P–764 Risks of oocyte donation for third-party donors: a systematic literature review
Authors: Tassot J , D’Angelo A 
Published: August 2021

Abstract

Study question
What are the risks of oocyte donation? Which risks should be prioritised in policies aiming to improve the protection of third-party oocyte donors?

Summary answer
The risks for third-party oocyte donors are of a diverse nature, including physical risks, psychological risks, iatrogenic risks, and social risks.

What is known already
Oocyte donation involves ovarian stimulation and oocyte pick-up, which represent burdensome procedures for the donor. In a recent evaluation of the EU legislation on blood, tissue and cells, the European Commission highlighted that oocyte donors are currently not adequately protected. For effective oocyte donor protection measures to be developed and implemented, it is important to understand the risks that oocyte donors are exposed to. To date, there is no comprehensive overview of the existing knowledge on the physical and psychosocial risks of oocyte donation.

Study design, size, duration
A systematic literature review of the publications on PubMed, CINAHL, PsycINFO and the Notify Library was carried out. The search was conducted in May 2020. All empirical studies, including case reports, that reported or investigated negative experiences of oocyte donors and/or negative consequences of the donation on the donors’ physical health, mental health, or other aspects of their lives were included. No restriction was made with regard to the year of publication.

Participants/materials, setting, methods
In total, 88 empirical studies conducted in oocyte donors were reviewed. All reported information on oocyte donor risks was extracted and summarised. The identified risks were clustered into categories according to common themes and analysed with regard to their frequency of occurrence, severity, and imputability to the donation. A prioritisation of risks was carried out based on these three criteria, classifying each risk as a “priority risk” or a “non-priority risk”.

Main results and the role of chance
Nineteen priority risks were identified across the following six categories: short-term physical risks, long-term physical risks, short-term psychological risks, long-term psychological risks, iatrogenic risks, and social risks. The most frequently reported priority risks were moderate to severe Ovarian Hyperstimulation Syndrome (OHSS) and having lasting worries or concerns about the donation. While the findings confirmed the relevance of certain immediate physical risks for oocyte donors, no cases of death or permanent physical damage as a direct consequence of the donation could be detected. The results showed that donating oocytes can profoundly impact the donors’ psychological well-being in the short-term and in the long-term. Furthermore, the donation can have a strong effect on the donor’s social and family life, for instance, through the risk of unintended pregnancy. Moreover, it was found that oocyte donors are at risk of experiencing mistreatment or inadequate care during the donation procedure. Most studies included in the review reported on short-term risks of the donation. There is a high degree of uncertainty about the long-term health effects of oocyte donation. Due to the scarcity of large observational studies, the conclusions are mostly based on small studies and case reports, which limits the strength of any conclusion.

Limitations, reasons for caution
The literature search was limited to common databases for published data. Grey literature was not searched. Due to the heterogeneous nature of the relevant publications, it is possible that the search strategy was not able to detect all eligible articles.
Wider implications of the findings: The findings emphasise the importance of implementing effective donor protection policies that address not only the physical, but also the psychological, social, and iatrogenic risks of oocyte donation. Moreover, the findings call for a systematic follow-up of oocyte donors to gain insight into the long-term consequences of the donation.

Trial registration number
Not applicable