IVF Donor Eggs May Lead To Preeclampsia

A new study suggests that women who use donated eggs to get pregnant by in vitro fertilization (IVF) might be more at risk for a potentially dangerous complication than women who use traditional IVF methods.

Women who use IVF -- in which an egg is fertilized outside the body, then implanted into a woman’s uterus -- are already believed to be at an increased risk for preeclampsia -- a condition that occurs when a woman’s blood pressure rises during her second or third trimester and her kidneys fail to continue to retain protein.

Now, the study suggests that using donated eggs could possibly increase that risk even further. But doctors say more research is needed to confirm the findings.

Dr. Peter Klatsky, the lead author of the paper from Women and Infants Hospital in Providence, Rhode Island, said results from the study “should not be alarming or frightening.” Rather, the findings could help doctors understand what causes the condition and how to counsel patients who are at risk.

Preeclampsia is not a well-described condition, although being relatively common. About one in 20 pregnant women develop the condition, and the only cure is to give birth.

For those women who carry a baby to full term -- at least 37 weeks -- doctors can induce labor. In those who are in the earlier stages of pregnancy, doctors can only closely monitor the symptoms to make sure they do not progress.

Studies in the past have shown that women who use donor sperm and those who get pregnant with a new sexual partner have higher rates of preeclampsia than in other women. Those studies suggested that the condition could be related to the body’s immune response to cells it doesn’t recognize.

Klatsky and colleagues decided to start their own study to test if that pattern held true for eggs that the body would consider “foreign.”

The team of researchers compared 77 women who had given birth using donated eggs between 1998 and 2005 with 81 similar women who had gotten pregnant using IVF with their own eggs.

The researchers noted how many women in each group were diagnosed with either preeclampsia or pregnancy-related high blood pressure, as well as how many gave birth to their babies prematurely.

Their results show that about 5 percent of women who used their own eggs for IVF developed preeclampsia, compared to nearly 17 percent of women who used donor eggs. Women using donor eggs were also more likely to get high blood pressure without kidney problems and to deliver premature.

Their findings also showed that women who got pregnant using embryos that had been frozen and then thawed were more at risk for preeclampsia than women using fresh embryos. Klatsky said it’s a possible effect that is worth looking into with future studies.

Dr. Sacha Krieg, an obstetrician who studies infertility at the Kansas University Medical Center and was not involved with the study, agreed that doctors should counsel patients at increased risk for preeclampsia and monitor them more closely during pregnancy. But cautioned against trying to draw too much of a conclusion from a small study.

Krieg told Reuters Health she hopes that future studies will start with women who are just getting pregnant and track their health as they go through their pregnancy. While harder to conduct, such studies can often give researchers more accurate information.

However, both she and Klatsky hopes that the current study will give researchers more clues about how preeclampsia develops.

Having more information about the condition could help doctors “develop better treatments and better ways to prevent it, and better ways to counsel patients about their risks,” Klatsky told Reuters.

There are still signs that preeclampsia has something to do with the body’s immune response when it recognizes foreign cells. It would make sense, says Krieg. “We know that the immune response is important for both implantation and development of the fetus.”

Doctors need to learn more about how a fetus implants in the uterus, she added, because this is probably where the early stages of preeclampsia start, even if women do not show symptoms until much later.

Klatsky said the main message of the study is that doctors should be aware of possible risks to their patients, and most importantly that researchers should keep tracking the immune system response in pregnant women.

Results of the study are published in the journal Obstetrics & Gynecology.

Cyprus clinic at centre of human egg trafficking probe

Police are waiting for the green light from Ukrainian authorities in order to begin an investigation into claims of human eggs trafficking at a fertility clinic near the village of Zygi.
The clinic was run by a staff comprised mostly by Russians, with donors being mainly women from Eastern Europe.
Suspicion of illegal trade in human eggs came about after the testimonies of three Ukrainian women in their thirties, all of whom were working in Cyprus legally. According to police, these women sold their eggs illegally - in violation of Cypriot and European law which says that donors should only have their expenses covered.
Officially, the clinic is under investigation for failing to provide full data for the tracing of embryos and gametes. According to a police spokesperson, the clinic closed in May this year after an edict from the health ministry.
Health Ministry Inspector Pampos Charilaou said the clinic was forced to close as it failed to present an archive listing the origins of ovules, who owned them and the conditions under which they were kept.
“Without traceability of the ovules and sperm, I could not, as an inspector, give permission to this clinic to continue with the procedures they were implementing. You have to understand that we need that sort of detail in order to safeguard the safety and health of the recipients,” Charilaou said.
After the clinic closed, all of its biological material was transferred to the Health Ministry where it is now stored. “Although the law allows us to destroy the tissues and cells we have acquired from the clinic, we are storing them in good condition, but we don’t know where they come from, nor who owns them,” said Charilaou.
He also added that the Ministry’s Inspectors were only responsible for monitoring the traceability of ovules and gametes, and that issues regarding egg trafficking were a police concern.
A group of Italian patients of the clinic are demanding their embryos back so that they can continue with the fertilisation process in their own country. “I promised to my eight Cypriot embryos that have been confiscated that I will fight to the end,” said Maria, an Italian who came to Cyprus for treatment, speaking to French news agency AFP. She would not give her real name because of the investigation still in process, while she also condemned the Cypriot authorities for their “lack of control” in the case.
According to AFP, shortly after the clinic closed, the Italian and Israeli embassies – whose nationals made up many of the clinic’s patients – were flooded with calls from distressed couples who were worried about their embryos.
Many couples are working around restrictive laws on fertility treatment in their own countries by coming to Cyprus, a favoured destination for ‘fertility tourism’. Swift processes, lower prices and the anonymity of the gamete donors all help to attract patients to the island.

