DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20180167

Comparison of obstetric outcomes of pregnancies after donor oocyte IVF: Three-arm age-matched retrospective cohort study

Vikas Yadav, Priyanka Bakolia, Neena Malhotra, Reeta Mahey, Neeta Singh, Alka Kriplani

Abstract


Background: Oocyte donation has become widely used as a treatment option for infertile couples. The few available studies report conflicting evidence about the risk of hypertensive disorders in donor oocyte pregnancies after adjusting for maternal age and it is unclear whether pregnancy complications and obstetric risks are due to oocyte donation or to confounding factors such as maternal age. The aim of the present study was to evaluate and compare obstetric complications between women who conceived after oocyte donation and age-matched control women with spontaneous conception and self oocyte IVF conception.

Methods : The present study comprised of women aged 20-45 years conceived from oocyte donation (n=104) between 1/12/2010 to 15/10/2017. Two age-matched control groups—Self oocyte IVF (n=150) and the other containing women who conceived spontaneously (n=312) were used for comparison of obstetric and perinatal outcomes.

Results: Mean maternal age was statistically significantly higher in the Donor oocyte IVF group as compared to  self oocyte ivf and spontaneous conception group. Miscarriage, first trimester bleeding, pregnancy induced hypertension and gestational diabetes mellitus was significantly higher in Donor oocyte IVF group as compared to self-oocyte and spontaneous conception group (p=0.001). Using multiple logistic regression analysis age class adjusted PIH and GDM  incidence was significantly higher in donor oocyte group as compared to spontaneous conception (P=0.010).There was significant variation in perinatal outcomes between the three groups.

Conclusion: Oocyte donation should be treated as an independent risk factor for miscarriage, first trimester bleeding, hypertensive disorder and gestational diabetes mellitus in pregnancy.


Keywords


First trimester bleeding, Gestational diabetes mellitus, Oocyte donation, Pregnancy induced hypertension

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References


Ferraretti AP, Goossens V, Kupka M, Bhattacharya S, de Mouzon J, Castilla JA, et al. Assisted reproductive technology in Europe, 2009: results generated from European registers by ESHRE. Hum Reprod 2013;28(9):2318–31.

Lutjen P, Trounson A, Leeton J. The establishment and maintenance of pregnancy using in vitro fertilization and embryo donation in a patient with primary ovarian failure. Nature. 1984;307(5974):174-5.

Rosenwaks Z. Donor eggs:their application in modern reproductive technologies. Fertil Steril. 1987;47:895-909.

Devroey P, Wisanto A, Camus M. Oocyte donation in patients without ovarian function. Hum Reprod. 1988;3:699-704.

Wagner SJ, Barac S, Garovic VD. Hypertensive pregnancy disorders: current concepts. J Clin Hypertens (Greenwich). 2007;9:560-66.

Serhal PF, Craft IL. Oocyte donation in 61 patients. Lancet. 1989;1:1185-7.

Blanchette H. Obstetric performance of patients after oocyte donation. Am J Obstet Gynecol. 1993;168:1803-7.

Abdalla HI, Billett A, Kan AK, Baig S, Wren M, Korea L, et al. Obstetric outcome in 232 ovum donation pregnancies. Br J Obstet Gynaecol 1998;105(6 Pt 1):332-7.

Soderstrom-Anttila V, Foudila T, Hovatta O. A randomized comparative study of highly purified follicle stimulating hormone and human menopausal gonadotrophin for ovarian hyperstimulation in an oocyte donation programme. Hum Reprod. 1996;11:1864-70.

Klatsky PC, Delaney SS, Caughey AB, Tran ND, Schattman GL, Rosenwaks Z. The role of embryonic origin in preeclampsia: a comparison of autologous in vitro fertilization and ovum donor pregnancies. Obstet Gynecol. 2010;116(6):1387-92.

Levron Y, Dviri M, Segol I, Yerushalmi GM, Hourvitz A, Orvieto R, et al. The ‘immunologic theory’ of preeclampsia revisited: a lesson from donor oocyte gestations. Am J Obstet Gynecol. 2014;211(4):383.e1-5.

Salha O, Sharma V, Dada T, Nugent D, Rutherford AJ, Philips S et al. The influence of donated gametes on the incidence of hypertensive disorders of pregnancy. Hum Reprod. 1999;14:2268-73.

Sheffer-Mimouni G, Mashiach S, Dor J, Levran D, Seidman DS. Factors influencing the obstetric and perinatal outcome after oocyte donation. Hum Reprod. 2002;17:2636-40.

Toner JP, Grainger DA, Frazier LM. Clinical outcomes among recipients of donated eggs: an analysis of the U.S. national experience, 1996–1998. Fertil Steril. 2002;78:1038-45.

Wiggins DA, Main E. Outcomes of pregnancies achieved by donor egg in vitro fertilization-a comparison with standard in vitro fertilization pregnancies. Am J Obstet Gynecol. 2005;192:2002-6.

The Assisted Reproductive Technologies (Regulation) Rules – 2010, Ministry of health and family welfare govt. of india, New delhi; Available at http://www.icmr.nic.in/guide/ART%20REGULATION%20Draft%20Rules%201.pdf

Thomopoulos C, Tsioufis C, Michalopoulou H, Makris T, Papademetriou V, Stefanadis C. Assisted reproductive technology and pregnancy-related hypertensive complications: a systematic review. J Hum Hypertens. 2013;27:148-57.

Laresgoiti-Servitje E, Gomez-Lopez N, Olson DM. An immunological insight into the origins of pre-eclampsia. Hum Reprod Update. 2010;16:510-24.

LaMarca B, Cornelius D, Wallace K. Elucidating immune mechanisms causing hypertension during pregnancy. Physiology (Bethesda, Md). 2013;28:225-33.

Taglauer ES, Gundogan F, Johnson KL, Scherjon SA, Bianchi DW. Chorionic plate expression patterns of the maspin tumor suppressor protein in preeclamptic and egg donor placentas. Placenta. 2013;34:385-7.

Van MLPH, Scherjon SA, Claas FHJ. Egg donation pregnancy as an immunological model for solid organ transplantation. Transpl Immunol. 2011;25:89-95.

van der Hoorn ML, Scherjon SA, Claas FH. Egg donation pregnancy as an immunological model for solid organ transplantation. Transpl Immunol. 2011;25:89-95.

Wang Y, Tanbo T, _Abyholm T, Henriksen T. The impact of advanced maternal age and parity on obstetric and perinatal outcomes in singleton gestations. Arch Gynecol Obstet. 2011;284:31-7.

Karnis MF, Zimon AE, Lalwani SI, Timmreck LS, Klipstein S, Reindollar RH. Risk of death in pregnancy achieved through oocyte donation in patients with Turner syndrome: a national survey. Fertil Steril. 2003;80(3):498-501.

Braat DD, Schutte JM, Bernardus RE, Mooij TM, van Leeuwen FE. Maternal death related to IVF in the Netherlands 1984–2008. Hum Reprod. 2010;25(7):1782-6.