Evaluation of uterine arteries doppler and estrogen milieu in oocyte donation pregnancies

Introduction: The number of oocyte donation (OD) cycles have dramatically increased. While OD pregnancies face increased risks of obstetrical complications, especially pregnancy-induced hypertension and pre-eclampsia (PE), little is known about the physiology and the physiopathology of placentation. Method: We performed a prospective cohort study to analyze uterine arteries Doppler Pulsatility index (PI) and serum maternal 17 β – estradiol at 11+0-13+6 weeks’ gestation. Three groups of singleton pregnancies were studied: OD, in vitro fertilization pregnancies with autologous oocytes from fresh cycles (Autologous IVF) and spontaneous pregnancies. Outcomes were collected to include only physiological pregnancies. Results: The analysis by weeks showed a decreased uterine arteries PI between 11 and 13+6 weeks with a similar trend in all groups, but mean uterine artery PI at 11-13+6 weeks were significantly lower in OD recipients compared to Spontaneous Pregnancies and Autologous IVF (1.415 (DS 0.486) vs. 1.679 (DS 0.456) vs. 1.706 (DS 0.481) - p < 0.05). In spontaneous pregnancies,maternal serum levels of 17 β – estradiol grows between 11 and 13+6 weeks, with mean level of 2423 pg/ml at 11.5 weeks, 2521 pg/ml at 12.5 weeks and 4654 pg/ml at 13.5 weeks. Interestingly, in the same cohort we found a higher value in female fetuses with a mean of 3204 pg/ml (DS 1634) compared to the mean value of male fetuses of 2436 pg/ml (DS 1170) with a ratio female/male of 17 β – estradiol maternal serum concentration of 1,31 (IC95%: 1.04 – 1.65). Maternal serum levels of 17 β – estradiol in OD - oocyte recipients were significantly lower than in IVF and spontaneous pregnancies (1705.33 (DS 380.61) vs. 2121.50 (DS 1387.62) vs. 2844.93 (1516,29) p < 0.05). Conclusion: Mean uterine artery PI and 17-β estradiol at 11-13+6 weeks were significantly lower in OD recipients compared to Spontaneous Pregnancies and Autologous IVF. Oocyte donation has a significant impact on placentation in the first trimester of pregnancy