Placental villitis of unclear etiology during ovum donor in vitro fertilization pregnancy.
OBJECTIVE
Preliminary observations by a single pathologist at our institution revealed a 75% incidence of villitis of unexplained etiology in ovum donor in vitro fertilization pregnancies. Because the incidence of villitis of unexplained etiology in the general population is approximately 10%, we conducted a controlled study to compare the incidence of villitis of unexplained etiology in ovum donor in vitro fertilization pregnancies to that in in vitro fertilization pregnancies that do not use donated ova.


METHODS
Placental specimens of ovum donor in vitro fertilization pregnancies were matched randomly with pregnancies that resulted from both fresh and frozen/thawed native oocyte in vitro fertilization from March 5, 1995, to October 10, 2001, and examined in a blinded fashion by a single pathologist (D. J. R.) for villitis of unexplained cause. The incidence of villitis of unexplained etiology was analyzed in 27 patients who underwent ovum donor in vitro fertilization versus 37 patients who underwent native oocyte in vitro fertilization.


RESULTS
Villitis of unexplained cause occurred in 22.2% of ovum donor in vitro fertilization pregnancies, 10.8% of native oocyte in vitro fertilization pregnancies (fresh and frozen/thawed combined), and 14.3% of frozen/thawed cycles (P=.21).


CONCLUSIONS
Although the incidence was not statistically different than in in vitro fertilization that used native maternal oocytes, there was a 2-fold increase in villitis of unexplained cause in the ovum donor in vitro fertilization placentas, which suggests that immune-related disorders may be increased in ovum donor pregnancies.
Department of Obstetrics and Gynecology, Vincent Center for Reproductive Biology, Boston, MA, USA.
Aaron K
AK
Styer
Hannah J
HJ
Parker
Drucilla J
DJ
Roberts
Darryl
D
Palmer-Toy
Thomas L
TL
Toth
Jeffrey L
JL
Ecker
D000328:Adult; D002824:Chorionic Villi; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007249:Inflammation / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D014019:Tissue Donors