Donna A Wiggins1, Elliott Main. 1. Department of Obstetrics and Gynecology, California Pacific Medical Center, San Francisco, USA.
Abstract
OBJECTIVE: Prior studies on donor egg in vitro fertilization (DE-IVF) outcomes have been limited by the lack of an appropriate control group. Here, we review the obstetric and perinatal outcomes of pregnancies achieved by DE-IVF and compare these pregnancies with those of women who also needed similar assisted reproductive techniques, of similar socioeconomic status, and cared for by a small group of 8 physicians applying consistent diagnostic and treatment approaches. STUDY DESIGN: A retrospective review of 50 consecutive pregnancies achieved by DE- IVF and 50 consecutive pregnancies achieved by standard IVF (STD-IVF) was performed. Comparisons were made for demographic and medical confounding factors and for outcome measures. RESULTS: The 2 groups were nearly identical for gravidity, parity, and multiple gestations but did vary in maternal age. Average age of patients receiving DE-IVF was 41.9(+/-5.1), whereas the STD-IVF averaged 37.7(+/-3.6) years ( P < .001). Key obstetric outcomes did not differ between the 2 groups with the exception of pregnancy-induced hypertension. In patients with DE-IVF, 26% had pregnancy-induced hypertension (PIH) develop, whereas this occurred in only 8% of the STD-IVF group ( P = .02). Examining nulliparous patients only, 37.1% of DE-IVF had PIH develop, whereas only 8% of STD-IVF group achieved that diagnosis ( P < .003). An analysis with a multiple logistic regression in nulliparous patients found odds ratios of 7.1 (95% CI, 1.4-36.7) in DE versus STD-IVF, odds ratio 4.9 (95% CI, 1.3-18.3) for multiple gestation versus singleton, and odds ratio 1.0 (95% CI, 0.9-1.1) for maternal age. CONCLUSION: Nulliparous pregnancies achieved by DE-IVF are associated with an increased risk of PIH; however, excellent outcomes can still be expected.
OBJECTIVE: Prior studies on donor egg in vitro fertilization (DE-IVF) outcomes have been limited by the lack of an appropriate control group. Here, we review the obstetric and perinatal outcomes of pregnancies achieved by DE-IVF and compare these pregnancies with those of women who also needed similar assisted reproductive techniques, of similar socioeconomic status, and cared for by a small group of 8 physicians applying consistent diagnostic and treatment approaches. STUDY DESIGN: A retrospective review of 50 consecutive pregnancies achieved by DE- IVF and 50 consecutive pregnancies achieved by standard IVF (STD-IVF) was performed. Comparisons were made for demographic and medical confounding factors and for outcome measures. RESULTS: The 2 groups were nearly identical for gravidity, parity, and multiple gestations but did vary in maternal age. Average age of patients receiving DE-IVF was 41.9(+/-5.1), whereas the STD-IVF averaged 37.7(+/-3.6) years ( P < .001). Key obstetric outcomes did not differ between the 2 groups with the exception of pregnancy-induced hypertension. In patients with DE-IVF, 26% had pregnancy-induced hypertension (PIH) develop, whereas this occurred in only 8% of the STD-IVF group ( P = .02). Examining nulliparous patients only, 37.1% of DE-IVF had PIH develop, whereas only 8% of STD-IVF group achieved that diagnosis ( P < .003). An analysis with a multiple logistic regression in nulliparous patients found odds ratios of 7.1 (95% CI, 1.4-36.7) in DE versus STD-IVF, odds ratio 4.9 (95% CI, 1.3-18.3) for multiple gestation versus singleton, and odds ratio 1.0 (95% CI, 0.9-1.1) for maternal age. CONCLUSION: Nulliparous pregnancies achieved by DE-IVF are associated with an increased risk of PIH; however, excellent outcomes can still be expected.