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揭开秘密的面纱:德国卵子捐赠妊娠的母婴结局。

Lifting the veil of secrecy: maternal and neonatal outcome of oocyte donation pregnancies in Germany.

机构信息

Department of Obstetrics, Charité-Universitätsmedizin, 10117, Berlin, Germany.

Berlin Institute of Health, Berlin, Germany.

出版信息

Arch Gynecol Obstet. 2022 Jul;306(1):59-69. doi: 10.1007/s00404-021-06264-8. Epub 2021 Oct 4.

Abstract

BACKGROUND

In Germany, performing fertility procedures involving oocyte donation is illegal, as stated by the Embryo Protection Law. Nonetheless, in our clinical routine we attend to a steadily rising number of pregnant women, who have sought oocyte donation abroad. Due to the legal circumstances many women opt to keep the origin of their pregnancy a secret. However, studies have shown, that oocyte donation is an independent risk factor for the development of pregnancy complications, such as preeclampsia.

OBJECTIVE

The aim of this study is to evaluate maternal and neonatal outcomes of oocyte donation pregnancies in three large obstetric care units in Berlin, Germany.

METHODS

We retrospectively analyzed all available medical data on oocyte donation pregnancies at Charité University hospital, Vivantes Hospital Friedrichshain, and Neukoelln in the German capital.

RESULTS

We included 115 oocyte donation (OD) pregnancies in the present study. Our data are based on 62 singleton, 44 twin, 7 triplet, and 2 quadruplet oocyte donation pregnancies. According to our data, oocyte donation pregnancies are associated with a high risk of adverse maternal and fetal outcome, i.e., hypertension in pregnancy, preterm delivery, Cesarean section as mode of delivery, and increased peripartum hemorrhage.

CONCLUSION

Although oocyte donation is prohibited by German law, many couples go abroad to seek reproductive measures using oocyte donation after former treatment options have failed. OD pregnancies are associated with a high risk of preeclampsia, C-section as mode of delivery, and peripartum hemorrhage. Detailed knowledge of the associated risks is of utmost importance to both the patient and the treating physician and midwife.

摘要

背景

德国的《胚胎保护法》规定,涉及卵母细胞捐赠的生育程序是违法的。然而,在我们的临床实践中,越来越多的寻求国外卵母细胞捐赠的孕妇前来就诊。由于法律规定,许多女性选择对其妊娠的来源保密。然而,研究表明,卵母细胞捐赠是妊娠并发症(如子痫前期)发展的独立危险因素。

目的

本研究旨在评估德国柏林三家大型产科护理机构中卵母细胞捐赠妊娠的母婴结局。

方法

我们回顾性分析了 Charité 大学医院、Vivantes 弗里德里希沙因医院和柏林 Neukoelln 医院卵母细胞捐赠妊娠的所有可用医疗数据。

结果

本研究纳入了 115 例卵母细胞捐赠(OD)妊娠。我们的数据基于 62 例单胎妊娠、44 例双胎妊娠、7 例三胎妊娠和 2 例四胎妊娠。根据我们的数据,卵母细胞捐赠妊娠与不良母婴结局相关,如妊娠高血压、早产、剖宫产分娩以及围产期出血增加。

结论

尽管德国法律禁止卵母细胞捐赠,但许多夫妇在之前的治疗选择失败后会前往国外寻求卵母细胞捐赠的生殖措施。OD 妊娠与子痫前期、剖宫产分娩和围产期出血的风险增加相关。了解相关风险对患者和治疗医生和助产士至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b6d/9300520/4d5c3136b577/404_2021_6264_Fig1_HTML.jpg

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