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. (C) 2014 by American Society for Reproductive Medicine.