Oocyte donation pregnancies: maternal and fetal outcomes

Since the first successful use of donated oocytes in 1984, the number of oocyte donation (OD) cycles in Europe and United States has dramatically increased, becoming nowadays a common treatment option, especially to overcome infertility due to advanced age. Oocyte donation pregnancies address specific issues, due to the separation between the “oocyte age” of the conceptus and the “uterine compartment age” of the mother. Consequently, there has been increasing interest in the impact of OD on several aspects, especially maternal and fetal outcomes. We performed a retrospective study to analyze obstetrical and neonatal outcome of singleton oocyte donation pregnancies. Data relative to pregnant women who underwent their first trimester screening for aneuploidies between January 2005 and June 2013 were collected. 158 patients with singleton oocyte donation pregnancies were eligible for the study. 60 patients were not reachable at the time of telephone interview. 98 patients were enrolled for the study and were contacted by telephone interview to collect maternal and neonatal outcomes. Population: the mean maternal age of oocyte donation recipients was 43 years (range 30-54 years), while the mean age of oocyte donors was 26 years (range 18-36 years). Mean maternal pre-pregnancy BMI of recipients was 22.7 kg/m2 (± 3,51). 88.8% of patients were nulliparous. 40.8% of pregnant women had a Bachelor Degree. Obstetrical and neonatal outcome: 89% of women delivered by Cesarean Section and 78% of these were elective C-section by maternal request. 86.6% of patients (n= 84) delivered at term (≥37 weeks) while 13.4% of deliveries (n=13) were preterm (< 37 weeks). 1 pregnancy terminated with therapeutic abortion due to congenital malformation of genito-urinary tract of the fetus. Hypertensive disorders of pregnancies (pregnancy-induced hypertension and preeclampsia) complicated 19.3% of pregnancies. 7.1% of patients were affected by gestational diabetes. Less frequent complications reported were threatened abortion (4.1%), pPROM (3.1%), intrauterine growth restriction (1%) and post-partum hemorrhage (1%). 48 males (50%) and 48 females (50%) were born in our cohort. Mean birthweight of male neonates was 3175 g (± 490 g), with a minimum birthweight reported of 1915 g and a maximum of 4400 g (Q1= 2980 g; Q2= 3100 g; Q3= 3412 g.). Mean birthweight of female neonates was 2959 g (± 502 g), (range 1480- 3700 g; Q1= 2852 g; Q2= 3000 g; Q3= 3212 g). The birthweight of neonates from oocyte donation pregnancies resulted significantly distributed under 50° percentile of standard reference percentile curves of spontaneous pregnancies. In our cohort, oocyte donation pregnancies are associated with a high incidence of hypertensive disorders of pregnancies. Furthermore, birthweight of neonates from oocyte donation pregnancies results significantly distributed under 50° percentile of standard reference gestation-specific curves of spontaneous pregnancies. These findings are in agreement with previous studies which also reported a higher incidence of pregnancy-induced hypertension, preeclampsia and placental pathology in oocyte donation pregnancies. In this light, the recognition of risks associated with oocyte donation pregnancies, should lead obstetricians to consider tailored clinical surveillance and, possibly, preventive strategies and appropriate screening.