PLACENTATION IN OOCYTE DONATION PREGNANCIES: EVALUATION OF UTERINE ARTERIES DOPPLER AND PLACENTAL HORMONES

Introduction and objective: The aim of our study was to investigate the hypothesis that placentation in oocyte donation pregnancies (OD) presents differences compared to pregnancies conceived naturally or through in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) technique using autologous oocytes, as a result of alteration in normal placental and fetal-maternal interaction responsible of physiological placentation, due to genetic or hormonal factor and abnormal uterine and placental perfusion. Methods: To verify this issue we performed 2 study concurrently. We first performed a longitudinal study to measure uterine artery doppler pulsatility index (PI) at first (11-13+6 weeks), second (19-21 weeks) and third trimester (30-32 weeks) and maternal serum levels of and 17-β estradiol at 11-13+6 weeks in 55 OD pregnancies, in 48 (IVF/ICSI) pregnancies with autologous oocytes and 122 spontaneous pregnancies. The second was a retrospective study performed in order to analyze free β-human chorionic gonadotropin (hCG), pregnancy-associated plasma protein-A (PAPP-A) and nuchal translucency in 13624 spontaneously conceived pregnancies (Controls), 171 oocyte donation pregnancies (OD IVF/ICSI) and 76 IVF pregnancies with autologous oocytes (Autologous IVF/ICSI). Results: Mean uterine artery PI was significantly lower in OD in all trimester of pregnancy. First trimester: Controls 1,679 (DS 0,456), Autologous IVF/ICSI 1,706 (DS 0,481) and OD IVF/ICSI - oocyte recipients 1,415 (DS 0,486), showing the latter a reduced value [IC95% - p 0.001 (OD vs. Spontaneous conceived pregnancies) and p 0.007 (OD vs. Autologous IVF/ICSI)]; II trimester: Controls 0,96 (0,294), Autologous IVF/ICSI 1,15 (0,407), OD IVF/ICSI - oocyte recipients 0,80 (0,292) (p < 0.05). III trimester, only the analysis between OD and spontaneous conceived pregnancies showed the same trend (p 0.018). Free β-hCG levels were significantly higher both in OD IVF/ICSI pregnancies (1.44 ± 1.06 MoM) and Autologous IVF/ICSI (1.48 ± 1.02 MoM) compared to Controls (1.15 ± 0.84 MoM; p<0.05) and Age-matched Controls (1.18 ± 0.98 MoM; p<0.05). PAPP-A levels did not significantly differ among the four groups. Significantly lower nuchal translucency was detected in Controls (1.41 ± 0.36 mm) compared to OD IVF/ICSI (1.46 ± 0.44 mm; p<0.05), in Autologous IVF/ICSI (1.51 ± 0.34 mm; p<0.05) and Age-matched Controls (1.44 ± 0.42 mm; p<0.05). Conclusion: Oocyte donation has a significant impact either on biophysical and biochemical markers.