ABSTRACT
OBJECTIVE: To compare maternal, obstetric, and neonatal outcomes between women who underwent oocyte donation at or after age 50 years and from 45 through 49 years. DESIGN: Single-center, retrospective cohort study. SETTING: Maternity hospital. PATIENT(S): Forty women aged 50 years and older ("older group") and 146 aged 45-49 years ("younger group"). INTERVENTION(S): Comparison between the older and younger groups, globally and after stratification by type of pregnancy (singleton/twin pregnancy). MAIN OUTCOME MEASURE(S): Maternal, obstetric, and neonatal outcomes. RESULT(S): The rate of multiple-gestation pregnancies was similar in both groups (35% in the older and 37.7% in the younger group). We observed no significant difference globally between the two groups for outcomes, except for the mean duration of postpartum hospitalization, which was significantly longer among the older women (mean ± SD, 9.5 ± 7.4 days vs. 6.8 ± 4.4 days). The rates of isolated pregnancy-related hypertension and of fetal growth restriction in singleton pregnancies were statistically higher in the older than in the younger group (19.2% vs. 5.5%, and 30.7% vs. 14.3%, respectively). Complication rates with twin pregnancies were similar between groups and very high compared with singleton pregnancies. CONCLUSION(S): Complication rates were similar among women aged 50 years and older and those aged 45-49 years. Nonetheless, given the high rate of complication in both groups, especially among twin pregnancies, single embryo transfer needs to be encouraged for oocyte donations after age 45 years.
Subject(s)
Fertilization in Vitro/adverse effects , Infertility, Female/therapy , Maternal Age , Oocyte Donation/adverse effects , Pregnancy Complications/etiology , Pregnancy, Twin , Embryo Transfer/adverse effects , Female , Fertility , Fertilization in Vitro/mortality , Hospital Mortality , Hospitals, Maternity , Humans , Infant, Newborn , Infertility, Female/diagnosis , Infertility, Female/physiopathology , Live Birth , Middle Aged , Oocyte Donation/mortality , Paris , Perinatal Mortality , Pregnancy , Pregnancy Complications/diagnosis , Pregnancy Complications/mortality , Pregnancy Outcome , Pregnancy Rate , Retrospective Studies , Risk Assessment , Risk Factors , Time Factors , Treatment OutcomeABSTRACT
OBJECTIVE: To use a national registry to examine the role of oocyte donation on pregnancy outcomes in singleton pregnancies. DESIGN: Retrospective cohort. SETTING: Not applicable. PATIENT(S): Women undergoing autologous cycles and donor oocyte recipients in the United States from 2008-2010. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Preterm delivery, birth weight <2,500 g, small for gestational age birthweight, perinatal death. RESULT(S): The rates of preterm delivery and low birthweight for all members of this cohort were higher than the US national average. Pregnancies resulting from oocyte donation were significantly more likely to end before 34 weeks' and 37 weeks' gestation (adjusted odds ratio [OR] = 1.30, 95% confidence interval [CI] = 1.03-1.64 for 34 weeks' gestation, adjusted OR = 1.28, 95% CI = 1.12-1.46 for 37 weeks' gestation), and to result in infants weighing <2,500 g (adjusted OR = 1.21, 95% CI = 1.02-1.44). However, once gestational age at delivery is accounted for, these infants are actually at decreased risk of having a small for gestational age birthweight (adjusted OR = 0.72, 95% CI = 0.58-0.89) and of perinatal death (adjusted OR = 0.29, 95% CI = 0.09-0.94). CONCLUSION(S): Data from a national cohort indicate that donor oocyte recipients are more likely to deliver preterm when compared with autologous patients. The effect of donor oocyte donation on birthweight is likely a function of an increased rate of preterm delivery among this population.
