No significant IVF, perinatal differences with embryos from donor, autologous oocytes

Key takeaways:

• Embryos from donor or autologous oocytes had similar implantation, live birth, ectopic pregnancy and miscarriage rates.
• Gestational age and birth weight were also similar in donor or autologous oocyte groups.

Use of embryos from donor or autologous oocytes resulted in no significant differences in live birth, implantation, ectopic pregnancy and miscarriage rates, gestation duration or infant birth weight, researchers reported.

“The frequency of age-related embryonic aneuploidy may explain the low implantation and live birth rate achieved by assisted reproduction technology treatments in women > 38 years old,” Mauro Cozzolino, MD, PhD, a gynecologist in the IVIRMA Global Research Alliance at IVI Rome and IVI Foundation at La Fe Health Research Institute, and colleagues wrote. “Yet, the increasing popularity of preimplantation genetic testing for aneuploidy, particularly in older women, has generated literature that consistently focuses on the possible advantages and limitations of its application, which may have diverted attention from other age-related factors that are potentially associated with the ploidy-independent decline in human fertility.”

Cozzolino and colleagues conducted a retrospective, observational, multicenter cohort study, published in Fertility and Sterility, with data from 556 single, frozen euploid embryo transfers from women aged 39 to 46 years who underwent IVF with intracytoplasmic sperm injection and preimplantation genetic testing for aneuploidy from 2017 to 2021. Of all blastocysts, 278 were derived from autologous oocytes and 278 from donor oocytes.

Primary outcome was live birth rate after first embryo transfer, and secondary outcomes included rates of implantation, ectopic pregnancy and miscarriage, and gestational age and birth weight at delivery.

Implantation and live birth rates were similar at 57.91% and 41.01%, respectively, for women using embryos from donor oocytes and 57.19% and 42.45%, respectively, for women using embryos from autologous oocytes. In addition, ectopic pregnancy and miscarriage rates were also similar occurring in 0.72% and 16.19%, respectively, of pregnancies using donor oocytes and 0.36% and 14.39%, respectively, of those using autologous oocytes.

Mean gestational age and mean infant birth weight at delivery were also similar at 38.5 and 39.16 weeks for women using donor oocytes and those using autologous oocytes.

In the univariate and multivariate analyses, researchers observed no association between advanced maternal age and live birth rate.

“Our findings suggest that the age-related reproductive decline in women is likely associated with meiotic failures, and patients > 40 years old with at least one euploid embryo can remain hopeful with the knowledge that they have comparable live birth rate to age-matched women using donor oocytes,” the researchers wrote. “Nevertheless, future studies should develop strategies to overcome chromosomal aneuploidies in oocytes to improve assisted reproduction technology for advanced reproductive-aged patients.”