Abstract
Research question
Do donor age, AMH, AFC, BMI and reproductive history predict response to ovarian stimulation?
Do donor and recipient clinical markers and embryology parameters predict recipient
pregnancy and live birth?
Design
Retrospective cohort study of 494 altruistic oocyte donors aged 18–35 years; 340 were
matched to 559 recipients. Predictors of donor total oocyte yield and total mature
oocyte yield were identified. Total and mature oocyte number were compared according
to stratified donor AMH and age. Donor, recipient and embryology parameters predictive
of recipient primary outcomes (clinical pregnancy and live birth) were identified.
Results
Donor age and AMH predicted total oocyte yield (P = 0.030 and P < 0.001)) and total mature oocyte yield (P = 0.011 and P < 0.001). Donors aged 30–35 years with AMH 15–29.9 pmol/l had lower total oocyte
yield (P = 0.004) and mature oocyte yield (P < 0.001) than donors aged 18–24 years. Up to an AMH threshold of 39.9 pmol/l, increasing
AMH levels predicted higher total oocyte yield (<15 pmol/l versus 15–29.9 pmol/l,
P = 0.001; 15–29.9 pmol/l versus 30–39.9 pmol/l, P < 0.001; 30–39.9pmol/l versus ≥ 40 pmol/l, P = 1.0) and mature oocyte yield (<15 pmol/l versus 15–29.9 pmol/l, P = 0.005; 15–29.9 pmol/l versus 30–39.9 pmol/l, P = 0.006; 30–39.9 pmol/l versus ≥40 pmol/l, P = 1.0). In recipients, the rate of transferrable embryos per oocytes received, fertilized
and number of embryo transfers needed to achieve the primary outcome were predictors
of cumulative clinical pregnancy (P = 0.011, P = 0.017 and P < 0.001) and live birth (P = 0.008, P = 0.012 and P < 0.001) rates. Recipient BMI (P = 0.024) and previous miscarriages (P = 0.045) were predictors of cumulative live birth rate. Donor age 18–22 years was
associated with a lower incidence of recipient clinical pregnancy (P = 0.004) and live birth (P = 0.001) after the first embryo transfer versus donor age 23–29 years.
Conclusions
Donor age and AMH are independent predictors of oocyte yield. Raised recipient BMI
and history of miscarriages reduce cumulative live birth rates, which may be increased
by selecting donors aged 23–29 years, instead of younger donors.
KEYWORDS
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Biography
Dr Vanessa Pataia completed her MSc in Reproductive and Developmental Biology from Imperial College London in 2013 and PhD in Biosciences from King's College London in 2018. She currently works as a research associate at the London Egg Bank investigating factors that influence oocyte donor and recipient treatment success.
Key message
Donor age and AMH are predictors of oocyte yield and may help identify high-quality oocyte donors. Raised recipient BMI and prior miscarriages reduce cumulative live birth rate, which may be increased by the selection of donors aged 23-29 rather than younger donors. Donor, recipient and embryology factors influence recipient outcomes.
Article info
Publication history
Published online: May 23, 2021
Accepted:
May 13,
2021
Received in revised form:
May 7,
2021
Received:
February 5,
2021
Declaration: The authors report no financial or commercial conflicts of interest.Identification
Copyright
© 2021 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
