This study investigates neonatal outcomes in singleton and multiple pregnancies following in vitro fertilization (IVF) using donor (IVF-D) versus autologous (IVF-A) material. A retrospective cohort analysis was conducted with 988 neonates born between 2017 and 2024 across three tertiary neonatal units in Romania. The primary outcomes included preterm birth, low birthweight, neonatal asphyxia, and congenital malformations. IVF-D pregnancies were associated with a higher prevalence of adverse neonatal outcomes, particularly in multiple gestations. Preterm birth and low birthweight were more frequent in the IVF-D group, with donor-conceived neonates exhibiting increased rates of neonatal ventilation and prolonged hospitalization. Additionally, congenital anomalies, particularly cardiac malformations, were more prevalent in IVF-D pregnancies, suggesting possible immunological and epigenetic influences. Despite these differences, overall neonatal survival was comparable between groups. These findings contribute to the existing literature on assisted reproductive technologies, emphasizing the need for further research to clarify the biological mechanisms influencing neonatal outcomes and to optimize the clinical management of IVF pregnancies using donor gametes.
Keywords: assisted reproductive technology; donor gametes; in vitro fertilization; neonatal outcomes.