Improvements achieved in an oocyte donation program over a 10-year period:: sequential increase in implantation and pregnancy rates and decrease in high-order multiple pregnancies

Objective: To compare outcome parameters and cumulative pregnancy rates (PRs) in oocyte donation cycles over a period of 10 years. Design: Retrospective study. Setting: University-affiliated assisted reproductive technology program. Patient(s): Women undergoing oocyte donation (10,537 cycles) between 1995 and 2005. Intervention(s): Ovarian stimulation and oocyte retrieval in donors. Embryo transfer performed in recipients after endometrial preparation. Main Outcome Measure(s): Outcome parameters and cumulative PRs were calculated and compared in relation to indication, age, and origin of sperm used. Result(s): Overall PR, implantation rate, clinical PR, and miscarriage rate per embryo transfer performed were 54.9%, 27%, 50.3%, and 19%, respectively. Ongoing PR per transfer was 40.2%, and twin and high-order multiple PRs were 39% and 6%, respectively. Mean number of embryos transferred was reduced from 3.6 +/- 0.8 to 1.9 +/- 0.3, implantation rate improved from 16.7% to 38.3%, and ongoing PR improved from 31% to 44.3%. Cumulative PRs did not differ significantly among different indications for oocyte donation, age groups, or origin of sperm used for oocyte insemination. Overall cumulative PRs after three and five cycles were calculated as 87% and 96.8%, respectively. Conclusion(s): Significant improvements in outcome parameters were achieved within 10 years. Similar cumulative PRs were observed regardless of recipient age, indication for oocyte donation, or sperm origin.