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. 2003 Oct;20(10):400–408. doi: 10.1023/A:1026236726568

Factors Associated with an Optimal Pregnancy Outcome in an Oocyte Donation Program

Sebastian Mirkin 1, Trinidad Garcia Gimeno 1, Carmina Bovea 1, Laurel Stadtmauer 1, William E Gibbons 1, Sergio Oehninger 1
PMCID: PMC3455173  PMID: 14649379

Abstract

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 ≤q33 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.

Keywords: FSH, implantation, IVF, LH, Oocyte donation, pregnancy

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REFERENCES

  • 1.Centers for Disease Control and Prevention: Assisted Reproductive Technology Success Rates, National Summary and Fertility Clinic Reports, Centers for Disease Control and Prevention, 1999, pp 42–43
  • 2.Stolwijk AM, Zielhuis GA, Sauer MV, Hamilton CJ, Paulson RJ. The impact of the woman's age on the success of standard and donor in vitro fertilization. Fertil Steril. 1997;67(4):702–710. doi: 10.1016/s0015-0282(97)81370-2. [DOI] [PubMed] [Google Scholar]
  • 3.American Society for Reproductive Medicine (ASRM): Guidelines for Gametes and Embryo Donation. A Practice Committee Report. Guidelines and Minimum Standards, ASRM, 1997 [DOI] [PubMed]
  • 4.American Society for Reproductive Medicine (ASRM): Guidelines on Number of Embryos Transferred, A Practice Committee Report, 1999
  • 5.2002 Guidelines for gamete and embryo donation. Fertil Steril 2002;6(S5):S6-S9 [DOI] [PubMed]
  • 6.Borini A, Violini F, Bianchi L, Bafaro MG, Trevisi MR, Flamigni C. Improvement of pregnancy and implantation rates in cyclic women undergoing oocyte donation after long-term down-regulation. Hum Reprod. 1995;10(11):3018–3021. doi: 10.1093/oxfordjournals.humrep.a135839. [DOI] [PubMed] [Google Scholar]
  • 7.Paulson RJ, Hatch IE, Lobo RA, Sauer MV. Cumulative conception and live birth rates after oocyte donation: Implications regarding endometrial receptivity. Hum Reprod. 1997;12(4):835–839. doi: 10.1093/humrep/12.4.835. [DOI] [PubMed] [Google Scholar]
  • 8.Younis JS, Simon A, Laufer N. Endometrial preparation: Lessons from oocyte donation. Fertil Steril. 1996;66(6):873–884. doi: 10.1016/s0015-0282(16)58677-4. [DOI] [PubMed] [Google Scholar]
  • 9.Muasher SJ, Oehninger S, Simonetti S, Matta J, Ellis LM, Liu HC, Jones GS, Rosenwaks Z. The value of basal and/or stimulated serum gonadotropin levels in prediction of stimulation response and in vitro fertilization outcome. Fertil Steril. 1988;50(2):298–307. doi: 10.1016/s0015-0282(16)60077-8. [DOI] [PubMed] [Google Scholar]
  • 10.Oehninger S, Kruger TF, Simon T, Jones D, Mayer J, Lanzendorf S, et al. A comparative analysis of embryo implantation potential in patients with severe teratozoospermia undergoing in-vitro fertilization with a high insemination concentration or intracytoplasmic sperm injection. Hum Reprod. 1996;11(5):1086–1089. doi: 10.1093/oxfordjournals.humrep.a019302. [DOI] [PubMed] [Google Scholar]
  • 11.Veeck LL. An Atlas of Human gametes and Conceptuses. New York: Parthenon; 1998. pp. 40–45. [Google Scholar]
  • 12.Oehninger S, Veeck L, Lanzendorf S, Maloney M, Toner J, Muasher S. Intracytoplasmic sperm injection: Achievement of high pregnancy rates in couples with severe male factor infertility is dependent primarily upon female and not male factors. Fertil Steril. 1995;64(5):977–981. doi: 10.1016/s0015-0282(16)57913-8. [DOI] [PubMed] [Google Scholar]
  • 13.Queenan JT, Jr, Veeck LL, Toner JP, Oehninger S, Muasher SJ. Cryopreservation of all prezygotes in patients at risk of severe hyperstimulation does not eliminate the syndrome, but the chances of pregnancy are excellent with subsequent frozenthaw transfers. Hum Reprod. 1997;12(7):1573–1576. doi: 10.1093/humrep/12.7.1573. [DOI] [PubMed] [Google Scholar]
  • 14.Khalifa E, Brzyski RG, Oehninger S, Acosta AA, Muasher SJ. Sonographic appearance of the endometrium: The predictive value for the outcome of in-vitro fertilization in stimulated cycles. Hum Reprod. 1992;7(5):677–680. doi: 10.1093/oxfordjournals.humrep.a137718. [DOI] [PubMed] [Google Scholar]
  • 15.Ueno J, Oehninger S, Brzyski RG, Acosta AA, Philput CB, Muasher SJ. Ultrasonographic appearance of the endometrium in natural and stimulated in-vitro fertilization cycles and its correlation with outcome. Hum Reprod. 1991;6(7):901–904. doi: 10.1093/oxfordjournals.humrep.a137455. [DOI] [PubMed] [Google Scholar]
  • 16.Veeck LL, Amundson CH, Brothman LJ, DeScisciolo C, Maloney MK, Muasher SJ, et al. Significantly enhanced pregnancy rates per cycle through cryopreservation and thaw of pronuclear stage oocytes. Fertil Steril. 1993;59(6):1202–1207. doi: 10.1016/s0015-0282(16)55977-9. [DOI] [PubMed] [Google Scholar]
