Oocyte donation: insights into implantation

Objective: To ascertain whether obstetric, gynecologic, or congenital varia bles affect implantation efficiency or eventual delivery in donor oocyte re cipients. Design: Clinical study. Setting: Academic tertiary care infertility clinic. Patient(s): A total of 370 recipients. Intervention(s): Fresh ET following oocyte donation in a hormone replacemen t cycle. Main Outcome Measure(s): Regression analyses were performed to detect any s tatistically significant difference in the pregnancy rate (PR), delivery ra te, miscarriage rate, or implantation rate associated with different obstet ric, gynecologic, and congenital independent variables while accounting for the age of the recipient in each analysis. Result(s): For all recipients, a clinical PR per transfer of 58.9% was achi eved, with an implantation rate of 30%. A significant decline in the implan tation rate was noted in relation to increasing age of the recipient. A his tory of tubal disease was associated with a significantly lower implantatio n rate and a significantly lower ongoing and delivered PR. Asherman's syndr ome, despite surgical correction, appeared to negatively affect the ongoing and delivered PR. Conclusion(s): With the exceptions of recipient age and a history of tubal disease, all other uterine factors studied did not appear to influence the implantation potential of an embryo resulting from oocyte donation. A histo ry of tubal disease had a distinctly negative effect on implantation effici ency and delivery potential for a given recipient. This finding highlights the need to identify the mechanisms underlying the negative effect of tubal disease so that donor oocyte recipients and all other patients with this c ause of infertility can benefit from directed therapy. (C) 1998 by American Society for Reproductive Medicine.