Oocyte donation recipients of very advanced age: perinatal complications for singletons and twins

Abstract

Objective: To compare maternal, obstetric, and neonatal outcomes between women who underwent oocyte donation at or after age 50 years and from 45 through 49 years.

Design: Single-center, retrospective cohort study.

Setting: Maternity hospital.

Patient(s): Forty women aged 50 years and older ("older group") and 146 aged 45-49 years ("younger group").

Intervention(s): Comparison between the older and younger groups, globally and after stratification by type of pregnancy (singleton/twin pregnancy).

Main outcome measure(s): Maternal, obstetric, and neonatal outcomes.

Result(s): The rate of multiple-gestation pregnancies was similar in both groups (35% in the older and 37.7% in the younger group). We observed no significant difference globally between the two groups for outcomes, except for the mean duration of postpartum hospitalization, which was significantly longer among the older women (mean ± SD, 9.5 ± 7.4 days vs. 6.8 ± 4.4 days). The rates of isolated pregnancy-related hypertension and of fetal growth restriction in singleton pregnancies were statistically higher in the older than in the younger group (19.2% vs. 5.5%, and 30.7% vs. 14.3%, respectively). Complication rates with twin pregnancies were similar between groups and very high compared with singleton pregnancies.

Conclusion(s): Complication rates were similar among women aged 50 years and older and those aged 45-49 years. Nonetheless, given the high rate of complication in both groups, especially among twin pregnancies, single embryo transfer needs to be encouraged for oocyte donations after age 45 years.

Keywords: Advanced maternal age; obstetric complications; oocyte donation; twin pregnancy.