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High-risk of preterm birth and low birth weight after oocyte donation IVF: analysis of 133,785 live births
Reproductive BioMedicine Online, September 2017, Volume 35, Issue 3, Pages 318-324
A higher risk of pregnancy complications occurs after assisted reproductive techniques compared with spontaneously conceived pregnancies. This is attributed to the underlying infertility and assisted reproduction technique procedures involved during treatment. It is a matter of interest whether use of donor oocytes affects perinatal outcomes compared with pregnancies after autologous IVF. Anonymized data were obtained from the Human Fertilization and Embryology Authority. The analysis included 5929 oocyte donation and 127,856 autologous IVF live births. Data from all women who underwent donor oocyte recipient or autologous IVF cycles, both followed with fresh embryo transfer, were analysed to compare perinatal outcomes of preterm birth (PTB) and low birthweight (LBW) after singleton and multiple live births. The risk of adverse perinatal outcomes after oocyte donation was increased: adjusted OR (aOR) 1.56, 99.5% CI 1.34 to 1.80 for PTB and aOR 1.43, 99.5% CI 1.24 to 1.66 for LBW were significantly higher after oocyte donation compared with autologous IVF singletons. The adjusted odds PTB (aOR 1.21, 99.5% CI 1.02 to 1.43) was significantly higher after oocyte donation compared with autologous IVF multiple births. Analysis of this large dataset suggests significantly higher risk of PTB and LBW after ooctye donation compared with autologous IVF pregnancies.
Keywords: Autologous IVF, Live birth, Low birth weight, Oocyte donation, Preterm birth.
Over the years, the average age of a woman at first childbirth has increased owing to the trend of delayed childbearing ( Lutz et al., 2003; Matthews and Hamilton, 2009 ). This deferred attempt at starting a family along with age-related fertility decline has resulted in a higher proportion of women aged over 40 years seeking assisted reproductive technique treatment ( Ishihara et al., 2015 ). Live birth rates for women aged over 40 years after autologous IVF, however, remains, low varying from 5–15% overall, and approaching almost zero at age 45 years or over ( van Disseldorp et al., 2007; Mansour et al., 2014; European IVF-Monitoring Consortium et al, 2016 ).
Oocyte donation has been offered as a more successful alternative compared with autologous IVF for women of advanced reproductive age ( Sauer et al., 1996 ). Oocyte donation cycles result in higher success rates, with reported delivery rates of up to 47% ( Ishihara et al., 2015 ) . Pregnancy and live birth rates are comparable for recipients across all age groups ( European IVF-Monitoring Consortium et al, 2016 ) . Over the years, the number of oocyte donation treatment cycles worldwide has steadily increased ( Dyer et al., 2016 ). In Europe, about 30,000 oocyte donation cycles out of the reported 600,000 IVF and intracytoplasmic spem injection (IVF–ICSI) cycles were carried out in 2011 ( European IVF-Monitoring Consortium et al, 2016 ). In the USA, the number of reported oocyte donation cycles increased from 10,801 in 2000 to 18,306 in 2010 ( Kawwass et al, 2013 ).
Singleton pregnancies after IVF–ICSI have been associated with adverse obstetric and perinatal outcomes compared with spontaneous conceptions ( Helmerhorst et al., 2004; Jackson et al., 2004; Pandey et al., 2012 ). One of the reasons for adverse perinatal outcomes afrer IVF is underlying infertility, which is an independent risk factor ( Basso and Baird, 2003 ). Hormonal changes caused by ovarian stimulation and IVF processes may also negatively affect obstetric and neonatal outcomes after IVF ( Pinborg et al., 2013 ).
Earlier studies have indicated higher obstetric complications and poorer perinatal outcomes in pregnancies after oocyte donation compared with spontaneous conceptions ( Elenis et al., 2015; Henne et al., 2007; Malchau et al., 2013; Söderström-Anttila et al., 1998 ) . The poorer perinatal outcomes have been linked to higher prevalence of pre-eclampsia in oocyte donation pregnancies compared with spontaneous conceptions ( Elenis et al., 2015; Klatsky et al., 2010; Malchau et al., 2013 ) .
