Obstetric risks in young egg recipients
Patients and methods. We analysed the course of pregnancy, labour and perinatal outcomes in 389 women aged 18 to 35 years. In 30 women, pregnancy occurred after in vitro fertilisation (IVF) with the use of donor eggs (oocytes) (DE-IVF), in 236 patients as a result of the «surrogate motherhood» programme (SM-IVF), in 123 women pregnancy occurred after IVF with own eggs (OE-IVF).
Results. The course of the current pregnancy was complicated by a high frequency of threatened miscarriage in the first and second trimesters, and also threatened preterm labour in all three groups. Preeclampsia (20.0%) and gestational hypertension (16.6%) were found in pregnant women of the DE-IVF group (p < 0.05). One patient of this group was diagnosed with HELLP syndrome. Assessment of pregnancy and labour complications showed a higher incidence of premature placental abruption in groups of pregnant women with allogeneic fetus (DE-IVF and SM-IVF). It is noteworthy that chorioamnionitis was diagnosed in
3 women (1.5%) only in the surrogate motherhood group (p > 0.05%). The incidence of multiple pregnancies was comparable in all three groups. The current pregnancy ended with full-term delivery in 53.3; 78.3 and 76.7% of women, respectively. Preterm labour was noted more often in the DE-IVF group (46.7 vs. 21.6 and 25.2%; p < 0.05). It should be noted that there are more cases of caesarean section in the DE-IVF (93.3%) and OE-IVF groups (79.7%). In assessment of height-to-weight parameters, the average weight of newborns was lower in the DE-IVF group – 2755.2 ± 498.7 g as compared to 3059.8 ± 511.9 g in the SM-IVF group and 2801.2 ± 422.3 g in the OE-IVF group. This fact can be accounted for by a high incidence of preterm labour in this group. Newborns weighting less than 2500 g in the DE-IVF group amounted to 29.7%. Most newborns in the groups of study had Apgar scores greater than 7 at both the 1st and 5th minutes.
Conclusion. DE recipients, irrespective of age, are subject to greater risks for development of obstetric complications than pregnant women after IVF with own eggs, so they should be referred to a high risk group of obstetric complications. Obstetricians-gynaecologists and reproductologists should beforehand inform women, entering DE-IVF or surrogate motherhood programmes, about high risks for obstetric complications.
Key words: allogeneic fetus, gestational hypertension, egg donation, perinatal outcomes, preterm labour, premature placental abruption, preeclampsia, surrogate motherhood.
For citation: Trifonova N.S., Zhukova E.V., Grineva A.M., Aleksandrov L.S., Ishchenko A.I., Borisova N.I., Nikonov A.P., Berishvili M.V., Zholobova M.N. Obstetric risks in young egg recipients. Vopr. ginekol. akus. perinatol. (Gynecology, Obstetrics and Perinatology). 2017; 16(4): 21–26. (In Russian).