P-137: Obstetric and perinatal outcomes in age matched cohorts of ovum donor recipients and in vitro fertilization patients

Abstract

ObjectiveTo assess differences in obstetric and perinatal outcomes between patients undergoing transfer cycles after using donated oocytes (DER) as compared to patients utilizing their own ova (IVF).DesignWe conducted a retrospective study of patients undergoing DER cycles and compared their obstetric outcomes with an age matched cohort of IVF patients who delivered using embryos derived from their own ova.Materials and methodsWe reviewed 89 pregnancies in two age matched cohorts of patients undergoing IVF (n=44) and DER (n=45). Chi square, t-test and multivariate regression was performed to assess the impact of embryonic origin on obstetric outcomes, including preeclampsia (PreE), pregnancy induced hypertension (PIH), gestational age (GA) and low birth weight infants (LBR).ResultsBoth PIH and PreE were diagnosed more often in patients undergoing DER cycles than IVF, 31% vs. 9% (p=0.01) and 10% vs. 3% (p=0.04), respectively. DER patients were also at risk for having more LBW and preterm deliveries, 22% vs. 7% (p=0.02) and 39% vs. 14% (p<0.01), respectively. DER cycles resulted in mean birthweights of 363g lower than IVF cycles (95% CI, 90-636). DER patients also had significantly higher rates of twin gestations, 14% vs. 31% (p=0.048). After controlling for maternal age and twin gestations, the increased incidence of PIH among DER cycles persisted, with an odds ratio of 3.6 (95% CI, 1.03-12.49). Differences in birth weight were no longer statistically significant, however a trend toward lower birth weights persisted with DER demonstrating an adjusted mean weight of 193g lighter in DER patients.ConclusionProviders can counsel patients and obstetric providers that while DER cycles increase pregnancy rates and decrease risks of aneuploidy, patients remain at higher risk for other obstetric complications. Our findings suggest a possible immunologic role in obstetric outcomes and disease, particularly in the etiology of PreE and PIH. Further investigation into the role of antigenicity and maternal factors are needed to better understand the etiology of pregnancy-induced hypertension and the possible embryonic origins of in utero development. ObjectiveTo assess differences in obstetric and perinatal outcomes between patients undergoing transfer cycles after using donated oocytes (DER) as compared to patients utilizing their own ova (IVF). To assess differences in obstetric and perinatal outcomes between patients undergoing transfer cycles after using donated oocytes (DER) as compared to patients utilizing their own ova (IVF). DesignWe conducted a retrospective study of patients undergoing DER cycles and compared their obstetric outcomes with an age matched cohort of IVF patients who delivered using embryos derived from their own ova. We conducted a retrospective study of patients undergoing DER cycles and compared their obstetric outcomes with an age matched cohort of IVF patients who delivered using embryos derived from their own ova. Materials and methodsWe reviewed 89 pregnancies in two age matched cohorts of patients undergoing IVF (n=44) and DER (n=45). Chi square, t-test and multivariate regression was performed to assess the impact of embryonic origin on obstetric outcomes, including preeclampsia (PreE), pregnancy induced hypertension (PIH), gestational age (GA) and low birth weight infants (LBR). We reviewed 89 pregnancies in two age matched cohorts of patients undergoing IVF (n=44) and DER (n=45). Chi square, t-test and multivariate regression was performed to assess the impact of embryonic origin on obstetric outcomes, including preeclampsia (PreE), pregnancy induced hypertension (PIH), gestational age (GA) and low birth weight infants (LBR). ResultsBoth PIH and PreE were diagnosed more often in patients undergoing DER cycles than IVF, 31% vs. 9% (p=0.01) and 10% vs. 3% (p=0.04), respectively. DER patients were also at risk for having more LBW and preterm deliveries, 22% vs. 7% (p=0.02) and 39% vs. 14% (p<0.01), respectively. DER cycles resulted in mean birthweights of 363g lower than IVF cycles (95% CI, 90-636). DER patients also had significantly higher rates of twin gestations, 14% vs. 31% (p=0.048). After controlling for maternal age and twin gestations, the increased incidence of PIH among DER cycles persisted, with an odds ratio of 3.6 (95% CI, 1.03-12.49). Differences in birth weight were no longer statistically significant, however a trend toward lower birth weights persisted with DER demonstrating an adjusted mean weight of 193g lighter in DER patients. Both PIH and PreE were diagnosed more often in patients undergoing DER cycles than IVF, 31% vs. 9% (p=0.01) and 10% vs. 3% (p=0.04), respectively. DER patients were also at risk for having more LBW and preterm deliveries, 22% vs. 7% (p=0.02) and 39% vs. 14% (p<0.01), respectively. DER cycles resulted in mean birthweights of 363g lower than IVF cycles (95% CI, 90-636). DER patients also had significantly higher rates of twin gestations, 14% vs. 31% (p=0.048). After controlling for maternal age and twin gestations, the increased incidence of PIH among DER cycles persisted, with an odds ratio of 3.6 (95% CI, 1.03-12.49). Differences in birth weight were no longer statistically significant, however a trend toward lower birth weights persisted with DER demonstrating an adjusted mean weight of 193g lighter in DER patients. ConclusionProviders can counsel patients and obstetric providers that while DER cycles increase pregnancy rates and decrease risks of aneuploidy, patients remain at higher risk for other obstetric complications. Our findings suggest a possible immunologic role in obstetric outcomes and disease, particularly in the etiology of PreE and PIH. Further investigation into the role of antigenicity and maternal factors are needed to better understand the etiology of pregnancy-induced hypertension and the possible embryonic origins of in utero development. Providers can counsel patients and obstetric providers that while DER cycles increase pregnancy rates and decrease risks of aneuploidy, patients remain at higher risk for other obstetric complications. Our findings suggest a possible immunologic role in obstetric outcomes and disease, particularly in the etiology of PreE and PIH. Further investigation into the role of antigenicity and maternal factors are needed to better understand the etiology of pregnancy-induced hypertension and the possible embryonic origins of in utero development.