A recent retrospective study published in Fertility and Sterility has compared the risk of gestational hypertension in two groups of pregnant women after undergoing assisted reproductive techniques (ART) using both autologous (from the pregnant woman’s oocytes) and donated embryos (obtained after fertilizing donor oocytes).

The aim of the study was to determine whether pregnancies with donated embryos have a higher risk of obstetric complications than pregnancies after autologous transfer of cryopreserved and thawed embryos (FET).

For this purpose, the results obtained in six French assisted reproduction centers during the period 2003-2018 were evaluated.

The study sample consisted of two groups of women under 44 years old. The first, of 73 women pregnant with a single embryo from a donor. The second, of 136 pregnant women, also a singleton pregnancy, but after autologous FET (of embryos from their own oocytes).

The percentages of hypertensive disorders in pregnancy (HDPs) were comparatively analyzed both in the group of donated embryos and in the group of autologous FET. It was shown that they were significantly more frequent in the group of women who gestated donated embryos, especially in its most severe forms (17.5% vs. 4.6%). In contrast, their isolated hypertension frequencies were comparable (7.0% vs. 7.3%).

A multivariate analysis confirmed an increased severe HDP risk in pregnant women with donated embryos (odds ratio 2.08 [95% confidence interval: 1.08–4.02]). In addition, the number of cesarean sections was more frequent for donated-embryo pregnancies (47.3% vs. 29.2%). No significant differences were observed for prematurity, birth weight and length, Apgar score, small for gestational age, large for gestational age, neonatal malformations, and sex ratio.

The authors concluded that the risk of severe HDP was 4 times higher for donated-embryo pregnancies than for autologous-FET pregnancies, even for young women. The HDP risk must be acknowledged when scheduling transfers of donated embryos to inform donated-embryo recipients. In addition, they should be provided with more exhaustive monitoring during pregnancy.

Bioethical assessment

This new study reveals another risk associated with ART, in this case related to the pregnant mother of donated embryos, not autologous.

Previously, we have already published that there are increases in the risk of the appearance of certain pathologies associated with assisted reproductive techniques. Women who are going to undergo IVF must be informed of them, since the existence of these complications must be known by the interested parties before making a decision in this regard.

A study published in the same journal in 2020 reported that singletons conceived through ART had an increased risk of infant mortality from birth up to 1 year of life, predominantly in the early neonatal period and in pregnancies after transfer of frozen and thawed embryos.

Respect for the principle of patient autonomy requires that patients be provided with all the information related to the clinical procedure they are about to undergo, so that they can properly assess the benefit/risk balance before making a decision.

The information provided to women who are going to undergo ART should include the risks associated with these techniques, both for pregnant women and for the unborn child. (See more HERE).

The lack of adequate information limits the ability to make free decisions, which causes some women to opt for alternatives of which they may not be aware of the associated risks, both for their own health and that of their child.

 

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