Preterm Birth and Small-for-Gestational Age in Singleton In Vitro Fertilization Births Using Donor Oocytes

Abstract

We used 2006-2015 US National Assisted Reproductive Technology Surveillance System data to compare preterm birth and fetal growth for livebo n singletons (24-42 week gestation) following donor versus autologous oocyte in vitro fertilization (IVF). Using binary and multinomial logistic regressi n, we computed adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for associations between use of donor oocytes and preterm delivery, small-f r-gestational-age (SGA), and large-for-gestational age (LGA), stratified by fresh and thawed embryo status and accounting for maternal characteristics and year of birth. There were 204,855 singleton births from fresh embryo transfers and 106,077 from thawed embryo transfers. Among fresh embryo transfers, donor oocyte births had higher odds of preterm (aOR 1.32, 95% CI 1.27-1.38) and LGA (aOR 1.27, 95% CI 1.21-1.33) but lower odds of SGA (aOR 0.81, 95% CI 0.77-0.85). Among thawed embryo transfers, donor oocyte births had higher odds of preterm (aOR 1.57, 95% CI 1.48-1.65) and SGA (aRR 1.22, 95% CI 1.14-1.31), but lower odds of LGA (aOR 0.87, 95% CI 0.82-0.92). Use of donor oocytes was associated with increased odds of preterm delivery irrespective of embryo status; odds of SGA were increased for donor versus autologous oocyte births among thawed embryo transfers only.