| Background and objectives:Premature ovarian insufficiency(POI),previously known as premature ovarian failure(POF),is defined as a ovarian functional recession characterized by a cessation of menstruation for at least 4 months before the age of 40 age with elevated basal follicle-stimulating hormone(FSH)level>25 IU/L.POI is one of the important causes of female infertility,seriously affecting the physical and mental health of women.It is estimated that POI affects 1%to 2%of women under the age of 40.Currently,oocyte donation(OD)is recommended and considered as the hope for women with this disease to become a mother.At present,the safety of assisted reproductive technology(ART)is a hot topic in clinical reserch.With the widely use of oocyte donation,the potential obstetric and neonatal outcomes are receiving increasing attention.Several studies have demonstrated that diminished ovarian reserve is associated with a high incidence of abnormal perinatal outcomes,including pregnancy-induced hypertension,pre-eclampsia and so on,but the conclusions are not consistent at present.POI women have some specific physiological features,such as diminished ovarian response,elevated basal FSH level and long-term deficiency of estrogen.However,the obstetric and perinatal outcomes in women with POI after OD pregnancies have not been reported.The objective of the present study was to compare obstetric and neonatal outcomes in women with POI after cryopreserved OD,women using cryopreserved autologus oocytes(AO)during introcytoplamic sperm injection-embryo transfer(ICSI-ET)treatment and women after spontaneous conception(SC).Materials and methodsThis study includes three groups.OD group:64 singleton pregnancy women with POI after cryopreserved oocyte donation were enrolled from the Center for Reproductive Medicine of Shandong University between January 2012 and August 2018 and the diagnostic criteria for POI patients were applied as follows:I.patients age<40;?.oligomenorrhea or amenorrhea;?.basal serum FSH>25IU/L.AO group:84 singleton pregnancy women using autologus oocytes also were enrolled from the Center for Reproductive Medicine of Shandong University between January 2012 and August 2018.SC group:104 singleton pregnancy women after spontaneous conception were recruited from Department of Obstetrics and Gynecology,Qilu Hospital of Shandong University between January 2018 and June 2018.The baseline characteristics,obstetric and neonatal outcomes were compared among the three groups.ResultsThe incidence of pregnancy-induced hypertension was significantly higher in OD group than SC group(12.5%versus 0%;P=0.001)and similar difference was found in AO group than SC group(9.5%versus 0%;P=0.004).No similar defference was found between OD and AO group.The rate of cesarean section was found to be significantly higher in OD group than SC group(71.9%versus 51.0%;P=0.007)and it was also significantly higher in AO group than SC group(75.0%versus 51.0%;P=0.001).Other obstetric outcomes and all neonatal outcomes were comparable among three groups.ConclusionsPOI women who received OD is associated with an increased risk of pregnancy-induced hypertension compared with SC pregnancies,which may due to the diminished ovarian reserve and long-term exposure to a high-concentration estrogen circumstance.Women using AO have the same higher risk,which may due to patients suffering from polycystic ovarian syndrome(PCOS)or possessing rich ovarian response and long-term exposure to a high-concentration estrogen circumstance.POI women who received OD is not associated with the high incidence of adverse neonatal outcomes.High incidence of cesarean section in Patients receiving OD and patients using AO may attribute to their high incidence of pregnancy-induced hyper;tension and their baby being precious baby.In conclusion,more attention is needed for the blood presure of POI pregnancy women. |
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