A recent study reviewed data from the first decade of this century to determine the relative risks and overall safety of surrogacy procedures. The finding? Surrogacy works pretty well, and the risks are low. The risk of complications with the stimulation or surgical process of ART related procedures was low in the United States during the period, according to the study.
Researchers used data gathered from the National ART Surveillance System, a government agency that collects cycle-level information on ART procedures in the United States. While complications throughout the stimulation and surgical process were reported, they were relatively few during the given time period, said the researchers.
Reported complications included infection, hemorrhaging requiring transfusion, moderate or severe ovarian hyperstimulation syndrome, a negative reaction to medication, complications with anesthesia, hospitalization, patient death within 12 weeks of stimulation, and other complications not discussed.
Throughout the review of the data, the most commonly reported complication was ovarian hyperstimulation syndrome (OHSS). With regard to autologous cycles, the presence of OHSS was noted as 153.5 per 10,000 cycles, and the rate of hospitalization was noted as 34.8 per 10,000 cycles. In review of complications associated with donors, OHSS and hospitalization were still the most common problems. 31 cases of OHSS were reported per 10,000 cycles reviewed, and 10.5 cases of hospitalization per 10,000 cycles for donors.
While the prospect of maternal death within 12 weeks of stimulation is concerning, based on the findings the rate of maternal death was not significant. Overall, 58 total deaths were reported in the data reviewed from 2000-2011. With regard to the 58 cases reviewed, there was no temporal pattern that was discovered. No deaths were reported in any of the donor cases that were reviewed.
The results of the reviewed data reveal that in the United States risk for stimulation and surgical complications were low between 2000-2011 and no concerning trends or patterns were noted. Notably, because there is an already low rate of occurrence for complications in the stimulation and surgical process, it may be more difficult to identify temporal patterns. Complications may also be underreported by patients which could further inhibit comprehensive understanding of their prevalence. Overall, complications were low, but further and more detailed research into the most common complications, OHSS, may reveal further data regarding factors which influence or predict OHSS.
For more information see the full report in the Jama Network.
