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Is oocyte donation a risk factor for preeclampsia? A systematic review and meta-analysis

  • Anna Blázquez
  • Désirée García
  • Amelia Rodríguez
  • Rita Vassena
  • Francesc Figueras
  • Valérie Vernaeve
Assisted Reproduction Technologies

Abstract

Purpose

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).

Methods

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).

Results

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.

Conclusions

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.

Keywords

Induced hypertension In vitro fertilization Oocyte donation Preeclampsia Pregnancy 

Notes

Acknowledgments

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

None.

Supplementary material

10815_2016_701_MOESM1_ESM.docx (190 kb)
Supplementary Table 1 Influence analysis under the random effect model. Of note, the exclusion of any of the studies did not relevantly change the weighted ORs. (DOCX 189 kb)
10815_2016_701_Fig4_ESM.gif (13 kb)
Supplementary Figure 1

Bubble graph with fitted meta-regression line of multiple pregnancy rate (prevalence difference between oocyte donation and IVF groups) against log-OR for PE. (GIF 12 kb)

10815_2016_701_MOESM2_ESM.tif (85 kb)
High Resolution Image (TIF 85 kb)
10815_2016_701_Fig5_ESM.gif (11 kb)
Supplementary Figure 2

Bubble graph with fitted meta-regression of age (difference between oocyte donation and IVF means) against log-OR for PE. (GIF 11 kb)

10815_2016_701_MOESM3_ESM.tif (81 kb)
High Resolution Image (TIF 80 kb)
10815_2016_701_MOESM4_ESM.docx (14 kb)
Supplementary Information 1 The search equation used in this systematic review. (DOCX 13.5 kb)

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Anna Blázquez
    • 1
  • Désirée García
    • 2
  • Amelia Rodríguez
    • 1
  • Rita Vassena
    • 1
  • Francesc Figueras
    • 3
  • Valérie Vernaeve
    • 1
    • 2
  1. 1.Clínica EUGINBarcelonaSpain
  2. 2.Fundació Privada EUGINBarcelonaSpain
  3. 3.BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPSUniversity of Barcelona and Centre for Biomedical Research on Rare Diseases (CIBER-ER)BarcelonaSpain

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