Placental pathology in egg donor pregnancies.

OBJECTIVE

To determine placental pathology and immune response at the maternal-fetal interface in pregnancies conceived by IVF via egg donation compared with nondonor IVF pregnancies.

DESIGN

Retrospective case-control study.

SETTING

Academic medical center.

PATIENT(S): The study population included 20 egg donor and 33 nondonor IVF pregnancies of >24 weeks' gestation.

INTERVENTION(S): None.

MAIN OUTCOME MEASURE(S): Perinatal complications (gestational hypertension, abruption, preterm delivery, cesarean section), microscopic features indicating an immune response and trophoblast damage, and characterization of inflammatory cells using immunohistochemistry.

RESULT(S): There was an increase in gestational hypertension and preterm delivery in egg donor pregnancies. Dense fibrinoid deposition in the basal plate with severe chronic deciduitis containing significantly increased numbers of T helper and natural killer cells were demonstrated in egg donor placentas. Trophoblast damage was also increased in the preterm egg donor group.

CONCLUSION(S): There are significant histological and immunohistochemical differences between the placentas of egg donor and nondonor IVF pregnancies. The increased immune activity and fibrinoid deposition at the maternal-fetal interface of egg donor pregnancies could represent a host versus graft rejection-like phenomenon.