Although the available studies have consistently indicated adverse perinatal outcomes after oocyte donation compared with with spontaneous conceptions, the evidence is conflicting when comparing perinatal outcomes after oocyte donation pregnancies versus autologous IVF pregnancies. Krieg et al. (2008) compared oocyte donation and autologous IVF pregnancies and found similar obstetric and neonatal complications. Another controlled study reported a higher risk of pregnancy-induced hypertension in oocyte donation pregnancies but found no overall effect on perinatal outcomes when compared with pregnancies after autologous IVF ( Stoop et al., 2012 ). Conversely, Gibbons et al. , (2011) found significantly lower mean birth weight and length of gestation in oocyte donation pregnancies compared with autologous IVF ( Gibbons et al, 2011 ). Recent studies have also reported higher perinatal risks after oocyte donation compared with autologous IVF–ICSI ( Dude et al., 2016; Nejdet et al., 2016 ).
In view of the existing uncertainty about the effect of oocyte donation on perinatal outcomes, we conducted a study based on the analysis of a large national database of 100,092 singleton and 33,693 multiple live births. The aim of this study was to compare the perinatal outcomes of PTB and LBW in singleton and multiple pregnancies after fresh oocyte donation versus autologous fresh IVF cycles.
Materials and methods
Anonymized data from assisted reproduction technique cycles carried out in the UK between 1991 and 2011 were obtained from the Human Fertilization and Embryology Authority, which maintains records of all assisted reproduction technique cycles submitted prospectively by all centres in the UK ( www.hfea.gov.uk/5874.html , HFEA authority). We included only fresh oocyte donation and autologous IVF cycles that resulted in a live birth. The treatment cycles that were not included in the analysis are shown in Figure 1 , along with reasons for exclusion. As HFEA anonymized data are freely accessible on their website, ethics approval was not required for the present study.
Information was obtained for recipient age groups and age groups of women having autologous IVF (18–34, 35–37, 38–39, 40–42, 43–44, 45 years and over), type of infertility (female primary or secondary infertility), cause of infertility (tubal disease, ovulatory disorder, male factor, unexplained, endometriosis), previous live births, day of embryo transfer (<day 5 or ≥day 5), number of embryos transferred, initial multiple pregnancy with spontaneous reduction resulting in singleton live birth (vanishing twin), gestational length at delivery and birth weight. Information was also obtained for oocyte donor age groups (<20, 21–25, 26–30, and 31–35 years). Perinatal outcomes of PTB, early PTB, LBW and very LBW were compared between fresh oocyte donation and autologous fresh IVF cycles. A live birth is defined as a birth event in which at least one baby is born alive. Preterm birth is defined as live birth before 37 weeks gestation and early PTB is live birth before 32 weeks. Low birth weight is birth weight less than 2500 g and very LBW is birth weight less than 1500 g.
Characteristics of the two groups were described using percentages for categorical variables and means or medians for continuous variables. Live birth, singleton live birth, multiple birth, PTB, early PTB, LBW, and very LBW rates were calculated for both groups. Adjusted logistic regression was carried out for all four perinatal outcomes for pre-decided confounding variables: age of women undergoing autologous IVF and recipient age, year of treatment, cause of infertility, previous live birth, number of embryos transferred, day of embryo transfer and vanishing twin. We conducted a subgroup analysis for perinatal outcomes in women aged less than 40 years after oocyte donation and autologous IVF and adjusted the outcomes for same potential confounders mentioned earlier. Within the oocyte donation group, we explored the influence of donor age by adjusted logistic regression. Analysis of one cycle per woman could not be performed owing to anonymised nature of the dataset; as individual woman could have contributed for more than one cycle. For this limitation, we used wider 99.5% confidence intervals instead of the more common 95% confidence intervals. P < 0.05 was considered as statistically significant. STATA, version13.1 (Stata corp, College Station, Tx, USA) was used for statistical analysis.
A total of 397,449 cycles were excluded from 1,004,487 assisted reproduction technique cycles during the data-selection process ( Figure 1 ). The number of IVF–ICSI cycles available for analysis were 607,038, which included 22,207 oocyte donation and 584 831 autologous IVF cycles. A total of 6113 live births took place after oocyte donation cycles and 131,461 live births took place after autologous IVF. Among the oocyte donation live births, perinatal outcome data were not available for 184, hence a total of 4248 singleton live births and 1681 multiple live births were available for analysis. For autologous IVF cycles, a total of 95,844 singleton live births and 32,012 multiple live births were available for analysis after excluding 3605 births with missing data for perinatal outcomes.