  • 17.Oehninger S, Mayer J, Muasher S. Impact of different clinical variables on pregnancy outcome following embryo cryopreservation. Mol Cell Endocrinol. 2000;169(1–2):73–77. doi: 10.1016/s0303-7207(00)00355-5. [DOI] [PubMed] [Google Scholar]
  • 18.Jones HW, Jr, Jones D, Kolm P. Cryopreservation:Asimplified method of evaluation. Hum Reprod. 1997;12(3):548–553. doi: 10.1093/humrep/12.3.548. [DOI] [PubMed] [Google Scholar]
  • 19.Jung SH, Ahn C. Sample size estimation for GEE method for comparing slopes in repeated measurements data. Stat Med. 2003;22(8):1305–15. doi: 10.1002/sim.1384. [DOI] [PubMed] [Google Scholar]
  • 20.Zar JH. Biostatistical Analysis. Eaglewood cliffs, NJ: Prentice-Hall; 1998. [Google Scholar]
  • 21.Lewit N, Kol S. The low responder female IVF patient with hypogonadotropic hypogonadism: Do not give up! Fertil Steril. 2000;74(2):401–402. doi: 10.1016/s0015-0282(00)00599-9. [DOI] [PubMed] [Google Scholar]
  • 22.Regan L, Owen EJ, Jacobs HS. Hypersecretion of luteinising hormone, infertility, and miscarriage. Lancet. 1990;336(8724):1141–1144. doi: 10.1016/0140-6736(90)92765-a. [DOI] [PubMed] [Google Scholar]
  • 23.Homburg R, Berkowitz D, Levy T, Feldberg D, Ashkenazi J, Ben Rafael Z. In vitro fertilization and embryo transfer for the treatment of infertility associated with polycystic ovary syndrome. Fertil Steril. 1993;60(5):858–863. doi: 10.1016/s0015-0282(16)56287-6. [DOI] [PubMed] [Google Scholar]
  • 24.Homburg R, Jacobs HS. Etiology of miscarriage in polycystic ovary syndrome. Fertil Steril. 1989;51(1):196–197. doi: 10.1016/s0015-0282(16)60457-0. [DOI] [PubMed] [Google Scholar]
  • 25.Ludwig M, Finas DF, al-Hasani S, Diedrich K, Ortmann O. Oocyte quality and treatment outcome in intracytoplasmic sperm injection cycles of polycystic ovarian syndrome patients. Hum Reprod. 1999;14(2):354–8. doi: 10.1093/humrep/14.2.354. [DOI] [PubMed] [Google Scholar]
  • 26.Licciardi FL, Liu HC, Rosenwaks Z. Day 3 estradiol serum concentrations as prognosticators of ovarian stimulation response and pregnancy outcome in patients undergoing in vitro fertilization. Fertil Steril. 1995;64(5):991–994. doi: 10.1016/s0015-0282(16)57916-3. [DOI] [PubMed] [Google Scholar]
  • 27.Smotrich DB, Widra EA, Gindoff PR, Levy MJ, Hall JL, Stillman RJ. Prognostic value of day 3 estradiol on in vitro fertilization outcome. Fertil Steril. 1995;64(6):1136–1140. [PubMed] [Google Scholar]
  • 28.Phophong P, Ranieri DM, Khadum I, Meo F, Serhal P. Basal 17 beta-estradiol did not correlate with ovarian response and in vitro fertilization treatment outcome. Fertil Steril. 2000;74(6):1133–1136. doi: 10.1016/s0015-0282(00)01621-6. [DOI] [PubMed] [Google Scholar]
  • 29.Caligara C, Navarro J, Vargas G, Simon C, Pellicer A, Remohi J. The effect of repeated controlled ovarian stimulation in donors. Hum Reprod. 2001;16(11):2320–2323. doi: 10.1093/humrep/16.11.2320. [DOI] [PubMed] [Google Scholar]
  • 30.Spandorfer SD, Moomjy M, Davis OK, Barmat LI, Cholst I, Rosenwaks Z. Oocyte donation: Does a previous attempt affect a subsequent attempt? Fertil Steril. 1998;70(2):222–226. doi: 10.1016/s0015-0282(98)00167-8. [DOI] [PubMed] [Google Scholar]
  • 31.Noyes N, Hampton BS, Berkeley A, Licciardi F, Grifo J, Krey L. Factors useful in predicting the success of oocyte donation: A 3-year retrospective analysis. Fertil Steril. 2001;76(1):92–97. doi: 10.1016/s0015-0282(01)01823-4. [DOI] [PubMed] [Google Scholar]
  • 32.Check JH, Askari HA, Choe J, Baker A, Adelson HG. The effect of the age of the recipients on pregnancy rates following donor-oocyte replacement. J Assist Reprod Genet. 1993;10(2):137–140. doi: 10.1007/BF01207736. [DOI] [PubMed] [Google Scholar]
  • 33.Shapiro H, Cowell C, Casper RF. The use of vaginal ultrasound for monitoring endometrial preparation in a donor oocyte program. Fertil Steril. 1993;59(5):1055–1058. doi: 10.1016/s0015-0282(16)55927-5. [DOI] [PubMed] [Google Scholar]
  • 34.Coulam CB, Bustillo M, Soenksen DM, Britten S. Ultrasonographic predictors of implantation after assisted reproduction. Fertil Steril. 1994;62(5):1004–1010. doi: 10.1016/s0015-0282(16)57065-4. [DOI] [PubMed] [Google Scholar]
  • 35.Remohi J, Ardiles G, Garcia-Velasco JA, Gaitan P, Simon C, Pellicer A. Endometrial thickness and serum oestradiol concentrations as predictors of outcome in oocyte donation. Hum Reprod. 1997;12(10):2271–2276. doi: 10.1093/humrep/12.10.2271. [DOI] [PubMed] [Google Scholar]

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