Is oocyte donation a risk factor for preeclampsia? A systematic review and meta-analysis
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The objective of this meta-analysis is to determine whether there is a higher incidence of preeclampsia (PE) in pregnancies achieved by oocyte donation (OD) compared with pregnancies achieved by in vitro fertilization with autologous oocytes (IVF).
A systematic review was performed to identify relevant studies published from January 1994 until April 2015 with at least an abstract in English using PubMed, ISI Web of Knowledge, and clinicaltrials.gov. The 11 studies included in this systematic review were retrospective and prospective cohort studies of women reporting results on the association between oocyte donation vs. in vitro fertilization (exposure) and preeclampsia (outcome).
Oocyte donation is a risk factor for the development of PE compared to IVF cycles, with a weighted OR of 3.12 under a fixed effects method (FEM: no heterogeneity between the studies). The weighted OR under a random effects model was 2.9 (REM: heterogeneity between the studies). The meta-regression analysis showed that neither multiple pregnancies (estimate = 0.08; p = 0.19) nor patient age (estimate = −2.29; p = 0.13) significantly explained the variability of the effect of oocyte donation on PE. Q statistic was 12.78 (p = 0.237), suggesting absence of heterogeneity between the studies.
Pregnancies achieved by oocyte donation confer a threefold increase in the likelihood of developing PE than those achieved by in vitro fertilization with own oocytes. Physicians should be aware of this risk in order to both counsel patients and monitor pregnancies accordingly.
KeywordsInduced hypertension In vitro fertilization Oocyte donation Preeclampsia Pregnancy
The authors would like to thank M.J. Lopez of Clínica EUGIN, Barcelona 08029, Spain, for the help in selecting the studies included.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Sources of funding
- 4.American College of O, Gynecologists, Task Force on Hypertension in P. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists' Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013;122(5):1122–31. doi: 10.1097/01.AOG.0000437382.03963.88.
- 21.Yogev Y, Melamed N, Bardin R, Tenenbaum-Gavish K, Ben-Shitrit G, Ben-Haroush A. Pregnancy outcome at extremely advanced maternal age. Am J Obstet Gynecol. 2010;203(6). doi: 10.1016/j.ajog.2010.07.039.
- 25.Wells G, Shea B, O'Connell D, Peterson J, Welch V, Losos M et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. [http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp]. Accessed 19/2/2015.
- 27.Sterne J. Meta-analysis in Stata: an updated collection from the Stata Journal. College Station (Texas): Stata Press; 2009.Google Scholar
- 28.Schwarzer G. Meta-analysis. The R Foundation for Statistical Computing. 2007.Google Scholar
- 32.Blickstein I. Motherhood at or beyond the edge of reproductive age. Int J Fertil Women's Med. 2003;48(1):17–24.Google Scholar
- 39.Tilburgs T, Roelen DL, van der Mast BJ, de Groot-Swings GM, Kleijburg C, Scherjon SA, et al. Evidence for a selective migration of fetus-specific CD4 + CD25bright regulatory T cells from the peripheral blood to the decidua in human pregnancy. J Immunol. 2008;180(8):5737–45.CrossRefPubMedGoogle Scholar