Journal of Assisted Reproduction and Genetics

, Volume 36, Issue 9, pp 1917–1926 | Cite as

Risk of ischemic placental disease is increased following in vitro fertilization with oocyte donation: a retrospective cohort study

  • Anna M. ModestEmail author
  • Katherine M. Johnson
  • S. Ananth Karumanchi
  • Nina Resetkova
  • Brett C. Young
  • Matthew P. Fox
  • Lauren A. Wise
  • Michele R. Hacker
Assisted Reproduction Technologies



Assess the risk of ischemic placental disease (IPD) among in vitro fertilization (IVF; donor and autologous) pregnancies compared with non-IVF pregnancies.


This was a retrospective cohort study of deliveries from 2000 to 2015 at a tertiary hospital. The exposures, donor, and autologous IVF, were compared with non-IVF pregnancies and donor IVF pregnancies were also compared with autologous IVF pregnancies. The outcome was IPD (preeclampsia, placental abruption, small for gestational age (SGA), or intrauterine fetal demise due to placental insufficiency). We defined SGA as birthweight < 10th percentiles for gestational age and sex. A secondary analysis restricted SGA to < 3rd percentile.


Of 69,084 deliveries in this cohort, 262 resulted from donor IVF and 3,501 from autologous IVF. Compared with non-IVF pregnancies, IPD was more common among donor IVF pregnancies (risk ratio (RR) = 2.9; 95% CI 2.5–3.4) and autologous IVF pregnancies (RR = 2.0; 95% CI 1.9–2.1), adjusted for age and parity. IVF pregnancies were more likely to be complicated by preeclampsia (donor RR = 3.8; 95% CI 2.8–5.0 and autologous RR = 2.2; 95% CI 2.0–2.5, adjusted for age, parity, and marital status), placental abruption (donor RR = 3.8; 95% CI 2.1–6.7 and autologous RR = 2.5; 95% CI 2.1–3.1, adjusted for age), and SGA (donor RR = 2.7; 95% CI 2.1–3.4 and autologous RR = 2.0; 95% CI 1.9–2.2, adjusted for age and parity). Results were similar when restricting SGA to < 3rd percentile.


Pregnancies conceived using donor IVF and autologous IVF were at higher risk of IPD and its associated conditions than non-IVF pregnancies and associations were consistently stronger for donor IVF pregnancies.


Autologous oocyte Donor oocyte Ischemic placental disease Placental abruption Preeclampsia Small for gestational age 



We would like to acknowledge Laura Dodge and JoAnn Jordan for their assistance with obtaining data for this study. We would also like to acknowledge Stacey Missmer and Olga Basso for their review of this study.

Study funding

AMM was supported by NIH T32 HD052458—Boston University Reproductive, Perinatal and Pediatric Epidemiology Training Program.

Supplementary material

10815_2019_1545_MOESM1_ESM.docx (57 kb)
ESM 1 (DOCX 56 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyBeth Israel Deaconess Medical Center/Harvard Medical School330 Brookline Avenue, KS 3, BostonUSA
  2. 2.Department of EpidemiologyBoston University School of Public HealthBostonUSA
  3. 3.Center for Vascular Biology ResearchBeth Israel Deaconess Medical Center/Harvard Medical SchoolBostonUSA
  4. 4.Department of MedicineCedars-Sinai Medical CenterLos AngelesUSA
  5. 5.Boston IVFWalthamUSA
  6. 6.Department of Global HealthBoston University School of Public Health715 Albany Street, BostonUSA
  7. 7.Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonUSA

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