Document Detail

Outcomes of high-order multiple implantations in women undergoing ovum donation.
MedLine Citation:
PMID:  9360184     Owner:  NLM     Status:  MEDLINE    
Increasing numbers of young women with ovarian failure and women of advanced reproductive age (> 40 yrs) utilize oocyte donation to treat their infertility. In both groups, women who become pregnant frequently experience multiple gestation, occurring in up to 30% of pregnancies. Advanced maternal age and high-order multiple gestations are associated with an increased risk for obstetric complications. We reviewed the pregnancies of patients with high-order multiple gestations (> or = 3 gestational sacs) with respect to their antepartum course and neonatal outcomes. Mothers were divided into two groups according to age at conception; Group I (> or = 40 yr, n = 20) and Group II (< 40 yr, n = 10). These 30 high-order multiple gestations were found among 127 successful oocyte donation cycles (23.6% of all pregnant patients). Data regarding pregnancy outcomes were gained by chart review and telephone interview. Results demonstrated spontaneous reductions in the number of implantation sites were similar between groups (Group I: 21.4% vs. Group II: 17.6%). Multifetal pregnancy reduction (MFPR) was more often chosen by older women (Group I: 45% vs. Group II: 10%; P < 0.05). Antenatal complications were commonly experienced by both groups (> 80%) as were operative deliveries (> 85%). However, neonatal outcomes were generally good, with only one death occurring in the 79 delivered infants (1.3%). We conclude transferring supernumerary embryos to women undergoing ovum donation places patients at great risk for high-order multiple gestations. These pregnancies are associated with increased antenatal and neonatal complications. Although advanced maternal age is normally an added risk factor, well-screened older patients carrying high-order multiple gestations experienced similar outcomes as younger mothers.
T B Koopersmith; S R Lindheim; R A Lobo; R J Paulson; M V Sauer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of maternal-fetal medicine     Volume:  6     ISSN:  1057-0802     ISO Abbreviation:  J Matern Fetal Med     Publication Date:    1997 Sep-Oct
Date Detail:
Created Date:  1997-12-11     Completed Date:  1997-12-11     Revised Date:  2004-11-18    
Medline Journal Info:
Nlm Unique ID:  9211288     Medline TA:  J Matern Fetal Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  268-72     Citation Subset:  IM    
Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles, USA.
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MeSH Terms
Embryo Implantation*
Embryo Transfer
Fertilization in Vitro
Gestational Age
Infertility, Female / therapy*
Maternal Age
Middle Aged
Oocyte Donation*
Pregnancy Outcome
Pregnancy Reduction, Multifetal
Pregnancy, High-Risk
Pregnancy, Multiple
Retrospective Studies
Treatment Outcome*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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