Characteristics of the cohorts are shown in Table 1 . Most (55.7%) donor oocyte recipients were women aged over 40 years compared with 14.2% among women undergoing autologous IVF. Although the main cause of infertility was ovulatory dysfunction (52.2%), among women undergoing oocyte donation IVF, male factor cause (51.5%) was most common in women undergoing autologous IVF. Most oocyte donation (93.2%) cycles and autologous IVF (91.2%) cycles had cleavage stage transfer (<5 day). The mean number of embryos transferred was 2.07 (SD 0.72) in oocyte donation and 1.81 (SD 0.90) in autologous IVF ( Table 1 ).
|Characteristic||Donor recipient, n (%)
( n = 22207)
|Autologous, n (%)
( n = 584831)
|Age at treatment|
|18–34 years||4299 (19.4)||279019 (47.7)|
|35–37 years||2990 (13.5)||141415 (24.2)|
|38–39 years||2555 (11.5)||81295 (13.9)|
|40–42 years||4344 (19.6)||64476 (11.0)|
|43–44 years||3090 (13.9)||14518 (2.5)|
|≥45 years||4929 (22.2)||4108 (0.7)|
|Type of infertility|
|Female primary||10352 (46.6)||260795 (44.6)|
|Cause of infertility a|
|Tubal disease||2712 (12.2)||152023 (26.0)|
|Ovulatory disorder||11597 (52.2)||67297 (11.5)|
|Male factor||7929 (35.7)||300997 (51.5)|
|Unexplained||3593 (16.2)||186863 (32.0)|
|Endometriosis||868 (3.9)||42949 (7.3)|
|Number of previous IVF cycles|
|0||8215 (37.0)||309973 (53.0)|
|1||4301 (19.4)||130995 (22.4)|
|2||3424 (15.4)||68991 (11.8)|
|3||2266 (10.2)||34853 (6.0)|
|4+||4001 (18.0)||40019 (6.8)|
|Year of treatment|
|1991–1995||2409 (10.8)||79646 (13.6)|
|1996–2000||5832 (26.3)||128478 (22.0)|
|2001–2005||6761 (30.4)||140246 (24.0)|
|2006–2011||7205 (32.4)||236461 (40.4)|
|Number of oocytes: median (IQR)||7 (5, 10)||10 (7, 14)|
|Number of embryos: median (IQR)||5 (3, 7)||5 (2, 8)|
|Previous live birth (yes)||1333 (6.0)||37690 (6.4)|
|Day of embryo transfer|
|<day 5||19751 (93.2)||462513 (91.2)|
|≥day 5||1440 (6.8)||44,464 (8.8)|
|Number of embryos transferred|
|(Mean and SD)||2.07 (0.72)||1.81 (0.90)|
a Causes of infertility are not mutually exclusive.
The incidence of vanishing twin in oocyte donation was 5.7% (241/4248) and 4.9% (4663/95844) in autologous IVF singletons.
Live birth outcomes after oocyte donor recipient and autologous IVF
The overall live birth rates were 27.5% (99.5% CI 26.7 to 28.4%) per initiated cycle after oocyte donation compared with 22.5% (99.5% CI 22.3 to 22.6%) per initiated cycle after autologous IVF. The multiple birth rates were 28.4% (99.5% CI 26.7 to 30.0%) for oocyte donation and 25.0 (99.5% CI 24.6 to 25.3%) for autologous IVF.
Perinatal outcomes after oocyte donor recipient and autologous IVF
A total of 100,092 singleton live births with information on gestational age at delivery and birth weight were analysed for perinatal outcomes. The incidence of PTB was 14.8% after oocyte donation and 9.4% after autologous IVF. The incidence of early PTB was 3.1% and 1.8% after oocyte donation and autologous IVF, respectively. The incidence of LBW after oocyte donation was 13.8% and 9.5% after autologous IVF. The incidence of very LBW was 2.6% and 1.9% after oocyte donation and autologous IVF, respectively. The unadjusted odds of PTB (OR 1.68, 99.5% CI 1.48 to 1.91), early PTB (OR 1.77, 99.5% CI 1.37 to 2.29), LBW (OR 1.53, 99.5% CI 1.35 to 1.74) and very LBW (OR 1.42, 99.5% CI 1.07 to 1.87) were significantly higher after oocyte donation compared with autologous IVF. There was a higher risk of the adverse perinatal outcomes after adjusting for potential confounding factors; PTB (adjusted odds ratio [aOR] 1.56, 99.5% CI 1.34 to 1.80), early PTB (aOR 1.40, 99.5% CI 1.04 to 1.90) and LBW (aOR 1.43, 99.5% CI 1.24 to 1.66) were significantly higher after fresh oocyte donation compared with fresh autologous IVF. The aOR for very LBW was 1.08, 99.5% CI 0.79 to 1.49 ( Table 2 ).
