Complications and Side Effects of Oocyte Donation

  • Randy S. Morris


Oocyte donation represents a special case in the treatment of infertility since it involves some degree of risk to an otherwise uninvolved party: the oocyte donor. This differs considerably from sperm donors, who are at little or no physical risk from the donation process. Therefore, it is important to understand the potential complications affecting a donor and have them explained fully in the informed consent process. One must also take care in applying data from the in vitro fertilization (IVF) literature to oocyte donors, as it appears that donors may not be at the same risk from the IVF process as infertile IVF patients. In addition, some of the purported risks are theoretical, while others may not yet be apparent.


Ovarian Stimulation GnRH Agonist Pelvic Inflammatory Disease Oocyte Retrieval Ovarian Cancer Risk 
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  1. 1.
    Morris RS, Sauer MV. Oocyte donation in the 1990s and beyond. Assist Reprod Rev. 1993; 3: 211–217.Google Scholar
  2. 2.
    Rosenberg H, Epstein Y. Follow-up study of anonymous ovum donors. Hum Reprod. 1995; 10: 2741–2747.PubMedGoogle Scholar
  3. 3.
    PhysiciansDesk Reference. 49th ed. Montvale, NJ: Medical Economics Data Production Company; 1995: 2502–2503.Google Scholar
  4. 4.
    Friedman AJ, Juneau-Norcross M, Rein MS. Adverse effects of leuprolide acetate depot treatment. Fertil Steril. 1993; 59: 448–450.PubMedGoogle Scholar
  5. 5.
    Johansen JS, Riis BJ, Hassager C, et al. The effect of a gonadotropin releasing hormone analog (nafarelin) on bone metabolism. J Clin Endocrinol Metab. 1988; 67: 701–706.PubMedCrossRefGoogle Scholar
  6. 6.
    Hodgen GD. General applications of GnRH agonists in gynecology: past, present, and future. Obstet Gynecol Surv. 1989; 44: 293–296.PubMedCrossRefGoogle Scholar
  7. 7.
    Feldberg D, Ashkenazi J, Dicker D, et al. Ovarian cyst formation: a complication of gonadotropin releasing hormone therapy. Fertil Steril. 1989: 51: 42–45.PubMedGoogle Scholar
  8. 8.
    Ben-Rafael Z, Bider D, Menashe Y, Maymon R, Zolti M, Mashiach S. Follicular and luteal cysts after treatment with gonadotropin releasing hormone analog for in vitro fertilization. Fertil Steril. 1990; 53: 1091–1094.PubMedGoogle Scholar
  9. 9.
    Droesch K, Barbieri RL. Ovarian hyperstimulation syndrome associated with the use of the gonadotropin releasing hormone agonist leuprolide acetate. Fertil Steril. 1994; 62: 189–190.PubMedGoogle Scholar
  10. 10.
    Meldrum DR, Wisot A, Hamilton F, et al. Timing of initiation and dose schedule of leuprolide influence the time course of ovarian suppression. Fertil Steril. 1988: 50: 400–402.PubMedGoogle Scholar
  11. 11.
    Martinez F, Barri PN, Coroleu V. Case report: accidental GnRH agonist administration during early pregnancy. Hum Reprod. 1988; 3: 669.PubMedGoogle Scholar
  12. 12.
    Wilshire GB, Emmi AM, Gagliardi CC, Weiss GW. Gonadotropin releasing hormone agonist administration in early human pregnancy is associated with normal outcomes. Fertil Steril. 1993; 60: 980–983.PubMedGoogle Scholar
  13. 13.
    Young DC, Snabes MC, Poindexter AN. GnRH agonist exposure during the first trimester of pregnancy. Obstet Gynecol. 1993; 81: 587–589.PubMedGoogle Scholar
  14. 14.
    Elefant E, Biour B, Blumberg-Tick J, Roux C, Thomas F. Administration of a gonadotropin releasing hormone agonist during pregnancy: follow-up of 28 pregnancies exposed to triptoreline. Fertil Steril. 1995; 63: 1111–1113.PubMedGoogle Scholar
  15. 15.
    Fraunfelder FT. Possible ocular adverse effects associated with leuprolide injections. JAMA 1995; 273: 773–774.PubMedCrossRefGoogle Scholar
  16. 16.
