Recipient outcomes in an oocyte donation programme: should very young donors be excluded?

RESEARCH QUESTION: Does the oocyte donor's age affect live birth rate (LBR) in recipients? DESIGN: Retrospective study of 3766 oocyte recipient cycles carried out between January 2009 and December 2018. Cycles were categorized into groups according to donor's age: <20 years (4.7%); 20-25 years (41.1%); ≥26 years (54.2%). Chi-squared test was used to evaluate differences in LBR and analysis of variance was used to test differences in embryo quality, and fertilization and embryo development rates. A generalized linear mixed model was applied to estimate the odds for each end point. RESULTS: LBR was 40.7%. When analysed according to donors' age, significant differences were found: 33.9% for the youngest group, 39.1% for the group aged 20-25 years, and 42.5% for donors aged ≥26 years (P = 0.022). When adjusting for confounding factors (recipient age, number of transferred embryos and day of embryo transfer), LBR was lower in the group aged <20 years (OR 0.70; CI 95% 0.50 to 0.99) and in the group aged 20-25 years (OR 0.85; CI 95% 0.74 to 0.98) compared with the group aged ≥26 years. No significant differences were observed in fertilization rates (74.2%, 76.1% and 77.5%) or embryo development rates (57.0%, 61.4% and 62.0%). The number of good-quality embryos transferred was significantly lower in the group aged <20 years (1.03 ± 0.71; 1.18 ± 0.69; 1.19 ± 0.67; P = 0.015). CONCLUSIONS: LBR is significantly lower when donors are younger than 25 years and, especially, when they are younger than 20 years.

Single or double embryo transfer? Decision-making process in patients participating in an oocyte donation program.

In IVF/ICSI programs, after receiving the information about the success results of single embryo transfer (SET) vs double embryo transfer (DET) and the risks of multiple pregnancy, a significant number of patients opt for SET. Up to date, no comparable studies have been published in oocyte recipients. The aim of this study was to evaluate if the counseling provided to oocyte recipients influence their decision on the number of embryos to be transferred. Fifty-five recipients expressed their preference and the relevance for the decision-making process that they attribute to certain factors through an anonymous questionnaire completed pre and post-counseling. Before counseling, 32 out of 55 recipients preferred DET, 13 preferred SET and 10 were undecided. From the 32 recipients who preferred DET, 16 (50%) maintained their preference after counseling, 13 (40.6%) changed their decision to SET and 3 (9.4%) changed to undecided (McNemar's test: p < .05). After counseling, the patients attached less importance to the probability of pregnancy and more importance to maternal and perinatal risks (p < .05). We conclude that after counseling, a significant number of recipients changed their preferences from DET to SET.