Faculty Bibliography

PURPOSE/OBJECTIVE:The objective of this study was to investigate stress levels among women undergoing elective oocyte cryopreservation by comparing their self-reported quality of life measures with women undergoing in vitro fertilization during the fertility treatment cycle. METHODS:Patients undergoing oocyte retrieval at a single institution were offered a voluntary, anonymous, and written questionnaire. The survey was adapted and validated from the Fertility Quality of Life tool to assess self-reported fertility treatment-related problems and was tested for construct validity and reliability. Based on exploratory factor analyses, three subscales were created as follows: fertility treatment-related stress, tolerability, and environment. Relationships between patient characteristics and fertility treatment-related measures were examined with Fisher's exact test, ANOVA, and multivariate regression with significance p < 0.05. RESULTS:A total of 461 patients (331 IVF, 130 egg freeze) were included in the analysis. Medically indicated egg freezing patients were excluded. Overall, both IVF and egg freeze patients reported stress during the current fertility cycle and there were no significant differences between IVF and egg freeze patients for any subscale scores. Three sets of generalized linear models were run and found age to be associated with fertility treatment-related stress and tolerability scores, with younger patients experiencing greater difficulties. Additionally, patients who underwent repeat cycles reported more fertility treatment-related stress. CONCLUSIONS:Patients undergoing egg freezing have similar responses to quality of life questions as patients undergoing IVF. Repeat cycles and younger age contribute to perceptions of stress. This information supports developing stress reduction strategies for all women undergoing egg freezing.

PURPOSE/OBJECTIVE:To assess the experiences and psychological outcomes of oocyte donors from one fertility center. METHODS:An anonymous survey was distributed via a secure email to 161 donors who underwent oocyte donation-anonymous, directed/known, and recruited agency-between January 2008 and January 2019 at the NYU Langone Fertility Center. RESULTS:Thirty-six donors completed the survey with the majority between 2 and 10 years since donation. Respondents reported a high prevalence of psychiatric symptoms or diagnoses post-donation. The majority of donors reported positive thoughts and feelings toward their donation process as well as to the knowledge of children born from their donation. Negative comments about donation were in the minority but focused on unexpected aspects about the process or outcome. Based on qualitative analysis, thoughts about family or "family-oriented thoughts" were the most frequent theme in respondent comments. 62.5% of respondents reporting that they would be open to identity-disclosure or open donation after experiencing the process. CONCLUSIONS:Despite a high reported prevalence of psychiatric symptoms, the majority of respondents felt positively about the donation experience as well as the prospect of open donation or identity-disclosure post-donation. Further research on long-term psychological outcomes, related to all aspects of donation, is important as the counseling and informed consent of oocyte donors continues to evolve. These data will be particularly important with regard to the aspect of disclosure, both planned and unplanned, in the modern era of electronic information sharing.

Objective: There is an inverse relationship between the use of elective oocyte donation and the understanding of long-term potential impact. We sought to assess the long-term medical and psychological health status of all elective oocyte donators (anonymous, directed, agency) at a single institution.
Design(s): Anonymous quantitative and qualitative survey.
Material(s) and Method(s): An anonymous survey was emailed to all donors with a working email who donated between 2008 - 2019 (n=161).
Result(s): 36 donors completed the survey (response rate 22.4%). The majority identified as Caucasian (77.1%). Most identified as not religious (33.3%), atheist (19.4%) or spiritual (16.7%). 44.4% reported they are currently single and 33.3% as currently married. 41.6% had at least a Bachelors degree, 38.9% a Masters and 16.7% a Doctorate. 48.6% reported half altruistic/half financial motivations, 14.3% reported pure altruism and another 14.3% purely financial. Most (54.3%) were between 25-30 years old at time of first donation. 40.0% donated between 2-5 years ago and another 34.3% 5-10 years ago. 40.0% of respondents donated once, 17.1% twice, 17.1% three times, and 25.7% 4 or more times. Most reported no post-op complications (34.3%) or minor symptoms only (51.4%). 30.6% reported at least 1 pregnancy but 57.1% hadn't tried or are not interested. Of donors reporting pregnancies, none required Assisted Reproductive Technology for conception but 13.3% reported >2 losses. Of donors with living biological children, 75% reported their children had no medical problems. 1 directed donor reported her niece has Schaff-Yang syndrome. 80% reported no update in their medical history; 2 reported new allergies, 1 epilepsy, 1 anemia, 1 collagenous colitis, 1 fibrocystic breasts, and 1 reported a keratoacanthoma removal. 1 respondent each reported a diagnosis of ovulatory dysfunction, blocked fallopian tubes, unexplained fertility and fibroids respectively. Over half of donors reported being treated for or having ever experienced symptoms of depression or anxiety. Birth control was the most reported new medication. 63.0% reported no update in their family history. 2 reported new cancers in grandmothers (breast, cervical) and 3 reported a family death (depression, colon cancer, old age). 31.3% reported they knew children were born from their oocytes and all wrote positive comments about the knowledge of livebirth. 80.6% reported that they would make the same choice to donate and 58.1% reported they would recommend donation. 62.5% would still have donated under open donation or ID disclosure models. 81.3% were interested in maintaining contact for future updates.
Conclusion(s): Most donors did not have major medical history updates. The majority felt positively about donation but also reported a high rate of depression/anxiety, which could be related. Donors felt positively about open disclosure and maintaining contact with recipients. Continued long-term follow up will help provide better counseling about the medical risks/benefits of donation. Moving toward an open disclosure may expand the psychological benefits for both donor and recipient. References: None
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