Donor oocyte conception and pregnancy complications: a systematic review and meta‐analysis

Abstract

Background Observational studies showed that women with a donor oocyte (DO) pregnancy have an increased risk of pregnancy complications.Objectives Systematic review and meta-analysis to compare pregnancy complications of DO pregnancy with autologous oocyte in vitro fertilisation (IVF), and whether DO pregnancy acts as an independent risk factor.Search strategy Online searches of databases from 1 January 1980 to 31 January 2015 were performed using a set of relevant keywords.Selection criteria All studies comparing pregnancy complications of women with donor oocyte IVF and autologous oocyte IVF were included.Data collection and analysis Data collected included demographics and pregnancy complications. Methodological quality assessment was performed using the Newcastle-Ottawa scale. Statistical analysis was performed using REVIEW MANAGER 5.3 and STATA 13.0. Meta-regression was performed for age.Main results In total, 11 studies (n = 81 752) were included. Ten studies (n = 11 539) examined the primary outcome. The risk of developing hypertensive disorders in pregnancy was significantly higher for DO pregnancy (odds ratio, OR 3.92; 95% confidence interval, 95% CI 3.21-4.78). Further subgroup analysis for singleton and twin pregnancies showed that the risk was significantly higher for DO pregnancy in each group. Secondary outcomes including small for gestational age (OR 1.81), caesarean section (OR 2.71), and preterm delivery (OR 1.34) were significantly higher with DO pregnancy. Meta-regression for the covariate of age suggested that risk was independent of age.Author's conclusions Donor oocyte pregnancy acts as an independent risk factor for pregnancy complications, including hypertensive disorders, small for gestational age, and preterm delivery. Women should be counselled carefully before undergoing DO-assisted conception.Keywords Donor oocyte pregnancy, in vitro fertilisation, preelampsia, pregnancy-induced hypertension.Tweetable abstract Donor oocyte conception is an independent risk factor for obstetric complications.

Risk of adverse pregnancy and perinatal outcomes after high technology infertility treatment: a comprehensive systematic review

“…Very interesting data from sub-analysis demonstrated that in donor cycles the incidence of LBW was increased in PTB (RR 1.24, 95 % CI 1.19 to 1.29) but decreased (RR 0.86, 95 % CI 0.8 to 0.93) in term deliveries. The third meta-analysis included 11 observational studies for a total of 81,752 cycles comparing obstetric complications of pregnancies achieved after OD and autologous oocyte, and controlled for specific ART procedure (IVF or ICSI) [153]. In OD pregnancies the risk of developing PIH/PE, considered the primary endpoint, was significantly higher (OR 3.92, 95 % CI 3.21 to 4.78) also after sub-analysis for singleton (OR 2.90, 95 % CI 1.98 to 4.24) and twin (OR 3.69, 95 % CI 2.62 to 5.19) pregnancies [153].…”

“…The third meta-analysis included 11 observational studies for a total of 81,752 cycles comparing obstetric complications of pregnancies achieved after OD and autologous oocyte, and controlled for specific ART procedure (IVF or ICSI) [153]. In OD pregnancies the risk of developing PIH/PE, considered the primary endpoint, was significantly higher (OR 3.92, 95 % CI 3.21 to 4.78) also after sub-analysis for singleton (OR 2.90, 95 % CI 1.98 to 4.24) and twin (OR 3.69, 95 % CI 2.62 to 5.19) pregnancies [153]. Also the odds for SGA (OR 1.81, 95 % CI 1.26 to 2.60), PTB (OR 1.34, 95 % CI 1.08 to 1.66), and caesarean section (OR 2.71, 95 % CI 2.23 to 3.30) were increased [153].…”

“…In OD pregnancies the risk of developing PIH/PE, considered the primary endpoint, was significantly higher (OR 3.92, 95 % CI 3.21 to 4.78) also after sub-analysis for singleton (OR 2.90, 95 % CI 1.98 to 4.24) and twin (OR 3.69, 95 % CI 2.62 to 5.19) pregnancies [153]. Also the odds for SGA (OR 1.81, 95 % CI 1.26 to 2.60), PTB (OR 1.34, 95 % CI 1.08 to 1.66), and caesarean section (OR 2.71, 95 % CI 2.23 to 3.30) were increased [153]. Meta-regression for the covariate of age suggested that risk was independent of age [153].…”

“…Also the odds for SGA (OR 1.81, 95 % CI 1.26 to 2.60), PTB (OR 1.34, 95 % CI 1.08 to 1.66), and caesarean section (OR 2.71, 95 % CI 2.23 to 3.30) were increased [153]. Meta-regression for the covariate of age suggested that risk was independent of age [153]. Similarly, also the fourth meta-analysis [154] including 11 retrospective and prospective cohort studies confirmed that OD increase the risk of PE (in comparison with homologous IVF cycles) of about 70 % and that neither multiple pregnancies nor patient age can explain that effect by meta-regression analysis.…”

A man‐made disease: Fetal neonatal alloimmune thrombocytopenia due to incompatibility between oocyte donor and gestational mother

“…HPA data of parents should be obtained in case another pregnancy is planned, as the findings may affect future choices of a different gestational mother or oocyte donor. Performing HPA typing for the surrogate mother, oocyte donor, and father in all such contemplated pregnancies should be considered since pregnancy complications, and probably FNAIT as well, are more common in oocyte donor pregnancies …”