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Risks of egg collection must be kept in perspective

4 July 2005
By Dr Jess Buxton
genetics editor, BioNews and Laura Riley, director, Progress Educational Trust
Appeared in BioNews 315
In this week's BioNews, we report on the case of a woman set to receive damages after she had a stroke following IVF. The patient, left brain-damaged, had developed a rare side effect of fertility treatment called ovarian hyperstimulation syndrome (OHSS). In its most severe form, OHSS can be potentially fatal - earlier this year, it was reported that 33-year-old Temilola Akinbolagbe died from the condition. However, tragic though these two cases are, it is important to keep the risk of OHSS in context.

It is thought that fewer than five women have died from OHSS in the UK since IVF treatment began, in 1978. As Alison Murdoch, chair of the British Fertility Society points out, although OHSS can be serious it's important to keep the risk in perspective. Around 40,000 women each year receive drugs to stimulate the ovaries to produce more eggs than usual during IVF treatment. While there is a tiny risk of OHSS associated with taking these drugs, the vast majority of women do not develop the condition at all, and in those that do, the symptoms can be effectively treated. Professor Murdoch told BBC News Online that 'the risks of someone dying during a pregnancy are very much higher than the risks with IVF treatment'.

No medical procedure is without risk, and IVF is no exception. It is vital that patients receive full information on the risk of OHSS prior to treatment, including the symptoms to look out for. However, it is also important that this risk is not overblown. Such information should be made available by those who are solely concerned with IVF patients' welfare, rather than disseminated as part of any political axe-grinding.

Last week, a debate on the 'egg trade' in Europe, organised by pro-life pressure group Comment on Reproductive Ethics (Core), resulted in UK media coverage on the potential risks of egg donation (see Recommends) - including the risk of OHSS. It is alleged that women from poor European countries are being exploited and endangering their health, by offers of financial compensation in return for their eggs. In fact, an investigation by the Human Fertilisation and Embryology Authority (HFEA) found no evidence of wrong-doing at the one clinic in Romania about which concerns had been raised.

The issues surrounding the shortage of egg donors, and the relative merits of egg sharing and altruistic egg donation are ones that need to be debated. We also need a full debate on the supply of eggs for research, for which there is likely to be a growing demand. Payment for egg (and sperm) donors is one of the subjects of the HFEA's ongoing SEED (sperm, egg and embryo donation) review and the outcome of this, expected in a few months time, will undoubtedly add to the debate.

There are many groups with an interest in seeing a public debate on the future of egg donation, both for reproduction and for embryo and stem cell research. But in conducting this debate, it is vital that the risks of OHSS are not over-exaggerated. To do so is a disservice to the thousands of patients currently undergoing IVF treatment, the vast majority of whom will suffer no serious side effects.

SOURCES & REFERENCES
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