Bridging the donor gap: a prospective comparative study of obstetric and perinatal outcomes based on gamete sources in IVF at a tertiary care centre of South India
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20263034Keywords:
Donor gametes, IVF, Dual donor, , Pre-eclampsia, Hypertensive disorders of pregnancy, ART regulation actAbstract
Background: The assisted reproductive technology (regulation) act of 2021 has standardized third-party gamete donation in India. However, the introduction of non-maternal genetic material creates an allogenic state that potentially compromises placentation and increases obstetric risks. This study evaluated maternal and perinatal outcomes across different gamete configurations in a South Indian tertiary care facility.
Methods: This prospective comparative observational study consecutively enrolled 125 IVF-conceived pregnancies over an 18-month period. The cohort was stratified into: autologous (n=98), donor sperm (n=11), donor egg (n=8), and dual donor (n=8). Relative risks (RR) and 95% confidence intervals (CI) were calculated. Multivariable logistic regression adjusted for maternal age and pre-existing comorbidities to identify independent predictors of adverse outcomes.
Results: In crude analysis, the dual donor cohort carried the highest risk for hypertensive disorders of pregnancy (HDP) (100% incidence; RR: 1.707) and severe pre-eclampsia (75% incidence; RR: 4.641). On multivariable regression, dual donor status emerged as the only significant independent predictor for HDP, showing a 12-fold increase in disease odds (OR: 12.06, 95% CI: 0.68–214.80, p=0.040). Isolated donor sperm or oocyte configurations did not show independent risk predictions for HDP or preterm delivery (p>0.05). Caesarean section rates were exceptionally high across all donor arms (81.8% to 100%). Perinatal outcomes, including neonatal intensive care admissions and congenital anomalies, were reassuringly similar across cohorts, although extremely low birth weight was selectively elevated across all donor categories.
Conclusions: Dual donor gamete use is an independent predictor of hypertensive disorders of pregnancy. The elevated clinical risks warrant early high-risk triaging, timely tertiary referral, and proactive first-trimester prophylactic strategies.
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