SISTERS OF WOMEN WITH PREMATURE OVARIAN FAILURE MAY NOT BE IDEAL OVUMDONORS

Objectives: To determine whether the sisters of women with premature o varian failure (POF) showed a response to gonadotropin stimulation com parable to that of anonymous ovum donors. Design: Historical cohort st udy. Setting: Records of 228 consecutive ovum recipients in an academi c assisted reproductive technology program. Patient(s): Criteria for i nclusion were oocyte recipients age less than or equal to 40 years, FS H >18 mIU/mL (conversion factor to SI unit, 1.00), and/or failure to r espond appropriately to controlled ovarian hyperstimulation (COH). Sev enty-nine recipients were classified on the basis of whether they rece ived oocytes from anonymous donors (group I, n = 66) or sister donors (group II, n = 13). Main Outcome Measure(s): Controlled ovarian hypers timulation response, pregnancy rates (PRs), and implantation rates. Re sult(s): The ages of the donors to groups I and II were comparable (31 .1 +/- 16.7 versus 29.8 +/- 7.2 years), but those in group II exhibite d a higher baseline FSH level (12.8 +/- 2.1 versus 8.6 +/- 5.8 mIU/mL) . Group II versus I had a relative risk of 5.1 for cancellation (4 of 13 [30.8%] versus 4 of 66 [6.1%], respectively). In completed cycles o f groups I and II, respectively, there was no difference in serum E-2 on the day of hCG administration (2,356 +/- 826 versus 1,847 +/- 843 p g/mL; conversion factor to SI unit, 3.671), number of oocytes retrieve d (25 +/- 14 versus 22 =/- 13), number of embryos transferred (4.4 +/- 2.1 versus 4.0 +/- 1.0), spontaneous abortion rate (22.7% versus 25.0 %), PR (35.5% versus 36.4%), and implantation rate (16.2% versus 16.4% ). Conclusion(s): There is an increased cancellation rate and, consequ ently, an overall trend toward decreased ovarian response to gonadotro pin stimulation in the sisters of patients with POF. Despite these fac tors, the implantation rates and PRs of embryos derived from patients reaching retrieval were similar to those from anonymous donors. We rec ommend counseling women with POF that their sisters may not be ideal o vum donors. (C) 1997 by American Society for Reproductive Medicine.