Factors associated with an optimal pregnancy outcome in an oocyte donation program.

Purpose: To identify donor and recipient variables that may have a significant impact on pregnancy outcome in order to optimize results of an oocyte donation program.

Method: Retrospective analysis through a Generalized Estimating Equation (GEE) approach to clustered and binary clustered data, linear mixed effects model, scatter plot smoothing functions, and receiving operator characteristics (ROC) curves.

Setting: University-based center.

Intervention(s): None.

Main Outcome Measures: Pregnancy and implantation rates.

Patients: 257 donation and transfer cycles.

Result(s): Overall results were as follows: clinical pregnancy rate, 47%; implantation rate, 22%; abortion rate, 19%; and overall multiple pregnancy rate, 35%. The total reproductive potential was 60%. Implantation and pregnancy rates were not significantly related to any variable from donors or recipients. Abortion rate increased significantly with donors' increased basal serum LH. Pregnancy rate was significantly enhanced with improved embryo quality. In donors stimulated more than once, the pregnancy rate was 84%.

Conclusion(s): Although no single or combined donor or recipient variable(s) could be identified as predictor(s) of pregnancy, the data suggest that donors < or = 33 years of age with basal cycle day 3 serum levels of FSH 4-8 IU/L, LH < 8 IU/L, and E2 < 70 pg/mL had an optimal outcome. Transfer of two selected embryos on day 3 yields a favorable pregnancy outcome while significantly decreasing the occurrence of multiple pregnancies. These policies, in addition to embryo cryopreservation, were associated with optimal pregnancy outcome in oocyte donation.