P-459 Egg Donation Program: 'Two countries-two labs' in the transnational gamete donation (TGD) outcome and safety in 10 years

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Abstract Study question The aim of the study is to evaluate 10 years of pregnancy outcomes and safety in the Transnational Gamete Donation (TGD) program. Summary answer Oocyte donation offers high success rates in assisted reproduction technology (ART) for older women but increases the risk of placental and neonatal disorders. What is known already The demand for ART is increasing, with more couples choosing this option. Egg donation now represents 10% of procedures, according to the National Registry. In Italy, a lack of donors leads to the use of gametes from foreign banks. A multidisciplinary approach to patient care, involving intensive monitoring and personalized treatments before and during pregnancy, has greatly improved obstetric and neonatal outcomes. While this strategy has successfully reduced risks for mothers and babies, it has not entirely eliminated, particularly in pregnancies resulting from egg donation ART when compared to non-donor in vitro fertilization (IVF). Study design, size, duration A prospective study analyzed pregnancy outcomes obtained from egg donation IVF in the TGD program from January 2015, to June 2023. In patients under 45 years, embryo transfers included one blastocyst or two embryos. We analyzed n.984 clinical pregnancies with n.785 births from non-donor IVF vs n.688 from egg donation with n.609 births. Participants/materials, setting, methods Inclusion criteria included single or multiple clinical pregnancies achieved through Level II/III of egg donation in the TGD program. We compared abortion, ectopic pregnancy and delivery rates; moreover, evaluated obstetric and perinatal outcomes in the two groups. Main results and the role of chance Egg donation in the TGD program has a lower rate of early pregnancy loss (< 8 weeks) and ectopic pregnancies (EP) compared to non-donor IVF groups (n. 109 – 15,9% vs n. 220 – 22,4%, p < 0,05; n. 4 – 0,6% vs n. 16 – 1,6%, p < 0,05). Egg donation, also, is associated with a higher rate of deliveries (n. 540-78,5% vs n. 691-70,2%, p < 0,05), but it has a higher cesarean section rate (n. 390 -72.3% vs n.323 – 46.7%, p < 0,05). Moreover, in egg donation TGD programs the risks even higher for preterm births (n. 148 – 24,3% vs n. 150 – 19,1%, p < 0,05). Oocyte donation is independently associated with a higher rate of pregnancy-induced hypertension (n. 19 – 3.5% vs n. 12 – 1.7%, p < 0,05) and pre-eclampsia (n. 66 – 12.2% vs n.30 – 4.3%, p < 0,05). Egg donation in the TGD program has, in term of safety, the same rate of malformations as non-donor IVF and no maternal mortality. Limitations, reasons for caution not applicable Wider implications of the findings Egg donation TGD program’s pregnancies are associated with a higher rate of placental disorders of pregnancy, such as gestational hypertension and pre-eclampsia also the risk of poorer neonatal outcomes is increased in terms of preterm birth. However, EP and early pregnancy loss rates are lower in egg donation programs. Trial registration number No

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