Hypertensive pathologies and egg donation pregnancies: Results of a large comparative cohort study

In young egg recipients (<45 years old), hypertensive disorders during pregnancy were tripled compared with autologous assisted reproduction technologies pregnancies; the increase was higher for preeclampsia and eclampsia than for isolated hypertension.

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Volume 106, Issue 2, Pages 284-290

Authors:

Hélène Letur, M.D., Maëliss Peigné, M.D., Jeanine Ohl, M.D., Isabelle Cédrin-Durnerin, M.D., Emmanuelle Mathieu-D’Argent, M.D., Florence Scheffler, M.D., Veronika Grzegorczyk-Martin, M.D., Jacques de Mouzon, M.D., M.P.H.

Abstract:

Objective

To determine whether egg donation (ED) pregnancies are at higher risk of pregnancy-induced hypertension (PIH) than those achieved by autologous assisted reproductive technology (ART; controls).

Design

Anonymous comparative observational matched cohort study.

Setting

Assisted reproductive technology centers.

Patient(s)

Two hundred seventeen ED and 363 control singleton pregnancies matched at 7–8 weeks (pregnancy date, parity, cycle type [fresh/frozen] and women's age). According to French practice, all women were under 45.

Intervention(s)

None.

Main Outcome Measure(s)

Percentage of PIH for ED versus controls.

Result(s)

The groups were comparable (mean age, 34.5). PIH was more frequent during ED pregnancies (17.8% vs. 5.3%), as was preeclampsia (11.2% vs. 2.8%) and eclampsia (1.8% vs. 0.0%). In multivariate analyses, PIH risk increased with ED (odds ratio [OR], 3.92; 95% confidence interval [CI], 1.93–7.97) and women's age (OR, 1.08; 95% CI, 1.00–1.16). No significant effect of previous pregnancies or cycle rank/type was observed.

Conclusion(s)

This study had sufficient power to detect doubling of the PIH rate. It was demonstrated that the risk of PIH was tripled for ED versus controls. Even in young women, ED is a risk factor for PIH. An immunological explanation seems most likely, that is, the fetus is fully allogeneic to its mother. This risk must be acknowledged to inform couples and provide careful pregnancy monitoring.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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