surgeries, a history of pelvic inflammatory disease, endometriosis, and pelvic adhesions. All these factors are more likely to be found in women undergoing in vitro fertilization than in the general population, which implies that egg donors should have much lower surgical risks than women undergoing IVF.

Patients undergoing egg retrieval surgery generally rely on either intravenous anesthesia or intravenous conscious sedation. In general, anesthesia is safe, with deaths occurring only once every 200,000 to 300,000 cases. Because egg donors have few of the factors that increase the risks of anesthesia, including being male, being older, being obese, having inpatient rather than outpatient surgery, having surgery in an emergency setting, and having a high ASA classification, anesthesia should be even safer for egg donors than it is for surgical patients in general.

There are two main ways that surgery may affect a woman’s future fertility—either by bleeding and infection from the surgery leading to adhesions and the need for further surgeries, or else by the trauma to the ovaries causing the creation of antibodies that may make fertilization of an oocyte more difficult—but there is no data supporting either of these possibilities.



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