Maternal and neonatal outcomes in singleton pregnancies conceived using donor oocytes: a retrospective cohort study

This study aimed to determine whether donor oocyte versus autologous oocyte use is associated with adverse maternal or neonatal outcomes in singleton live births conceived using assisted reproductive technology.

This was a retrospective cohort study of singleton live births conceived using assisted reproductive technology and delivered within a tertiary-care university health system between January 2014 and August 2019. Multiple gestations and cases with missing data were excluded. Adverse maternal and neonatal outcomes were compared between live births conceived using donor versus autologous oocytes utilizing multivariate backwards-stepwise logistic regression to adjust for potential confounders. Data are presented as adjusted odds ratios (OR) with 95% confidence intervals (CI) with p <.05 considered statistically significant.

Among 1,015 singleton gestations, 97 (9.6%) were conceived using donor and 918 (90.4%) using autologous oocytes. Women using donor oocytes were older (42.5y vs. 35.4y, p <.001), more likely to have pre-gestational diabetes (5.2% vs. 0.7%, p =.001), more likely to utilize fresh embryo transfers, (29.9% vs. 18.9%, p =.01) and less likely to utilize PGT-A (25.8% vs. 51.3%, p <.001). A greater odds of a 5-minute APGAR score < 7 was noted among the donor oocyte group (4.1% vs. 0.9%, OR 4.64 [95% CI 1.30-14.45]). There were no other significant differences in maternal or neonatal outcomes between the two groups.

In singleton gestations conceived using assisted reproductive technology, donor oocyte use does not appear to be associated with an increased risk of adverse maternal or neonatal outcomes. This may be reassuring for patients hoping to achieve a live birth through use of donor oocytes.