P-416 Age and Oocyte Donation: An Analysis of Pregnancy Outcomes in Women Under and Above 45
Authors: Rahav Koren R , Shalev Ram H , Wiser A , Miller N 
Published: June 2023

Abstract

Study question
Do Maternal and Neonatal Risks Increase among oocyte recipients &gt; 45 years compared to younger oocyte recipients?

Summary answer
This study fails to demonstrate increased maternal and neonatal complications among oocyte recipients &gt;45 years. A lower socioeconomic status is strongly related with those risks.

What is known already
Oocyte donation (OD) is an integral part of modern assisted reproductive care, and its prevalence has increased dramatically. Although OD is an effective fertility option for women with advanced age these pregnancies have higher risks of maternal and obstetric morbidity.

Study design, size, duration
This study is a retrospective big data cohort study that utilizes electronic data from Maccabi Healthcare Services, a 2.5-million patient integrated care organization, which represents 25% of the pregnant population in the country. The data used in this study was collected from 2000 through 2018.

Participants/materials, setting, methods
A total of 1433 OD pregnancies were divided into two groups according to maternal age at birth: 946 singleton gestations (335 of women &gt; 45 and 611 of women ≤45) and 487 twin gestations (175 of women &gt; 45 and 312 of women ≤45). The two groups were compared for maternal characteristics, perinatal outcomes including PTB and small for gestational age (SGA), and obstetric outcomes.

Main results and the role of chance
For singletons, mean maternal age at birth was 47.6 for women &gt; 45 and 40.7 for women ≤45 (p &lt; 0.001). The women &gt; 45 group had significantly higher BMI and had higher birth weights (26.4 vs 25.6, p = 0.04 and 3011g vs 2920g, p = 0.04, respectively). The incidence of PTB &lt;37 weeks, PTB &lt;34 weeks and PTB &lt;32 weeks among singletons was higher among the women ≤45 group (24.9% vs 18.5%, p = 0.05, 7.9% vs 4.5%, p = 0.04 and 4.9% vs 2.5%, p = 0.05, respectively). Multivariable logistic regression analysis for PTB &lt;37 weeks and SGA in singletons demonstrated that maternal age &lt;45 and low socioeconomic status (SES) were significant variables. For twin gestations, mean maternal age at birth was 47.3 for women &gt; 45 and 40.2 for women ≤45 (p &lt; 0.001). The women &gt; 45 group had significantly lower SES and lower birth weights (6.8 vs 7.2 SES scale, p = 0.04 and 2119g vs 2256g, p = 0.01, respectively). multivariable logistic regression analysis for PTB &lt;37 weeks in twins demonstrated that low SES and maternal smoking were significant variables. No differences were found between the groups among singletons and twin gestations regarding hypertension, diabetes, intrauterine fetal demise, malpresentation, post-partum hemorrhage, retained placentae and cesarean deliveries.

Limitations, reasons for caution
Underdiagnoses and missing information regarding indications leading to OD may have led to better understanding of the data.

Wider implications of the findings
OD pregnancies should be considered high-risk. Understanding the differences in complications among age groups can help healthcare providers provide more personalized and effective care to women who are considering oocyte donation. Comparative studies between different age groups can contribute to future practices and policies related to oocyte donation.

Trial registration number
0046-18-BBL