low. We inferred from that, therefore, that the likelihood that there should be problems with fertility is low, but we don’t really know that. We don’t really have data to tell us, if these individuals who donated their eggs were followed, how their fertility would compare with a matched control group.
“We also know a lot about the biology of follicle selection,” he continued, “and we know about the physiology of administering exogenous gonadotropins and the fact that, in repeated stimulation cycles, there does not appear to be a reduction in the number of eggs that are produced. And we might infer from that, therefore, that fertility may not be compromised in the future, but we don’t really know that. We don’t have data on individuals—healthy research subjects—who have undergone repeated stimulation cycles, and we don’t have any data on what the future fertility of these individuals might be.”
Similarly, he said, based on what is known about the biology of follicles over time, we do not think that even repeated donations will cause a woman to have an earlier menopause, but again there are no data that tell us that for sure. We don’t really know that.
The only way to completely resolve these issues, Dr. Guzick said, is to follow a cohort of oocyte donors and observe what happens to them over time—to monitor their fertility over the years and compare it with a control population that did not donate their eggs. “And I think until we know that, we won’t truly be reassured about future fertility,” he said.
More generally, Dr. Giudice said, it is important to accumulate health data over the years for all women whose eggs are harvested for various purposes and to monitor them for long-term effects. “Almost every speaker addressed the issue of some type of database,” she observed.
With more data—and more complete data—it will be possible to quantify the various potential risks of oocyte donation much better than can be done today and therefore to put numbers to the various potential risks that a potential donor faces. Doctors and medical researchers should be able to offer concrete answers to some questions: Does ovarian stimulation increase a woman’s lifetime risk of uterine cancer? What effect does a history of pelvic inflammatory disease have on a woman’s risk factors for retrieval surgery? A more complete database will also allow researchers to tease out the answers to other questions: What effect does having had children have on the risks of oocyte donation? Is there any reason to prefer one age range over another among women who are donating oocytes for research purposes? These are the sorts of questions