Toward understanding obstetrical outcome in advanced assisted reproduction: varying sperm, oocyte, and uterine source and diagnosis

Objective: To evaluate the obstetrical outcome measures of birth weight (BW) and length of gestation (GA) in singleton pregnancies from in vitro fertilization (IVF), donor egg (DE), and gestational carrier (GC) cycles. Design: Retrospective data analysis. Setting: Clinics. Patient(s): SART data set from the years 2004-2006. Intervention(s): The BW and GA of singleton pregnancies were compared in IVF, DE, and GA cycles. Main Outcome Measure(s): The BW and GA data were compared to evaluate the effects on these outcomes of the source of the egg, the uterus, or sperm or the primary reason given for treatment. Result(s): The mean BW and GA for DE cycles were 3,236 g and 37.4 weeks, respectively, which were less than those of IVF [3,265 g and 37.7 weeks]. GC BW was greater at 3,309 g with GA of 37.2 weeks. No difference was seen between donor or spouse sperm source; however, most female fertility-diagnosis cycles were associated with lower BW and GA than male factor-related cycles. Conclusion(s): Reduced BW and GA were observed for DE cycles versus IVF or GC cycles, suggesting that the uterine environment was more important to these outcomes than egg quality. Whereas altering the sperm source had no effect, female infertility diagnoses were associated with reductions in BW and GA. (Fertil Steril (R) 2011;95:1645-9. (C) 2011 by American Society for Reproductive Medicine.)