    Hall LLH, Malone JM, Ginsburg KA. Flare-up of endometriosis induced by gonadotropin releasing hormone agonist leading to bowel obstruction. Fertil Steril. 1995; 64: 1204–1206.PubMedGoogle Scholar
  17. 17.
    Friedman AJ. Acute urinary retention after gonadotropin releasing hormone agonist treatment for leiomyomata uteri. Fertil Steril. 1993; 59: 677–678.PubMedGoogle Scholar
  18. 18.
    Ashkenazi J, Goldman JA, Dicker D, Feldberg D, Goldman GA. Adverse neurological symptoms after gonadotropin releasing hormone analog therapy for in vitro fertilization cycles. Fertil Steril. 1990; 53: 738–740.PubMedGoogle Scholar
  19. 19.
    Newton C, Slota D, Yuzpe AA, Tummon IS. Memory complaints associated with the use of gonadotropin-releasing hormone agonists: a preliminary study. Fertil Steril. 1996; 65: 1253–1255.PubMedGoogle Scholar
  20. 20.
    Redfearn A, Hughes EG, O’Connor M, Dolovich J. Delayed-type hypersensitivity to human gonadotropin: case report. Fertil Steril. 1995; 64: 855–856.PubMedGoogle Scholar
  21. 21.
    Li TC, Hindle JE. Adverse local reaction to intramuscular injections of urinary-derived gonadotropins. Hum Reprod. 1993; 8: 1835–1836.PubMedGoogle Scholar
  22. 22.
    Hurwitz A, Milwidsky A, Yagel S, Adoni A. Early unwinding of torsion in an ovarian cyst as a result of hyperstimulation syndrome. Fertil Steril. 1983; 40: 393–394.PubMedGoogle Scholar
  23. 23.
    Pryor RA, Wiczyk HP, O’Shea DL. Adnexal infarction after conservative management of torsion of a hyperstimulated ovary. Fertil Steril. 1995; 63: 1344–1346.PubMedGoogle Scholar
  24. 24.
    Chin NW, Friedman CI, Awadalla SG, Miller FA, Kim MH. Adnexal torsion as a complication of superovulation for ovum retrieval. Fertil Steril. 1987; 48: 149–150.PubMedGoogle Scholar
  25. 25.
    Narayanan M, Murthy PSR, Munaf SA, Shah LCP, Kini MD. Antiovarian antibodies and their effect on the outcome of assisted reproduction. J Assist Reprod Genet. 1995; 12: 599–605.PubMedCrossRefGoogle Scholar
  26. 26.
    Soderstrom-Anttila V. Follow-up study of Finnish volunteer oocyte donors concerning their attitudes to oocyte donation. Hum Reprod. 1995; 10: 3073–3076.PubMedGoogle Scholar
  27. 27.
    Morris RS, Wong IL, Do YS, et al. The pathophysiology of ovarian hyperstimulation syndrome. A proposal role of the ovarian derived prorenin to angioten-sin cascade (ODPAC). Adv Exp Med Bio. 1995; 377: 391–398.Google Scholar
  28. 28.
    Haning RV, Strawn EY, Nolten WE. Pathophysiology of the ovarian hyperstimulation syndrome. Obstet Gynecol. 1985; 66: 220–224.PubMedGoogle Scholar
  29. 29.
    Phillips LL, Gladstone W, Wiele RV. Studies of the coagulation and fibrinolytic systems in hyperstimulation syndrome after administration of human gonadotropins. J Reprod Med. 1975; 14: 138–143.PubMedGoogle Scholar
  30. 30.
    Kodama H, Fukuda J, Karube H, Matsui T, Shimizu Y, Tanaka T. Status of the coagulation and fibrinolytic systems in ovarian hyperstimulation syndrome. Fertil Steril. 1996; 66: 417–424.PubMedGoogle Scholar
  31. 31.
    Montgomery Rice VC, Richard-Davis G, Saleh AA, et al. Fibrinolytic parameters in women undergoing ovulation induction. Am J Obstet Gynecol. 1993; 169: 1549–1553.PubMedGoogle Scholar
  32. 32.
    Kaaja R, Siegberg R, Tiitinen A, Kosimies A. Severe ovarian hyperStimulation syndrome and deep vein thrombosis. Lancet 1989; 2: 1043.PubMedCrossRefGoogle Scholar
  33. 33.
