A commentary and accompanying editorial published in the May issue of Reproductive BioMedicine Onlinecalls for a registry of egg donors to monitor long-term health after egg donation.
In the commentary, Dr. Jennifer Schneider and her colleagues document five case histories of women in the US who were egg donors and then later developed breast cancer. Currently there are no registries of egg donors in the UK or in the US, and there are only a few long-term follow up studies on egg donors who have received fertility drugs to help others. This lack of data means that it is difficult to draw a firm conclusion on the effect that fertility drugs in donors may have on cancer risk.
"We don't know, of course, whether there is a likely connection between their egg donation and breast cancer," said Dr. Schneider. "The only way to have a real answer is to begin keeping track of egg donors and to gather information on the long-term health risks of egg donation. Until then, potential egg donors need more realistic and clear explanations about the lack of knowledge about such risks."
Recent studies have shown that there is no long-term risk of breast cancer from IVF, which requires women to undergo the same hormone treatment as egg donors. However, lack of data specific to egg donors has hampered proper assessment of potential risks in this population. The establishment of national egg donor registries that allow long-term follow up studies would effectively address this problem and shed light on the effects, if any, of repeated hormone treatments on younger egg donors.
Although this anecdotal report of five women developing breast cancer after hormone treatment might appear concerning, the editors highlight in their accompanying editorial that it is well below the estimated number of women in the population who would be statistically likely to develop breast cancer. However, the ovarian stimulation cycles that these women experienced were atypical in that they involved more aggressive regimes than commonly used. Very large numbers of eggs (28-33) were retrieved and they underwent many more rounds of treatment (up to 10) with fertility drugs than is common practice.
"We decided to publish this controversial report to highlight that the safety of any medical intervention should always be a major concern," said Professor Bart Fauser, Chief Editor of Reproductive BioMedicine Online, "especially in cases where women undergo drug treatment for the sole reason of helping others."
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Notes for editors
The commentary is "Long-term breast cancer risk following ovarian stimulation in young egg donors: a call for follow-up, research and informed consent" by Jennifer Schneider, Jennifer Lahl and Wendy Kramer (http://dx.doi.org/10.1016/j.rbmo.2017.02.003).
The editorial is: "Breast cancer risk after oocyte donation: should we really be concerned?" by Bart CJM Fauser and Juan Garcia Valasco (http://dx.doi.org/10/1016/j.rbmo.2017.03.005)
Both articles appear in Reproductive BioMedicine Online, volume 35 (2017), published by Elsevier.
No association between breast cancer risk and age at the time of IVF could be established in a recent long-term follow-up of more than 25,000 women (van den Belt-Dusebout et al., 2016).
Copies of these papers are available to credentialed journalists upon request; please contact Kimberley Bryon-Dodd, Kimberley.dodd@rbmonline.com.
Author contact:
Dr. Jennifer Schneider, jennifer@jenniferschneider.comProfessor, Bart Fauser, Chief Editor Reproductive BioMedicine Online: bcjmfauser@gmail.com
About Reproductive BioMedicine Online
Reproductive BioMedicine Online is an international journal dedicated to biomedical research on human conception and the welfare of the human embryo. It is published by a group of scientists and clinicians working in these fields of study, in collaboration with Elsevier.
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