BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1317
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          ASSEMBLY THIRD READING
          AB 1317 (Block)
          As Amended May 6, 2009
          Majority vote 

           HEALTH              11-0                                        
           
           -------------------------------- 
          |Ayes:|Jones, Block, Carter, De  |
          |     |Leon, Hall, Hayashi,      |
          |     |Hernandez,                |
          |     |Bonnie Lowenthal, Nava,   |
          |     |V. Manuel Perez, Salas    |
          |     |                          |
           -------------------------------- 
           SUMMARY  :   Requires a specified warning in all advertisements  
          for human egg donations associated with the delivery of  
          fertility treatment and requires donors to fertility treatment  
          centers be provided with medically accurate information  
          regarding potential risks.  Specifically,  this bill  :

          1)Requires any advertisement seeking oocyte (human egg cell)  
            donation associated with the delivery of fertility treatment  
            that includes assisted oocyte production to contain the  
            following warning:

               There are potential risks associated with human egg  
               donation.  Long-term risks associated with human egg  
               donation have not been determined.  Consultation with  
               your reproductive care specialist prior to entering  
               into a donor contract is advised.

          2)Requires physicians at fertility treatment clinics to provide  
            donors a medically accurate summary of health and consumer  
            issues associated with oocyte retrieval and to obtain written  
            informed consent from each donor.

          3)Exempts fertility clinics and donation agencies who formally  
            agree to abide by American Society for Reproductive Medicine  
            guidelines from the providing the specified warning. 

           EXISTING LAW  :

          1)Requires investigators to provide subjects making egg  








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            donations for research purposes a standardized, medically  
            accurate, written summary of health and consumer issues  
            associated with assisted reproductive production by the  
            investigator.

          2)Requires the written summary to specify potential risks  
            associated with the surgical procedure and the use of drugs,  
            medications and hormones prescribed for ovarian stimulation  
            and requires written and oral informed consent of all donors  
            prior to the procedures.

           FISCAL EFFECT  :   None

           COMMENTS  :   The author states that the high demand for human  
          oocytes has created a market often characterized by aggressive  
          outreach with substantial financial incentives to potential  
          oocyte donors.  The author maintains that financial incentives  
          may cause young women to put themselves unknowingly at risk of  
          future injury by donating their eggs without full knowledge of  
          the potential or long term consequences of their actions.  The  
          author further points out that the hormones administered to  
          stimulate donor egg production have in the past had serious  
          health consequences and that there is wide professional  
          recognition that the long term health consequences of oocyte  
          donation have not been determined.

          The American College of Obstetricians and Gynecologists, (ACOG)  
          finds that the potential of stem cell treatments and the recent  
          advances in fertility treatments have very substantially  
          increased demand for human egg cells, scientifically known as  
          "oocytes" (pronounced "oh-sites").  In 2004, in the United  
          States, almost 50,000 babies were born - representing almost 1%  
          of all newborns - as the result of 128,000 fertility treatments  
          by 411 clinics.  Regulation of the donation process varies based  
          on what type of entity seeks the donation.  In California,  
          oocyte donations for research purposes require informed consent  
          from the donor and require donors be provided medically accurate  
          written and oral information on the potential risks of the  
          procedure.  Most physicians who provide fertility treatments  
          follow recommended, voluntary guidelines on compensation of  
          donors and other practices promulgated by the American Society  
          for Reproductive Medicine and are required to secure informed  
          consent from donors.  However, according to ACOG, a number of  
          private egg donor agencies operate in this state without formal  








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          regulation or oversight, and these agencies may offer  
          substantial financial incentives to donors. 

          The Centers for Disease Control and Prevention, Institute of  
          Medicine (IOM) undertook a comprehensive review of the potential  
          acute and chronic risks associated with oocyte donation which  
          found the most prominent negative side effect is ovarian  
          hyperstimulation syndrome which causes nausea and vomiting,  
          breathing difficulties, kidney and liver problems.  However, the  
          IOM's research indicated only about 0.1 to 0.2% (roughly 1.4  
          cases per 100,000 women) experienced any of these symptoms.  The  
          IOM also evaluated the concern that the fertility drugs would  
          increase the risks of hormone dependent cancers - in particular  
          breast, ovarian, and uterine cancers - but did not find a  
          positive association with cancer prevalence.  The IOM reported  
          low risks associated with the surgical procedures of oocyte  
          donation and did not find data suggesting that donation surgery  
          posed a risk to future fertility.  The IOM did express concern  
          that very little is known about the long-term health outcomes of  
          women who undergo these procedures and recommended additional  
          research.

           
          Analysis Prepared by  :    John D. Miller / HEALTH / (916)  
          319-2097 


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