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Let's learn from the sperm bank mistake, and develop a global egg registry now to keep track of what's going on.
Ever since the first babies were born from frozen eggs — Australian researchers reported a set of twins in 1986 — defrosting techniques have improved tremendously. Italians were pushed to perfect egg freezing because of strict limits on frozen embryos there. Americans were prodded by Lindsay Nohr Beck, a young woman with tongue cancer who insisted on having her eggs frozen because she worried the chemotherapy would destroy her ovaries. Since then, she has launched a foundation that raises money and awareness about egg freezing.
Not surprisingly, what started as a huge boon for cancer survivors has evolved into a global enterprise aimed at single women. Some ethicists worry that marketers are hyping success rates.
As of last count, the number of babies born from frozen eggs is anywhere from 475 to 1,000. The success rates range from 2 percent to 10 percent, depending on who is giving you the numbers. The huge variation means only one thing: the statistics are not reliable. That’s not a good thing for the scientists in the field or potential clients.
“An egg registry, at least on a national level if not international, is an idea whose time has come and will become a reality,” said Susan Crockin, an expert in reproductive technology law and co-author with Howard Jones of "Legal Conceptions: The Evolving Law and Policy of Assisted Reproductive Technology."
"The need however is primarily to track genetic information for the benefit of the multiple offspring. This is a health care issue, not a commercial issue. Professional guidelines in the U.S. require permanent records of gamete donation but no mechanism currently exists to capture and collate data," she said.
Last year, EMD Serono Inc, an affiliate of Merck KGaA, of Darmstadt, Germany, launched a frozen egg registry limited to the U.S. to monitor the safety of the process and figure out which freezing technique work best. There are two ways to freeze human eggs — one is slow-freezing and the other vitrification, which really isn’t freezing so much as encasing the egg.
A bigger registry, that includes fresh and frozen, and spans the globe would keep track of the entire business as well as evaluate the science. Ideally, this registry would be run by an international fertility society (some already exist) that has representatives from various countries. It's something we do for cancer — we have registries in each country and then they combine data — why not the egg industry?
We need to do precisely what we didn’t do for sperm. For instance, there have been babies born from sperm donors who end up with medical problems and there is no way to alert the other families who used the same sperm. The Merck Serono registry called HOPE (short for Human Oocyte Preservation Experience) is a start. Let’s aim to expand the data and broaden our knowledge base. The ethics, as always, will come as lawsuits arise.
Randi Hutter Epstein, M.D., is the author of "Get Me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank."