title: The role of embryonic origin in preeclampsia: a comparison of autologous in vitro fertilization and ovum donor pregnancies.
abstract: OBJECTIVE
  To compare the risk of gestational hypertension and preeclampsia in pregnancies conceived through standard in vitro fertilization (IVF) using autologous oocytes with pregnancies conceived using donated oocytes.
  
  
  METHODS
  We conducted a retrospective, matched cohort study of women undergoing IVF using autologous compared with donor oocytes between 1998 and 2005. Women with live births resulting from oocyte donor pregnancies were matched for age and plurality (singleton or twin) with women undergoing autologous IVF. Primary outcomes were the incidence of preeclampsia or gestational hypertension (with and without proteinuria) in the third trimester. Data on preterm delivery, low birth weight, and embryo cryopreservation were also recorded.
  
  
  RESULTS
  Outcome data were available for 158 pregnancies, including 77 ovum-donor recipient pregnancies and 81 pregnancies using autologous oocytes. There were no differences in age, parity, and gestational type between the two cohorts. The incidence of gestational hypertension and preeclampsia was significantly higher in ovum-donor recipients compared with women undergoing autologous IVF (24.7% compared with 7.4%, P<.01, and 16.9% compared with 4.9%, P=.02, respectively). Ovum-donor recipients were more likely than women undergoing autologous IVF to deliver prematurely (34% compared with 19%). This association remained after controlling for multiple gestation (odds ratio 2.6, 95% confidence interval 1.04-6.3). Sixteen pregnancies from cryopreserved embryos were more likely to have hypertensive disorders of pregnancy (odds ratio 5.0, 95% confidence interval 1.2-20.5).
  
  
  CONCLUSIONS
  Pregnancies derived from donor oocytes and cryopreserved-thawed embryos may be at a higher risk for hypertensive disorders of pregnancy. These findings inform future research and help counsel women using assisted reproductive technology.
authors.affiliation: From the Department of Obstetrics and Gynecology, Women and Infants Hospital of Rhode Island, Providence, Rhode Island; the Department of Obstetrics and Gynecology, University of Washington, Seattle, Seattle, Washington; Department of Obstetrics and Gynecology, Oregon Health Sciences University, Portland, Oregon; the Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, California; and the Department of Reproductive Endocrinology and Infertility, Weill Cornell Medical College, New York, New York.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Klatsky
authors.forename: Shani S
authors.initials: SS
authors.lastname: Delaney
authors.forename: Aaron B
authors.initials: AB
authors.lastname: Caughey
authors.forename: Nam D
authors.initials: ND
authors.lastname: Tran
authors.forename: Glenn L
authors.initials: GL
authors.lastname: Schattman
authors.forename: Zev
authors.initials: Z
authors.lastname: Rosenwaks
mesh_terms: D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects*; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000209:etiology; D018587:Oocyte Donation / Q000009:adverse effects*; D011225:Pre-Eclampsia / Q000209:etiology*; D011247:Pregnancy; D047928:Premature Birth; D014427:Twins