    Rizk B, Meagher S, Fisher AM. Severe ovarian hyperstimulation syndrome and cerebrovascular accidents. Hum Reprod. 1990; 5: 697–698.PubMedGoogle Scholar
  34. 34.
    Coney S. Auckland inquest into death after IVF. Lancet. 1995; 345: 849.CrossRefGoogle Scholar
  35. 35.
    Luxman D, Cohen JR, Gordon D, Wolman I, Wolf Y, David MP. Unilateral vulvar edema associated with paracentesis in patients with ovarian hyperstimulation syndrome. J Reprod Med. 1996; 41: 771–774.PubMedGoogle Scholar
  36. 36.
    Levin MF, Kaplan BR, Hutton LC. Thoracic manifestations of ovarian hyperstimulation syndrome. Can Assoc Radiol J. 1995; 46: 23–26.PubMedGoogle Scholar
  37. 37.
    Jewelicz R, Vande Wiele RL. Acute hydrothorax as the only symptom of ovarian hyperstimulation syndrome. Am J Obstet Gynecol. 1975; 121: 1121.Google Scholar
  38. 38.
    Golan A, Ron-el R, Herman H. Ovarian hyperstimulation syndrome: an update review. Obstet Gynecol Surv. 1989; 44: 430–440.PubMedCrossRefGoogle Scholar
  39. 39.
    Morris RS, Paulson RJ, Sauer MV, Lobo RA. Predictive value of serum estradiol concentrations and oocyte number in severe ovarian hyperstimulation syndrome. Hum Reprod. 1995; 10: 811–814.PubMedCrossRefGoogle Scholar
  40. 40.
    Sauer MV, Paulson RJ. Mishaps and misfortunes: complications that occur in oocyte donation. Fertil Steril. 1994; 61: 963–965.PubMedGoogle Scholar
  41. 41.
    Halme J, Toma SK, Talbert LM. A case of severe ovarian hyperstimulation in a healthy oocyte donor. Fertil Steril. 1995; 64: 857–859.PubMedGoogle Scholar
  42. 42.
    Borlum KG, Maigaard S. Transvaginal oocyte aspiration and pelvic infection [letter]. Lancet. July 1 1989; 2: 53.PubMedCrossRefGoogle Scholar
  43. 43.
    Yuzpe AA, Brown SE, Casper RF, Nisker J, Graves G, Shatford L. Transvaginal, ultrasound-guided oocyte retrieval for in vitro fertilization. J Reprod Med. 1989; 34: 937–942.PubMedGoogle Scholar
  44. 44.
    Howe RS, Wheeler C, Mastroianni L, Blasco L, Tureck R. Pelvic infection after transvaginal ultrasound guided ovum retrieval. Fertil Steril. 1988; 49: 726–728.PubMedGoogle Scholar
  45. 45.
    Van Os HC, Roozenberg BJ, Janssen-Caspers HS, et al. Vaginal disinfection with povidone iodine and the outcome of in-vitro fertilization. Hum Reprod. 1992; 7: 349–350.PubMedGoogle Scholar
  46. 46.
    Ashkenazi J, Farhi J, Dicker D, Shalev J, Ben-Rafael Z. Acute pelvic inflammatory disease after oocyte retrieval: adverse effects on the results of implantation. Fertil Steril. 1994; 61: 526–528.PubMedGoogle Scholar
  47. 47.
    Bennett SJ, Waterstone JJ, Cheng WC, Parsons J. Complications of transvaginal ultrasound directed follicle aspiration: a review of 2670 consecutive procedures. J Assist Reprod Genet. 1993; 10: 72–77.PubMedCrossRefGoogle Scholar
  48. 48.
    Dicker D, Ashkenazi J, Feldberg D, Levy T, Dekel A, Ben-Rafael Z. Severe abdominal complications after transvaginal ultrasonographically guided retrieval of oocytes for in vitro fertilization and embryo transfer. Fertil Steril. 1993; 59: 1313–1315.PubMedGoogle Scholar
  49. 49.
    Evers JLH, Larsen JF, Gnany GG, Sieck UV. Complications and problems in transvaginal sector scan-guided follicle aspiration. Fertil Steril. 1988; 49: 278–282.PubMedGoogle Scholar
  50. 50.
