Impact of oocyte donation on perinatal outcome in twin pregnancies.

Objective: To compare perinatal outcomes of twin pregnancies after oocyte donation (OD), in vitro fertilization (IVF) with autologous oocyte (AO), and non-IVF conception.

Design: Five-year retrospective cohort study.

Setting: Tertiary university medical center.

Patient(s): All patients with twin pregnancies who gave birth after 24 weeks of gestation. The outcomes of 102 OD twin pregnancies were compared with those of 201 AO and 369 non-IVF twin pregnancies.

Intervention(s): None.

Main Outcome Measure(s): Obstetrical complications (pregnancy-induced hypertensive disorders, gestational diabetes, cholestasis, preterm rupture of membranes, mode of delivery, and postpartum hemorrhage) and neonatal outcome (preterm birth, low birth weight, neonatal hospitalization, and perinatal mortality).

Result(s): There was an increased incidence of preeclampsia (OD 26.5%, AO 7.0%, non-IVF 8.7%) and postpartum hemorrhage (OD 23.5%, AO 12.4%, non-IVF 7.6%) in the OD group compared with the AO and non-IVF groups. After adjustment for confounding factors, including maternal age and chorionicity, the risk of preeclampsia remained higher in the OD group, as did the risk of postpartum hemorrhage. The OD group was not at higher risk than the AO and non-IVF groups for other complications, particularly for preterm birth or low birth weight.

Conclusion(s): OD twin pregnancies are associated with a higher risk of preeclampsia and postpartum hemorrhage than AO and non-IVF twin pregnancies.