|Donor, n (%)||Autologous, n (%)||OR (99.5% CI)||aOR a (99.5% CI)|
|Preterm birth (<37 weeks)||628/4248 (14.8)||8965/95844 (9.4)||1.68 (1.48 to 1.91)||1.56 (1.34 to 1.80)|
|Early preterm birth (<32 weeks)||132/4248 (3.1)||1707/95844 (1.8)||1.77 (1.37 to 2.29)||1.40 (1.04 to 1.90)|
|Low birth weight (<2500 g)||585/4248 (13.8)||9058/95844 (9.5)||1.53 (1.35 to 1.74)||1.43 (1.24 to 1.66)|
|Very low birth weight (<1500 g)||110/4248 (2.6)||1764/95844 (1.8)||1.42 (1.07 to 1.87)||1.08 (0.79 to 1.49)|
a Adjusted for female age category, period of treatment, causes of infertility, previous live birth, number of embryos transferred, stage of embryos transferred, and multiple pregnancy with spontaneous reduction resulting in singleton live birth.
A total of 33,693 multiple births with information on gestational length and birth weight were available for analysis. The incidence of PTB was 54.8 % (921/1 681) after oocyte donation and 51.4% (16 452/32 012) after autologous IVF. The incidence of early PTB was 10.5% (177/1 681) and 9.8 % (3 147/32 012) after oocyte donation and autologous IVF, respectively. The incidence of LBW after oocyte donation was 53.7 % (903/1 681) and 55.1% (17 654/32 012) after autologous IVF. The incidence of very LBW was 11.1% (186/1 681) and 9.8% (3 152/32 012) after oocyte donation and autologous IVF, respectively. No significant difference in risk of PTB (OR 1.15, 99.5% CI 1.00 to 1.32), early PTB (OR 1.08, 99.5% CI 0.86 to 1.36), LBW (OR 0.94, 99.5% CI 0.82 to 1.09) and very LBW (OR 1.14, 99.5% CI 0.91 to 1.43) was found for oocyte donation and autologous IVF. The adjustment was carried out for all the potential confounders described in the ‘Materials and methods’ section, except vanishing twin. The adjusted odds for PTB were significantly higher for oocyte donation compared with autologous IVF (aOR 1.21, 99.5% CI 1.02 to 1.43). No significant difference was found in risk of early PTB (aOR 1.09, 99.5% CI 0.82 to 1.44), LBW (aOR 0.99, 99.5% CI 0.84 tp1.18) and very LBW (aOR 1.15, 99.5% CI 0.88 to 1.52) for oocyte donation and autologous IVF after adjustment for confounders.
Perinatal outcomes after oocyte donor recipient and autologous IVF in women aged younger than 40 years
In singleton births among women aged younger than 40 years, the incidence of PTB was 15.1% after oocyte donation and 9.4% after autologous IVF. The incidence of early PTB was 3.2% and 1.8% after oocyte donation and autologous IVF, respectively. The incidence of LBW after oocyte donation was 15.0% and 9.4% after autologous IVF. The incidence of very LBW was 2.7% and 1.8% after oocyte donation and autologous IVF, respectively. The unadjusted odds of PTB (OR 1.72, 99.5% CI 1.43 to 2.07), early PTB (OR 1.84, 99.5% CI 1.26 to 2.69), LBW (OR 1.69, 99.5% CI 1.41 to 2.04) and very LBW (OR 1.47, 99.5% CI 0.97 to 2.22) were significantly higher after oocyte donation compared with autologous IVF. There was a higher risk of the adverse perinatal outcomes after adjusting for potential confounding factors; PTB (aOR 1.60, 99.5% CI 1.32 to 1.94), early PTB (aOR 1.51, 99.5% CI 1.02 to 2.25) and LBW (aOR 1.58, 99.5% CI 1.30 to 1.92) were significantly higher after fresh oocyte donation compared with fresh autologous IVF. The aOR for very LBW was 1.18, 99.5% CI 0.77 to 1.82 ( Table 3 ).
