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When Headlines Lie

eggploitation2 [1]We all know headlines are meant to sell news, so we are right to read articles through a discerning lens and even some healthy skepticism. We are also wise to consider the source. Is this a trusted reporter? Is this a reliable journal, paper, or author?

You can imagine my sense of outrage when last year both industry leaders [2] and the national news [3] began proclaiming headlines such as “Study: Egg Donors Remain Fertile After Procedure;” “Donating Eggs Does Not Hurt a Woman’s Future Fertility, Study Says;” and “Egg Donors Don’t Hurt Chances of Later Pregnancy, Study Finds.” [4]

Now another study has come out with this big headline [5]: “Multiple Egg Donations May Not Affect a Woman’s Future Fertility.”

Sadly, these headlines are far from the truth. They obscure reality and advance a false sense of security—Great news! I can sell my eggs and it won’t impact my ability to have a baby later.

The fact that these new studies are touted with such bold but fallacious claims really heightened my concern for women who would read the articles, believe what was being reported, and risk jeopardizing their short- and long-term health.

Perhaps most egregious is the fact that these studies are being advanced by industry stakeholders who have much to lose if women thought they were going to be harmed by selling their eggs. What is at stake? Precious eggs that translate into profits . . . huge profits.

I have read both of the studies and have them, if anyone is interested in reading them for themselves. It’s not just the headlines that are misleading. Both studies are flawed for reasons that may not be evident at first.

The first study was conducted as a phone survey. That alone should be a red flag. Calling people at home and asking them personal questions about something they did several years ago is problematic. In addition, the fact that this phone call comes from a stranger doesn’t lend itself to disclosing intimate details about selling your eggs nor about whether you’ve been able to go on with your life and conceive a child.

The study states that they identified 307 women, were able to contact 205, and 194 gave consent to participate. But in the results they report on only “sixty past oocyte donors” with no mention of what became of the other 134 egg donors who agreed to participate in the study. What happened to them?

Of the 60 women reported on, “at the time of the survey, 47 of these women had given birth and another seven had an ongoing pregnancy. The remaining six women reported an as yet unfulfilled desire of less than 12 months for a child.” In addition, there is no mention of the health of the children born after the women were egg donors or if the women had complications with their pregnancies or difficulties getting pregnant.

307 women identified, 205 contacted, 194 consented to participate in the study, and 60 donors (accounting for 47 births and 7 pregnancies) somehow makes for headlines claiming that donating your eggs has no negative effect on your future fertility? I don’t think so.

The latest study, just released by the American Society of Reproductive Medicine (ASRM) was only a paper presentation. It too is a very weak study. They specifically selected donors who had completed five or more donation cycles. This shows a selection bias for patients who could complete multiple donations rather than including those with fewer donations, those who had complications, or those who were unsuccessful in completing a donation. In addition, the study was limited to their own institution. This again demonstrates a selection bias, excluding a much broader and diverse sample.

The Journal of the American Medical Association (JAMA) just published online on October 17, 2013, a report [6] on the “Trends and Outcomes for Donor Oocyte Cycles in the United States, 2000-20120.” The report suggests a significant increase in the annual number of egg donor cycles completed. But what is most telling, in the same publication, is that the journal’s editorial piece states:

Although the results reported by Kawwass et al provide useful information on infertile couples and clinicians and suggest several productive areas for future research, the current NASS data regarding outcomes of donor oocyte cycles have an important limitation—no data on health outcomes in donors. Donors are at risk for all of the complications associated with ovulation induction, including the potentially life-threatening ovarian hyperstimulation syndrome. In addition, there is uncertainty about longer-term issues such as effects on the donor’s own fertility or the need to inform recipients about the discovery of health issues not known at the time of donation. Current evidence on donor outcomes is limited to single centers or to small samples susceptible to selection bias.

Given the promising data presented by Kawwass et al on perinatal outcomes after use of donor oocytes, the use of oocyte donors is likely to at least remain constant and may even increase. More complete data on both the short- and long-term outcomes of donation are needed so donors can make truly informed choices and, once the data are available, mechanisms can be put in place to ensure the donor recruitment and consent process at clinics is conducted according to the highest ethical standards (emphasis added).

Of the many egg donors I have interviewed, some have had difficulty conceiving and others have lost their ability to conceive. Several have come close to death.

Both the headlines and the claims of flawed studies such as these are a great disservice to women contemplating donating or selling their eggs.

Caveat Vendor!

Reprinted with permission from the Center for Bioethics and Culture [7].