P-787 Obstetric and perinatal outcomes in pregnancies conceived after oocyte donation or trophoectoderm biopsy in women from 38 years old

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Abstract Study question Do oocyte donation (OD) or trophoectoderm biopsy for preimplantational genetic testing (TB-PGT) impact obstetric and perinatal outcomes in women ≥ 38 years old? Summary answer Women aged ≥38 years, particularly those using donor oocytes, have a moderate risk of certain obstetric and perinatal complications. What is known already Obstetric and perinatal safety in reproductive medicine should be continuously reassessed. In this sense, the emergence of TB-PGT requires thorough analysis since there are controversial and limited published data. Similarly, OD is associated with higher incidence of preeclampsia, premature births, cesarean deliveries and lower live birth weights. Likewise, the age of the patient seeking assisted reproduction clinics has increased, yet few studies focus on obstetric and perinatal outcomes in women aged 38 years or older, a group that predominantly requests TB-PGT and OD. Further investigation in these patients is necessary to improve patient care and outcomes. Study design, size, duration This is a multicenter, retrospective, observational study that evaluates the obstetric and perinatal outcomes of pregnancies resulting in a live newborn in women ≥ 38 years after single frozen blastocyst-stage embryo transfer conducted between January 2017 and October 2022. The selected cycles were categorized into 3 groups depending on whether the embryo was originated from self-oocyte with TB-PGT (SO TB-PGT), self-oocyte without TB-PGT (SO non-TB-PGT) or OD. In all cases, only cryotransfers were included. Participants/materials, setting, methods A total of 600 live newborn from SO non-TB-PGT group, 3039 from SO TB-PGT group and 5043 from OD group were included. Descriptive analysis was conducted for group comparison. Multivariate models were performed adjusting for maternal age, maternal body mass index, oocyte age, sperm sample origin and embryo transfer day. SO non-TB-PGT was used as reference for comparison. p < 0.05 was considered statistically significant. Main results and the role of chance OD group was associated with higher odds of rupture of membranes before 37th week [AOR 3.677 (95% CI, 1,096–12.335; p = 0.035)] and preterm births [AOR 1.967 (95% CI, 1.163–3.328; p = 0.012)] and lower length at births [ARC -0.415 (95% CI, -0.802–-0,029; p = 0.035)]. On the other hand, both OD groups and SO TB-PGT group were associated with higher odds of deliveries by cesarian section [AOR 1.347 (95% CI, 1.034–1.755; p = 0.027) and AOR 1.562 (95% CI, 1.266–1.927; p < 0.001), respectively]. The rest of obstetrical and perinatal outcomes under study have not shown statistically significant differences between groups following our adjusted model. Limitations, reasons for caution Despite the large population included, the retrospective nature of this study may introduce biases due to incomplete clinical histories. Additionally, the reference group (SO non-TB-PGT) has a reduced sample size compared to the others, which could impact the conclusions obtained. Wider implications of the findings This study demonstrates the obstetric and perinatal safety of embryonic TB-PGT in women ≥ 38 years old. However, it highlights potential issues in OD cases, probably due to the need for immunological dialogue between embryo and mother. Further research is required to explore these implications. Trial registration number No

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