|Donor, n (%)||Autologous, n (%)||OR (99.5% CI)||aOR a (99.5% CI)|
|Preterm birth (<37 weeks)||278/1842 (15.1)||8362/89399 (9.4)||1.72 (1.43 to 2.07)||1.60 (1.32 to 1.94)|
|Early preterm birth (<32 weeks)||59/1842 (3.2)||1578/89399 (1.8)||1.84 (1.26 to 2.69)||1.51 (1.02 to 2.25)|
|Low birth weight (<2500 g)||277/1842 (15.0)||8444/89399 (9.4)||1.69 (1.41 to 2.04)||1.58 (1.30 to 1.92)|
|Very low birth weight (<1500 g)||49/1842 (2.7)||1631/89399 (1.8)||1.47 (0.97 to 2.22)||1.18 (0.77 to 1.82)|
a Adjusted for female age category, period of treatment, causes of infertility, previous live birth, embryos transferred, stage of embryos transfer, and multiple pregnancy with spontaneous reduction resulting in singleton live birth.
Influence of donor age on perinatal outcomes
The influence of donor ages categorized as 20 years or younger, 21–25 years, 26–30 years and 31–35 years on the risk of PTB and LBW in recipient was analysed. The donor age group 21–25 years was considered as the reference. No significant difference was observed in risk of PTB or LBW between donor age group 21–25 years compared with other donor age groups (≤20, 26–30 and 31–35years) in singletons ( Table 4 ).
|Oocyte donor age groups (years)||Preterm birth (<37 weeks)||Low birth weight (<2500 g)|
|aOR c (99.5% CI)||n (%)||OR
|≤20||12/51 (23.5)||1.86 (0.68 to 5.06)||1.96 (0.71–5.41)||12/51 (23.5)||2.04 (0.75 to 5.59)||2.11 (0.76 to 5.89)|
|21–25 b||63/443 (14.2)||N/A||N/A||58/443 (13.1)||N/A||N/A|
|26–30||165/1228 (13.4)||0.94 (0.60–1.47)||0.98 (0.62–1.54)||153/1228 (12.5)||0.94 (0.59 to 1.50)||0.98 (0.61 to 1.57)|
|31–35||309/2007 (15.4)||1.10 (0.72–1.67)||1.12 (0.73–1.72)||279/2007 (13.9)||1.07 (0.69 to 1.66)||1.08 (0.69 to 1.68)|
a Denominators include singleton live births for which oocyte donor age information was available.
b Reference group.
c Adjusted for female age category, period of treatment, causes of infertility, previous live birth, number of embryos transferred, stage of embryos transferred, and multiple pregnancy with spontaneous reduction resulting in singleton live birth.
The results of the study demonstrate significantly higher risk of PTB and LBW after oocyte donation compared with autologous IVF. In women aged younger than 40 years, risk of PTB and LBW was significantly higher in oocyte donation compared with autologous IVF. Influence of donor age on the above mentioned perinatal risks was not observed.
The strength of the present study was analysis of large data set collected from various centres. The study design has an additional strength in that perinatal outcomes after oocyte donation and autologous IVF were compared, helping explore oocyte donation as an independent risk factor since the underlying infertility and IVF process were common confounders. Although an earlier study has shown no difference in perinatal outcomes after fresh versus cryopreserved transfers in oocyte donation cycles, other studies have shown differences in perinatal outcomes after cryopreserved versus fresh embryo transfers, hence we excluded cryopreserved embryo transfer cycles ( Evans et al., 2014; Galliano et al., 2015; Maheshwari et al., 2012 ). The limitation of the study is lack of information on other confounding factors, such as smoking, BMI, related oocyte donor and recipient, ethnicity and co-existing medical conditions during pregnancy, which could influence the perinatal outcomes. Analysis of one cycle per woman could not be carried out owing to anonymized nature of the dataset. For this limitation, we used wider 99.5% confidence intervals instead of the more common 95% confidence intervals.
