Effect of oocyte donation on pregnancy outcomes in in vitro fertilization twin gestations

Objective To estimate the effect of oocyte donation on pregnancy outcomes in patients with twin pregnancies conceived via IVF. Design Retrospective cohort study. Setting Patients with IVF twin pregnancies delivered by one maternal-fetal medicine practice from 2005 to 2013. Patient(s) Fifty-six patients with IVF twin pregnancies who had oocyte donation and 56 age-matched controls with IVF twin pregnancies who used autologous oocytes. We excluded women aged >50 years because there were no age-matched controls aged >50 years using autologous oocytes. Intervention(s) None. Main Outcome Measure(s) Gestational hypertension, pre-eclampsia. Result(s) The baseline characteristics were similar between the groups, including maternal age, race, parity, chorionicity, and comorbidities. The mean (±SD) age was 43.0 ± 6.0 vs. 41.9 ± 1.7 years. There were no differences in outcomes between the groups in regard to preterm birth, birth weight, or gestational diabetes. There was a greater incidence of gestational hypertension (32.1% vs. 13.0%) and pre-eclampsia (28.3% vs. 13.0%) in the group that underwent IVF with donor oocytes. Conclusion(s) In patients who conceive twin pregnancies using IVF, oocyte donation increases the risk of gestational hypertension and pre-eclampsia. However, this did not translate into increased rates of preterm birth or low birth weight. Patients who require oocyte donation should be carefully counseled regarding the increased risk for pre-eclampsia and gestational hypertension but should be reassured that oocyte donation does not seem to lead to other adverse outcomes.