Can egg donation cause cancer?

Hi. I’m “Miranda.”

I received an email from a fertility clinic that I felt compelled to share with fellow egg donors.

This is my story.

As I considered donating eggs two years ago, the doctor explained that the medical risks of egg donation are minimal. There is no medical evidence of any long-term health risks. He specifically stated that IVF and egg donation do not increase an egg donor’s risk for ovarian cancer, breast cancer, or infertility. Satisfied, I signed the “informed” consent form.

Seven weeks later, he plucked two dozen eggs out of my ovaries. The process was smooth and easy; $7,200 richer, I went out for dinner after the retrieval to celebrate the successful cycle, and I was back to work the next day.

Recently, I decided to donate again. But this time, I was turned down.

Here’s what happened.

I applied at a nearby fertility center, reporting again on my application that my mother had breast cancer in her 40s. (She’s fine now.) I received the following response:

Rejection Email from Fertility Clinic:

Thank you for completing the application and the forthrightness with which you supplied your answers. We also appreciate your desire to help other people in the quest to have a child. However, after conferring with colleagues and due to the standards that are set by the American Society of Reproductive Medicine and the recipients with whom we are working, we must decline your offer to participate in our program. The specific reason is listed below.

Your family history of premenopausal breast cancer. While we noticed you have done a donation cycle before, there is new research surfacing in the medical field indicating that exposure to increased levels of estrogen through the donation process could potentially put you at a greater risk for breast cancer when there is a close family history of premenopausal breast cancer.

Please be assured that aside from these requirements, we would have liked to work with you.

Concerned, I asked where I could read more about the “surfacing research.” I received the following response:

Unfortunately, we weren’t given any specific citations regarding the research. It was simply a protocol placed by our medical director. I do know it’s fairly recent research.

This is a remarkable statement for a clinic to make to an applicant. Fertility doctors have assured donors for years that egg donation will not ‘give you cancer’ or even increase your risk. Of course, the vast majority of egg donors do not have a family history of premenopausal breast cancer. But we must ask, what other risks will surface in the future?

I appreciate being informed of the reason for my rejection, because most centers will not give rejected applicants anything but the vaguest of explanations (“many factors are taken into consideration…”). Interesting, though, that “standards that are set by… the recipients with whom we are working” is one factor. I think that is a polite way of saying “Recipients don’t want your potentially carcinogenic genes in their babies.”

The rejected application was for an egg ‘bank,’ a program in which they harvest and freeze unfertilized eggs with the expectation that intended parents will purchase my eggs at some point in the future. It is a financial investment for the clinic.

My first donation was traditional type in which my profile sat in an agency database until intended parent(s) chose to accept the breast cancer history and work with me. It took 11 months to be matched, but something about my profile made this family willing to accept the blemish of breast cancer.

Now I wonder whether my previous agency was aware of this “surfacing research” but was willing to put me in their database nonetheless because they have nothing to lose if no one chooses me.

There is some long-term research on infertile women who undergo IVF to have children. Most of the research finds the procedure basically safe (example). There is zero longitudinal research on health outcomes among donors. I want young women considering egg donation to understand that research on IVF among infertile women is not necessarily applicable to donors. On one hand, our bodies are presumably healthier – infertility itself raises the risk of certain cancers.

On the other hand, based upon my communication with fellow donors through We are Egg Donors, I feel certain that many fertility doctors are deliberately pushing our bodies harder than those of their “real,” paying patients.

Most donors are not informed and empowered enough to even ask about their E2 levels or follicles during a cycle; those who express concern to their doctor when their hormone levels are spiraling above recommended levels have been reminded that their compensation is contingent upon following instructions.

Ten to fifteen eggs is a solid number for a single retrieval for an IVF patient.

But many women in our group have had WELL over fifteen eggs retrieved in a single cycle.

Does the research on cancer risk among infertile women apply to the donor who was blasted with so much follicle stimulating hormone that she produced 50 eggs for an egg bank?

We don’t know.

But we’re asking.

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Photo credit: Flickr Creative Commons

Author credit: “Miranda” (Name changed)