Two-thirds of women who donated eggs to fertility clinics reported satisfaction with the process, but 16 percent complained of subsequent physical symptoms and 20 percent reported lasting psychological effects, according to the first study to examine the long-term effects of donation.
The research by scientists at the University of Washington included women who donated eggs at clinics in 20 states and is the largest study to explore the effects of donation in the United States, where the practice is not regulated.
"We don't know how many egg donors there are because no official records are kept and reporting is on a voluntary basis to the Centers for Disease Control and Prevention," said Nancy Kenney, UW associate professor of psychology and women studies and lead author of the study.
The researchers were surprised at the low number of women who reported an awareness of possible physical risk prior to donation. Nearly 63 percent viewed the potential physical risk as minor and 20 percent did not recall being made aware of physical risks at the time of their first donation.
"Many of these women may be forgetting that they were warned of the lesser risks, such as bloating and the discomfort from hormone injections," said Kenney. "It has been quite a while since they read the material handed out by clinics or heard the risk lecture and it could be that they simple forgot. The age of the women also could be a factor. Risks don't mean much to young women. They may be discounting the risk. If you are 25 and are told that something may cause cancer when you are 45 that may seem to be forever."
Of those women who reported physical problems in the donation process, bloating, pain and cramping, ovarian hyperstimulation, mood changes and irritability, and weight gain or loss were the most common complaints. Several women claimed infertility or decreased fertility or damage to their ovaries.
However, most of the women – 73 percent – however, reported being aware of some of psychological risks associated with egg donation prior to donating. These included the chance they might develop concern for or attachment to their eggs or to a potential or resulting offspring, concern that the donor or resulting child might want a future relationship with them, the possibility of having a genetic child in the world or the stress resulting from the donation process.
The women were split in their reasons for donating eggs. Nearly one-third (32 percent) said their motivations were completely based on helping others while almost 19 percent said financial concerns were their sole reason. The remainder cited a combination of altruistic and monetary factors for donation.
The research drew on the experiences of 80 women who donated eggs for the first time at least two years before filling out an 84-item questionnaire. Respondents donated eggs for the first time two to 15 years before completing the questionnaire and were an average of 30.6 years old when surveyed.
The study also found that:
- The average payment was $3,965, with fees ranging from $1,104 to $7,313. (The most recent first donation year was 2002 and payments were converted to 2002 dollars).
- Donors who said money was a very significant factor in donation received higher payments on average ($4,453) compared to those who said money was not important ($3,413).
- Seventy percent of the women donated eggs more than once. Most repeat donors underwent the procedure two or three times. One woman donated eggs on nine occasions.
- Forty-five percent of the women were students when they first donated.
- Ninety-four percent of the students said financial compensation was a significant factor in deciding to donate compared to 57 percent of the women who were not students.
- Most of the donations took place in California (23), Massachusetts (7), New York (7), Washington (7) and New Jersey (7).
Kenney said a higher percentage of women who cited altruistic reasons as their primary motivation (84 percent) reported feeling happy about their donation experiences than did the women whose decisions were mainly financial (61 percent).
"We were asking these women years later and a feeling of helping may last longer than money," she said. "We know if clinics don't offer money most women won't donate. Great Britain, where there is no paid egg donation program, for example, has a tremendous shortage of donors. But, as one of our donors said, 'if you do this just for money, you'll be sorry.'"
Kenney noted that a number of women offered suggestions to improve the donation process and complained about unequal treatment from clinics.
"Some women talked about how they were treated like delivery suppliers. Some clinics had separate entrances at the rear for donors and poorer waiting room facilities than for egg recipients. Some said they were handed a check at the end of he procedure and told 'see you around.' Others complained that they were offered limited extra health insurance for only a very limited time after a serious procedure," she said.
The study is in the current issue of the journal Fertility and Sterility and was funded by the UW's Royalty Research Fund. Co-author of the study is Michelle McGowan, who earned her doctorate at UW and is now a post-doctoral researcher in bioethics at Case Western Reserve University.
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