A Survey to Assess the Informed Consent Practices of Physicians Caring for oocyte Donors

A Survey to Assess the Informed Consent Practices of Physicians Caring for oocyte Donors
Christina Shields, Winifred Mak
Fertility and Sterility, 1 September 2021; 116(3)
Abstract
Objective
With increasing demand for donor oocytes, appropriate informed consent of oocyte donors (OD) is a priority as these women assume risk for a procedure that does not directly benefit them. Our study sought to investigate how physicians counsel on risks as part of informed consent of OD.
Materials and Methods
Physicians involved in the care of OD were invited to complete an anonymous 17-question online survey which included demographic variables and assessment of counseling practices such as whether short- and long-term complications are discussed with OD. The University of Texas Institutional Review Board approved the study.
Results
96 physicians responded (estimated response rate 17%). Respondents work in academic institutions (48%), private fertility clinics (46%), practices affiliated with commercial egg banks (6%), practices affiliated with academic institutions (11%), and are located across the Northeast (30%), Southeast (23%), Midwest (27%), Southwest (8%), and West (12%). Respondents in our study most often obtain consent either in person only or in person with other educational material. 98% responded that they always counsel on short-term potential side effects, versus 70% who always counsel on long-term potential side effects. A majority reported counseling on the incidence of ovarian hyperstimulation syndrome (OHSS) as 1-5% and acute serious complication (ASC) as <0.5% in accordance with the American Society for Reproductive Medicine (ASRM) bulletin on oocyte donation. The most discussed side effects are moderate pain / discomfort (100%), OHSS (96%), bloating (93%), intraperitoneal bleeding (79%), infection (78%), and ovarian torsion (78%). Interestingly, 21% also discussed general risk of cancer and 26% discussed risk of ovarian cancer. Regarding the maximum number of oocyte donation cycles, 65% of physicians recommend no more than 6 cycles and 32% recommend 3-5 cycles. Only 56% of respondents are aware of literature investigating long-term health outcomes of OD. Finally, 78% agree or strongly agree there should be a modality to track long-term health outcomes of OD.
Conclusions
Reassuringly, the majority of the physicians in our study counsel OD appropriately according to the ASRM guidelines and therefore from a physician’s perspective, appropriate informed consent is being obtained. There is a knowledge gap on long-term health outcomes of OD, likely due to lack of research in this area. Most physicians caring for OD agree that long-term health outcomes should be tracked.