Christchurch woman seeks an egg donor

Desperate to be a mum, a Christchurch woman with a genetic condition that means she cannot conceive is advertising for an egg donor after two failed in vitro fertilisation (IVF) cycles.

Can you help Lisa? Email reporters@press.co.nz.

Lisa never thought she would consider an egg donor, but said she doesn't want her inability to conceive to be her life's story.

She doesn't want to feel odd around friends and family with children, and instead wants to put her grief and anger aside and get on with her life.

But first she needs to try a donor egg to see if it will succeed where two IVF courses failed.

Now 38, there was never a time when Lisa even considered she might not be able to have children.

In a stable relationship for 10 years and married for five, she said she and her partner thought there was no hurry.

"Being able to have a family was something I took for granted."

But Lisa discovered she was the carrier of a hereditary condition that meant having children naturally wasn't an option.

The couple went through two treatment cycles. The egg harvesting went well but once the eggs became embryos only one from both cycles was worth implanting. The procedure failed.

"Trying IVF a third time would most likely end in the same heartbreaking result."

IVF was hard and the financial, emotional and physical burden too much to bear.

Lisa said the outcome has changed everything for her.

"I live daily with grief and feelings of shame surrounding my tainted femininity and inability to give life."

Her sister was also unable to have children, which means her quest for an egg needs to go beyond her immediate family.

She was widening her appeal to anyone willing to help. She needs someone between 21 and 37 who has completed her own family and who is willing to go through counselling, then IVF for no monetary reward, since egg donors are not allowed to be paid.

World's Oldest New Mom Dying At Age 72, Child Is Only 18 Months

When she was 70, Rajo Devi Lohan and her husband Balla took out almost $3,000 in loans for IVF treatments in Baddhu Patti, India, to conceive their only child, Naveen.

Now 72, Rajo is bedridden and doesn’t have the strength to lift 18-month-old Naveen. She admits she is dying, and too weak to recover from the pregnancy.

Dr. Keith Ablow, psychiatrist, fears that technology could be partly to blame for this controversial question of ethics.

“This is crossing the boundary into the inevitable results of when people use technology without guidance or conscience. And the trouble is that even reprehensible people can do so,” Ablow told the media.

After her cesarean birth, Rajo’s womb ruptured and she suffered severe internal bleeding.

Rajo and Balla, 73, farmers who have not received any education, say they did not know it was high risk to have a baby at their age, and were never warned of any complications by their doctor.

The doctor who performed the IVF treatments, Anurag Bishnoi, says Rajo’s medical state has nothing to do with his care or her pregnancy so late in life.

"Even though Rajo's health is deteriorating, at least she will die in peace. She does not have to face the stigma of being barren," Bishnoi told The Sun.

Ablow said he believes that after this incident, Bishnoi should be prevented from being able to make these kinds of medical decisions.

“This is not a doctor; this person should not be regarded as a doctor and stripped of any credentials regarding him as medical professional. He is a co-conspirator in a medical experiment,” Ablow said.

The National Fertility Centre in Haryana, where Rajo received her treatments, was criticized for helping another Indian woman, Bhateri Devi, give birth to triplets through IVF when the woman was 66. The center claims no wrongdoing in the pregnancies of both women.

Besides physical complications, another concern is the soundness of mind at the advanced ages of these women, as well as their ability to rationally think through her feelings of wanting to be a mother.

“If this doctor doesn’t have convincing data on hand that these women are competent to make medical decisions, then him impregnating them artificially should be viewed as an assault and treated criminally,” Ablow said.

“These are women who put their own feelings about wanting to have children, maybe even regret for not having them earlier, ahead of any concerns about the development of their children,” he said.

Aside from the physical health risks to a child being born to an elderly mother, the potential for psychological damage could be significant.

“These children have to live with people who make irrational decisions based on their well being with no concern for others, which is something no one wants in a parent, Ablow said. “Later on, it is likely that these children will be anxious when they understand how old their parents are and that they may not survive very long — and that will have its own psychological impact.”