A Comparison of Maternal and Neonatal Outcomes of 79 Ovum Donation Pregnancies Compared To 234 Autologous Ivf Controls

Abstract

Objective: To assess complication rates for ovum donation (OD) pregnancies, including post-partum haemorrhage (PPH), pre-term delivery, and low birth weight, and compare these to autologous IVF controls. Background: Ovum donation pregnancies have been shown to increase maternal and fetal risks including first trimester vaginal bleeding, pregnancy-induced hypertension (PIH), eclampsia, rate of caesarean section (CS), preterm delivery, PPH, low birth weight and small for gestational age infants. The Homerton University Hospital has an onsite fertility unit which carries out approximately 100 ovum donation cycles per year and a tertiary maternity unit which delivers 6000 babies a year. Methods: This is a retrospective analysis of 79 OD pregnancies and 234 autologous IVF controls who delivered between February 2011 and January 2015 at Homerton University Hospital. Data were collected using electronic patient records. Paired T-tests were used to determine significant differences between groups, and odds ratios used to determine significant differences between group outcomes. Main Outcome Measures: Percentage of live births, method of delivery, incidence of PPH, and incidence of preterm and low birth weight neonates. Results: Our ovum donation population achieved a live birth rate of 98.7%. The majority (87%) of OD pregnancies were delivered by caesarean section (46% elective, 54% emergency), compared to 55% in the control group (45% elective, 55% emergency). Rates of PPH reached statistical significance (P = 0.0097) with PPH >500 ml occurring in 82% of OD deliveries compared to 67% of control IVF deliveries. 29% of OD pregnancies had a PPH > 1000ml compared to 15% of control pregnancies. 28% of OD pregnancies were delivered preterm, and 36% were low birth weight (<2.5kg), but these were not significant when compared to controls. Conclusion: Our study shows that OD pregnancies carry a higher risk than autologous IVF pregnancies for postpartum haemorrhage. Women should be counselled about this by fertility specialists prior to pregnancy. They should be under consultant led care for their pregnancy and delivery. As OD pregnancies account for a relatively small number of IVF pregnancies, larger multi-centre studies are necessary to add to the data on this topic.