    Cohen J, Debache C, Pez JP, Junca AM, Cohen-Bacrie P. Transvaginal sonographically controlled ovarian puncture for oocyte retrieval for in vitro fertilization. J In Vitro Fert Embryo Transf. 1986; 3: 309–313.PubMedCrossRefGoogle Scholar
  51. 51.
    Feichtinger W, Kemeter P. Laparoscopic or ultrasonically guided follicle aspiration for in vitro fertilization. J In Vitro Fert Embryo Transf. 1984; 1: 244–249.PubMedCrossRefGoogle Scholar
  52. 52.
    Riddle AF, Sarma V, Mason BA, et al. Two years’ experience of ultrasound directed oocyte retrieval. Fertil Steril. 1987; 48: 454–458.PubMedGoogle Scholar
  53. 53.
    Ilbery M, Lyons B, Sundaresan V. Ovarian necrotizing vasculitis causing major intra-abdominal hemorrhage after IVF. Case report and literature review. Br J Obstet Gynecol. 1991; 98: 596–599.CrossRefGoogle Scholar
  54. 54.
    Van Hoorde GJ, Verhoff A, Zeilmaker GH. Perforated appendicitis following transvaginal oocyte retrieval for in-vitro fertilization and embryo transfer. Hum Reprod. 1992; 7: 850–851.PubMedGoogle Scholar
  55. 55.
    Jones WR, Haines CJ, Matthews CD, Kirby CA. Traumatic ureteric obstruction secondary to oocyte recovery for in vitro fertilization: a case report. J In Vitro Fert Embryo Transf. 1985; 6: 185–187.CrossRefGoogle Scholar
  56. 56.
    Amso NN. Role of assisted reproduction in endometriosis. In: Shaw RW, ed. Endometriosis: Current Understanding and Management. Oxford: Blackwell Science; 1985; 282–297.Google Scholar
  57. 57.
    Amso NN. Potential health hazards of assisted reproduction. Hum Reprod. 1995; 10: 1628–1630.PubMedGoogle Scholar
  58. 58.
    Whittemore AS, Harris R, Itnyre J, The Collaborative Ovarian Cancer Group. Characteristics relating to ovarian cancer risk: collaborative analysis of 12 US case-control studies. II. Invasive epithelial ovarian cancers in white women. Am J Epidemiol. 1992; 136: 1184–1203.PubMedGoogle Scholar
  59. 59.
    Cohen J, Forman R, Harlap S, Johannisson E, Lunenfeld B, de Mouzon J. IFFS expert group report on the Whittemore study related to the risk of ovarian cancer associated with use of fertility agents. Hum Reprod. 1993; 8: 996–999.PubMedCrossRefGoogle Scholar
  60. 60.
    Bristow RE, Karlan BY. Ovulation induction, infertility, and ovarian cancer risk. Fertil Steril. 1996; 66: 499–507.PubMedGoogle Scholar
  61. 61.
    Booth M, Beral V, Smith P. Risk factors for ovarian cancer: case-control study. Br J Cancer. 1989; 60: 592–598.PubMedCrossRefGoogle Scholar
  62. 62.
    Joly DJ, Lilienfeld AM, Diamond EL, Bross IDJ. An epidemiologic study of the relationship of reproductive experience to cancer of the ovary. Am J Epidemiol. 1974; 99: 190–209.PubMedGoogle Scholar
  63. 63.
    Rossing MA, Daling JR, Weiss NS, Moore DE, Self SG. Ovarian tumors in a cohort of infertile women. N Engl J Med. 1994; 331: 771–776.PubMedCrossRefGoogle Scholar
  64. 64.
    Hildreth NG, Kelsey JL, Li Volsi VA, Fischer DB, Holford TR, Mostow ED. An epidemiologic study of epithelial carcinoma of the ovary. Am J Epidemiol. 1982; 115: 714–719.Google Scholar
  65. 65.
    Weiss NS, Lyon JL, Liff JM, Vollmer WM, Daling JR. Incidence of ovarian cancer in relation to the use of oral contraceptives. Int J Cancer. 1981; 28: 669–671.PubMedCrossRefGoogle Scholar

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© Springer Science+Business Media New York 1998

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  • Randy S. Morris

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