A Retrospective Analysis of Pregnancy Outcomes in Recipients of Anonymously Donated Oocytes at a Large ART Center

Abstract

Objective: To compare the pregnancy outcome between two types of progesterone Support regimens—IM versus vaginal administration—in recipients of donated oocytes. Design: A retrospective analysis of oocyte donation outcomes at a large ART center. Materials and Methods: Pregnancy outcome was evaluated in 225 recipients of oocytes from anonymous donors (<32 years old) in an active oocyte donation program from January 2004 to December 2006. Anonymous donors underwent standard medication and monitoring with OCP pretreatment, followed by GnRH antagonist with gonadotropins added on day 2 of menses. Recipients on continuous OCPs received Lupron 10 units on CD 15, or Lupron was started on CD 21. Estrogen was started 4 days before donor's expected menses (Estrace 2 mg PO BID plus Vivelle 0.1 mg patch changed every 3 days). Endometrial TVUS was performed on day 7 of estrogen, and if the ET was <6 mm, estrogen dose was increased and remonitored in 3 days. Progesterone [either Crinone 8% intravaginal progesterone gel (90 mg, BID) or IM progesterone (IMP; 50 mg/day)] was started on the afternoon of donor oocyte retrieval. Embryo transfer was performed on day 4 of progesterone and on day 6 for blastocyst transfers. If pregnant, progesterone and estrogen were continued until 10 weeks EGA. Positive serum hCG, implantation, clinical pregnancy, delivery, and total pregnancy loss rates were compared between recipients receiving Crinone 8% gel (n = 105) versus IMP (n = 120). Statistical analysis was performed using a 2-sided Fisher exact test. Results: Groups were clinically homogenous for no. of cycles, recipient age, cycle length, no. of oocytes, no. of mature oocytes, fertilization rate, no. of embryos transfered, no. of embryos frozen, and no. embryos with high implantation potential transfered.Tabled 1Crinone 8% gelIMPNo. of cycles105120Recipient age41.5 ± 4.7341.8 ± 4.12Cycle length19.7 ± 6.3318.2 ± 5.55No. of oocytes17.9717.90No. of mature oocytes15.0115.23Fertilization rate66.26 ± 21.5067.52 ± 18.98No. of embryos transfered1.93 ± 0.372.06 ± 0.33No. of embryos frozen4.424.43No. of embryos with high implantation potential transfered1.55 ± 0.741.67 ± 0.64 Open table in a new tab There were no significant differences in pregnancy outcomes between recipients treated with Crinone 8% gel versus IMP.Tabled 1ProgesteroneSample size+ Serum hCG rate, n (%)Implantation rate, n(%)Clinical pregnancy rate, n (%)Delivery rate, n (%)Total pregnancy loss rate, n (%)Crinone 8%10565 (61.9%)89/203 (43.8%)61 (58.1%)54 (51.4%)11 (10.5%)IMP12071 (59.2%)91/245 (37.1%)64 (53.3%)58 (48.3%)13 (10.8%)P value.685.175.503.6891.00 Open table in a new tab Conclusions: Replacement with Crinone 8% gel was not different from IMP in terms of pregnancy outcomes within an oocyte donation program. Additionally, Crinone 8% gel has the advantage of avoiding painful IM injections.