Abstract
Assisted reproductive technology using donor-egg in vitro fertilization (D-IVF) has
enabled women 50 years and above to successfully achieve pregnancy. We examine the
safety profile of these pregnancies through a large, single-center case series and
retrospective cohort analysis in which all participants were carefully screened medically
prior to conception. Consecutive women aged ≥ 50 years (n = 101) who achieved a viable pregnancy via D-IVF were identified and their perinatal
outcomes were recorded. These data were compared with control data from younger (≤ 42
years) recipients of D-IVF (n = 41) who also achieved a viable pregnancy at our center during the same period.
Compared with the younger women, older recipients had statistically similar rates
of hypertensive disorders of pregnancy (23% versus 14%, odds ratio [OR] 1.9 [0.65
to 5.4]), gestational diabetes (4.0% versus 3.0%, OR 1.4 [0.15 to 113.0]), preterm
premature rupture of membranes/preterm labor (8.9% versus 14%, OR 0.59 [0.18 to 1.9]),
and abnormal placentation (2.1% versus 0%). Cesarean delivery was high in women ≥ 50
(81% of singletons, 100% of multiples). There was one maternal death, which occurred
before delivery in a 49-year-old woman who would have been 50 at term had she survived,
presumably secondary to myocardial infarction. Primary neonatal outcomes of gestational
age and birth weight were excellent and similar between groups. Women ≥ 50 years who
achieve pregnancy via D-IVF are at high risk for maternal complications, particularly
hypertensive disorders and cesarean section, but at rates similar to those seen in
younger recipients.
Keywords
menopausal pregnancy - egg donation - IVF
