Pregnancy Outcomes Following In Vitro Fertilization: A Multicenter Comparative Analysis Between Donor-oocyte Recipients and Self-oocyte Patients in Greece

Background/Aim: Delayed childbearing has increased the reliance on in vitro fertilization (IVF) with donor oocytes for women of advanced maternal age often facing more obstetric complications compared to younger women using self-oocytes. This study evaluated and contrasted key obstetric and perinatal parameters between these two groups. Patients and Methods: In this retrospective multicenter study, completed IVF embryo transfer cycles were analyzed. Clinical data including clinical pregnancy, miscarriage, ectopic pregnancy rates, and major pregnancy complications were collected. Obstetric outcomes (e.g., mode of delivery, preterm birth, and neonatal parameters such as birth weight, Apgar scores, and NICU admissions) were compared between the donor-oocyte recipients (DOR-IVF) and self-oocyte (SO-IVF) groups. Statistical analysis comprised chi-square tests, t-tests, and multivariable logistic and linear regressions to adjust for potential confounders. Results: The DOR-IVF group demonstrated a clinical pregnancy rate of 44.8% (196 cases) with an 8.8% miscarriage rate, while the SO-IVF group reported 242 clinical pregnancies with an 8.1% miscarriage rate. Overall, nine ectopic pregnancies (2%) were noted, with statistically significant differences in ectopic and miscarriage rates between the groups (p=0.008 and p=0.025, respectively). Although the mean gestational age was similar and NICU admissions did not differ significantly (p=0.125), the DOR-IVF group exhibited a higher incidence of pregnancy complications (p=0.009). Multivariable logistic regression identified DOR-IVF as an independent predictor for pregnancy complications (adjusted odds ratio 2.38; 95% confidence interval=1.53-3.70). Additionally, subgroup analyses revealed that 1-minute Apgar scores were positively associated with DOR-IVF status (p=0.048) and birth weight was inversely related to the number of babies transferred (p=0.006). Conclusion: DOR-IVF patients experience significantly increased risk in obstetric complications compared to younger women using SO-IVF, although neonatal outcomes remain largely similar.