(484) Donor gamete status and hypertensive disorders of pregnancy in pregnancies conceived with assisted reproductive technologies

It is hypothesized that abnormal maternal immune tolerance may lead to a higher risk of HDP in pregnancies conceived with ART, which accounts for an increasing percentage of live births in the United States.We sought to determine if pregnancies resulting from in vitro fertilization (IVF) of double donor gametes have a higher risk of HDP compared to other ART procedures in a cohort of deliveries in a healthcare center between 1998-2016.


Study Design: Pregnancies conceived via ART at the healthcare center’s infertility clinic were linked to delivery records. The overall cohort consisted of 48,749 deliveries; 1,949 of those deliveries were conceived with ART at the fertility clinic (13% used intrauterine insemination [IUI], 87% used IVF). HDP were ascertained using an electronic health record-based definition that incorporated quantitative blood pressure and laboratory data, as well as complications in labor and delivery. Gamete donation status was classified into four categories: no donor gamete, donor sperm, donor oocyte, double gamete donation. Adjusted generalized estimating equations accounting for multiple pregnancies per patient were used to determine differences in the risk of HDP by gamete donation categories.

Results: The overall rate of HDP in the non-ART population was 7.2%; in the ART population, the rate of HDP was 12.9%. After adjustment, the risk of HDP in donor oocyte and double gamete donation categories was significantly higher than the no donor gamete category (Table 1). There was no difference in the risk of HDP between donor sperm and no donor gametes. Results did not change after adjustment for IUI versus IVF and the use of intracytoplasmic injection of sperm (ICSI) in the IVF cohort.

Conclusion: Donor oocyte was associated with an increased risk of HDP compared to pregnancies conceived with autologous oocytes and partner sperm in this ART cohort. While a known risk factor in spontaneously conceived pregnancies is new partner sperm, donor sperm had a similar rate of HDP compared to no donor gametes.