P-779 18-year follow-up of 609 children born after oocyte donation: comparison with IVF and spontaneous conception based on a national health registry
N Miller, R Rahav Koren, H Shalev-Ram, H Gluska, A WiserAbstract
Study question
To evaluate long-term health outcomes in children born after oocyte donation compared to children born after in vitro fertilization with autologous oocytes and spontaneous conception.
Summary answer
Children born after oocyte donation (OD) may have an increased risk of immune diseases and anxiety disorders compared to spontaneous conception (SC).
What is known already
Oocyte donation has advanced considerably since the first pregnancies from oocyte and embryo donation were reported nearly four decades ago. While perinatal outcomes of children born from oocyte donation pregnancies have been studied, findings remain inconsistent. Some studies report higher rates of preterm delivery and low birth weight, compared to standard IVF pregnancies, whereas others find no significant differences. However, the long-term health effects of children born after oocyte donation remain largely unexamined.
Study design, size, duration
This study is a retrospective big data cohort study that utilizes electronic data from Maccabi Healthcare Services, a patient integrated care organization, which represents 25% of the pregnant population in the country. The data used in this study was collected from 2000 through 2018.
Participants/materials, setting, methods
The cohort consisted of three groups based on the mode of conception: 609 children born after oocyte donation (OD), 12,678 after IVF with autologous oocytes (AO), and 456,786 after spontaneous conception (SC). The groups were compared for basic characteristics, including maternal age at birth, gestational age, weight percentile, first-child status, and gender. Additionally, the prevalence of chronic diseases, as defined by the ICD-9 classification, was analyzed across the groups.
Main results and the role of chance
Mean maternal age was significantly higher in the OD group (40.8 ± 4.3) compared to IVF with autologous oocytes (34.6 ± 4.9, p = 0.001) and SC (31.2 ± 5.3, p = 0.001). Mothers in the OD group also had higher socioeconomic status than those in the AO and SC groups (7.1 ± 1.5 vs. 6.7 ± 2 vs. 6 ± 2, p = 0.001). Preterm labor before 37 weeks was more frequent in the OD group compared to the SC group (24% vs. 5.7%, p = 0.001). Similarly, pregnancy-induced hypertension was more common in the OD group than in both the AO and SC groups (4.1% vs. 1.7% vs. 0.7%, p = 0.001). The proportion of immunological diseases was significantly higher in the OD group compared to the SC group (0.3% vs. 0.1%, p = 0.047), though not significantly different from the AO group (0.3% vs. 0.2%, p = 0.31). No significant differences were found among groups for other chronic diseases including cardiovascular, endocrinology, urology, neurology, rheumatology, neural tube defects, cancer, chromosomal anomalies, or cerebral palsy. Anxiety was more prevalent in children born after OD compared to AO (0.7% vs. 0.2%, p = 0.018) and SC (0.7% vs. 0.2%, p = 0.008). However, no significant differences were observed for other psychiatric conditions, including schizophrenia, depression, and ADHD.
Limitations, reasons for caution
The study’s retrospective design, reliant on varied physician diagnoses, may have caused under- or over-diagnoses. Missing data on OD/AO indications and male partner characteristics and sperm parameters limited analysis.
Wider implications of the findings
Mothers using oocyte donation may be reassured in knowing that most long-term health conditions are uncommon in children born through this method. However, there may be a slightly increased risk of immunological and anxiety disorders. Additional population-based studies with extended follow-up are necessary to further validate these findings.
Trial registration number
No