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Older Women Using Egg Donation Not at Greater Risk for Complications
There's good news for women over 50 who become pregnant with egg donation: They are not at an elevated risk for developing obstetrical complications when compared to their younger counterparts.
A new study by Columbia University Medical Center researchers and published in the February 2012 issue of the American Journal of Perinatology, concludes that while all women who use egg donation to become pregnant are at an elevated risk for obstetrical complications — particularly hypertensive disorders and cesarean section — women over age 50 have complication rates similar to younger egg donation recipients.
"It is imperative that all older women undergo thorough medical screening before attempting pregnancy to ensure the best possible outcome," says Mark Sauer, professor of obstetrics and gynecology, and director of the Division of Reproductive Endocrinology at Columbia University Medical Center (CUMC). "But, really, that should apply to younger women, as well."
Dr. Sauer, who achieved the world's first donor egg pregnancies in menopausal women, explains that for several decades, although unclear exactly why, it has been documented that women using egg donation seem to have higher risk for such things as: multiple births (more embryos are transferred), high blood pressure, diabetes and preterm labor. "And it's been presumed that women of the most advanced age —women over 50 — would be of even higher risk," he says. "But that's not what the study shows. They were all at risk, but they weren't at any higher risk than the younger ones."
The study is the largest single-center study of it kind, meaning all participants were from Columbia University and underwent the same protocols. The researchers looked at 101 women age 50 and older. "These are all menopausal women — most of them had been through menopause," Dr. Sauer says. The average age of this group was right around 52, and they were all over the age of 50."
The researchers compared the older group's pregnancy results to egg donation recipients age 42 and younger. "The younger range of patients averaged 39 years, and they were from 30 to 42," Dr. Sauer explains. The two groups were evaluated for significant differences in perinatal complications, gestational age at delivery, baby's birth weight and mode of delivery. The researchers found that both older and younger women had similar rates of gestational hypertension, diabetes, cesarean delivery and premature birth.
"What we were glad to see is that basically the 50 year olds did just as well as the 40 year olds, and they didn't have any really serious problems beyond what we see in the younger patients as well," Dr. Sauer says. "But — and this is the important caveat — these women, every single one of them were pre-screened medically and very carefully for underlying medical problems, and that's probably why we're not seeing any major difference."
There were two women in the older group that experienced serious adverse effects. A 56-year-old woman developed heavy vaginal bleeding at 29 weeks of pregnancy and had to deliver by emergency cesarean hysterectomy two weeks later. She recovered with no further complications. A 49-year-old woman, who would have been 50 at time of delivery, died following acute cardiac arrest in her first trimester. That woman did have a heavy smoking habit, which she had not disclosed to her doctors.
Honestly disclosing your health history and assessing the risks of pregnancy is important before undergoing any fertility treatment. "Pregnancy is a major risk to your health and to your life," Dr. Sauer says. "Carrying a baby is a difficult thing physically to do. It's a nine-month chore, and if you develop medical problems, or you have a serious underlying medical problem, you could find yourself in a real compromised position very quickly once you're pregnant."