Obstetric and neonatal complications in pregnancies conceived after oocyte donation: a systematic review and meta-analysis

TY - JOUR

T1 - Obstetric and neonatal complications in pregnancies conceived after oocyte donation

T2 - a systematic review and meta-analysis

AU - Storgaard, M.

AU - Loft, A.

AU - Bergh, C.

AU - Wennerholm, UB

AU - Söderström-Anttila, V.

AU - Romundstad, LB

AU - Aittomaki, K.

AU - Oldereid, N.

AU - Forman, J.

AU - Pinborg, A.

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Background: Approximately 50 000 oocyte donation (OD) treatment cycles are now performed annually in Europe and the US. Objectives: To ascertain whether the risk of adverse obstetric and perinatal/neonatal outcomes is higher in pregnancies conceived by OD than in pregnancies conceived by conventional in-vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) or spontaneously. Search Strategy: A systematic search was performed in the PubMed, Cochrane and Embase databases from 1982–2016. Primary outcomes were hypertensive disorders of pregnancy, pre-eclampsia (PE), gestational diabetes mellitus, postpartum haemorrhage, caesarean section, preterm birth, low birthweight and small for gestational age. Selection criteria: Inclusion criteria were original studies including at least five OD pregnancies with a control group of pregnancies conceived by conventional IVF/ICSI or spontaneous conception, and case series with >500 cases reporting one or more of the selected complications. Studies not adjusting for plurality were excluded. Data collection and analysis: Thirty-five studies met the inclusion criteria. A random-effects model was used for the meta-analyses. Main results: For OD pregnancies versus conventional IVF/ICSI pregnancies the risk of PE was adjusted odds ratio (AOR) 2.11 (95% CI, 1.42–3.15) in singleton and AOR 3.31 (95% CI, 1.61–6.80) in multiple pregnancies. The risks of preterm birth and low birthweight in singletons were AOR 1.75 (95% CI, 1.39–2.20) and 1.53 (95% CI, 1.16–2.01), respectively. Conclusions: OD conceptions are associated with adverse obstetric and neonatal outcomes. To avoid the additional increase in risk from multiplicity, single-embryo transfer should be the choice of option in OD cycles. Tweetable abstract: Oocyte donation pregnancies have increased risk of a range of obstetric and neonatal complications.

AB - Background: Approximately 50 000 oocyte donation (OD) treatment cycles are now performed annually in Europe and the US. Objectives: To ascertain whether the risk of adverse obstetric and perinatal/neonatal outcomes is higher in pregnancies conceived by OD than in pregnancies conceived by conventional in-vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) or spontaneously. Search Strategy: A systematic search was performed in the PubMed, Cochrane and Embase databases from 1982–2016. Primary outcomes were hypertensive disorders of pregnancy, pre-eclampsia (PE), gestational diabetes mellitus, postpartum haemorrhage, caesarean section, preterm birth, low birthweight and small for gestational age. Selection criteria: Inclusion criteria were original studies including at least five OD pregnancies with a control group of pregnancies conceived by conventional IVF/ICSI or spontaneous conception, and case series with >500 cases reporting one or more of the selected complications. Studies not adjusting for plurality were excluded. Data collection and analysis: Thirty-five studies met the inclusion criteria. A random-effects model was used for the meta-analyses. Main results: For OD pregnancies versus conventional IVF/ICSI pregnancies the risk of PE was adjusted odds ratio (AOR) 2.11 (95% CI, 1.42–3.15) in singleton and AOR 3.31 (95% CI, 1.61–6.80) in multiple pregnancies. The risks of preterm birth and low birthweight in singletons were AOR 1.75 (95% CI, 1.39–2.20) and 1.53 (95% CI, 1.16–2.01), respectively. Conclusions: OD conceptions are associated with adverse obstetric and neonatal outcomes. To avoid the additional increase in risk from multiplicity, single-embryo transfer should be the choice of option in OD cycles. Tweetable abstract: Oocyte donation pregnancies have increased risk of a range of obstetric and neonatal complications.

KW - Caesarean section

KW - Low birthweight

KW - Oocyte donation

KW - Pre-eclampsia

KW - Preterm birth

U2 - 10.1111/1471-0528.14257

DO - 10.1111/1471-0528.14257

M3 - Review

C2 - 27592694

SN - 0140-7686

VL - 124

SP - 561

EP - 572

JO - The Journal of obstetrics and gynaecology of the British Commonwealth

JF - The Journal of obstetrics and gynaecology of the British Commonwealth

IS - 4

ER -