Studies comparing IVF pregnancies with spontaneous conceptions found significantly higher adverse perinatal outcomes after oocyte donation compared with spontaneous pregnancies after adjusting for important confounders ( Malchau et al., 2013; Marino et al., 2014 ). A Swedish study that included pregnancies after oocyte donation found a higher incidence of hypertensive disorders in the recipient pregnancies compared with spontaneous conceptions even though the oocyte recipients were relatively younger and healthier. The incidence of hypertensive disorders was not significantly different when oocyte donation recipient pregnancies were compared with autologous IVF pregnancies ( Elenis et al., 2015 ). A recent systematic review, which included 86,515 pregnancies from 19 studies, found increased risk of preeclampsia after oocyte donation compared with natural conceptions and other assisted reproduction technique methods ( Masoudian et al., 2016 ). Overall, the comparison of adverse perinatal outcomes after oocyte donation with spontaneous conceptions showed a higher risk after oocyte donation as assisted reproduction techniques themselves are considered a risk factor ( Elenis et al., 2015; Malchau et al., 2013; Pinborg et al., 2013 ) .
In a retrospective cohort analysis study, which included 71 oocyte recipients and 108 women who underwent autologous IVF, the investigators found no significant difference in PTB in oocyte donation (aOR 0.97, 95% CI 0.43 to 2.20) compared with autologous IVF, which is contrary to our finding ( Krieg et al., 2008 ). In this study, both singleton and multiple births were analysed together, whereas, in the present study, they were analysed separately, and this could be a possible reason for conflicting results. A study analysing data from Society for Assisted Reproductive Technology (SART) reported lower mean birth weights of 3 236 ± 652 g versus 3 265 ± 611 g and lower mean gestational ages 37.4 ± 2.4 weeks versus 37.7 ± 2.2 weeks for oocyte donation compared with autologous IVF singleton pregnancies ( Gibbons et al, 2011 ). In another cohort study from SART data set, a total of fresh 8 852 oocyte donation and 55,126 fresh autologous IVF singletons were analysed. The risks of PTB (aOR 1.28, 95% CI 1.12–1.46) and LBW (aOR 1.21, 95%CI 1.02–1.44) were significantly higher in oocyte donation compared with autologous IVF singletons ( Dude et al., 2016 ). A recent systematic review, which included 35 studies, found higher risk of PTB (aOR 1.75, 95% CI 1.39 to 2.20) and LBW (aOR 1.53, 95% CI 1.16 to 2.01) in singletons after oocyte donation versus autologous IVF–ICSI, which is in agreement with results of previous meta-analysis ( Adams et al., 2015; Storgaard et al., 2016 ). The investigators suggested single embryo transfer policy in oocyte donation cycles to avoid additional risk of multiple pregnancies.
Age is an important confounding factor for adverse perinatal outcomes. In the present study, subgroup analysis of women aged younger than 40 years was carried out to make the oocyte donation and autologous IVF groups more comparable. The subsequent analysis revealed significantly higher risk of PTB and LBW in oocyte donation compared with autologous IVF, which further validates our finding.
A previous study ( Gibbons et al., 2011 ) found no influence of donor age on perinatal outcomes, which is in agreement with our findings. The study included only two donor age groups (<35 years and 35–37 years), whereas the present study categorized donors into age groups 20 years and younger, 21–25 years, 26–30 years, 31–35 years. Current practices in most centres recommend donors aged less than 35 years for optimal outcomes. In our study, a non-significant trend towards higher risk of PTB and LBW was observed when donor age was 20 years or younger compared with 21–25 years. These data need cautious interpretation owing to low numbers in this subgroup. Further investigation into the effect of oocyte donation from very young donors on perinatal outcomes is needed.
Our study found significantly higher odds of having PTB and LBW after oocyte donation compared with autologous IVF, and risks of adverse perinatal outcomes remained significant in women younger than 40 years. This evidence is useful for clinicians in order to counsel women and couples undergoing oocyte donation IVF treatment. The information is important in the management of such pregnancies.
We thank the Human Fertilisation and Embryology Authority for providing access to and validating the data. SKS conceived the hypothesis. SKS directed the data analysis by MSK and BA. MSK and MM drafted the manuscript. MSK, SKS, MM and BA appraised the manuscript.
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Mohan S Kamath obtained his medical training (MBBCh) in 2000, MS in 2003 from the Department of Obstetrics and Gynaecology, Pune University, India and Diplomate of National Board (Obgyn) in 2004. He further specialized in Reproductive Medicine from Christian Medical College, Vellore, India in 2008 .He was awarded the Commonwealth fellowship (Reproductive Medicine) from University of Aberdeen, UK, in 2012. He is presently a peer reviewer for Cochrane Gynaecology and Fertility group.
Our retrospective analysis of a large dataset comparing perinatal outcomes after oocyte donation and autologous IVF found increased risk of preterm birth and low birth weight after oocyte donation cycles.
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