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Comparison of perinatal outcomes between spontaneous vs. commissioned cycles in gestational carriers for single and same-sex male intended parents

  • Assisted Reproduction Technologies
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Abstract

Purpose

To determine whether gestational carrier (GC) in vitro fertilization (IVF) cycles (commissioned cycles) for same-sex or single male intended parents have an increased incidence of adverse perinatal outcomes compared with spontaneous cycles in the same GCs.

Design

GC singleton pregnancies were identified from a database of 895 commissioned cycles from a large fertility center. Of these, 78 commissioned cycles met inclusion and exclusion criteria and were compared with 71 spontaneous cycles by the same GCs. The primary outcome was the composite score for adverse perinatal outcomes. Secondary outcomes included mode of delivery, birthweight, and gestational age. Chi-square test of association and Mann-Whitney U tests were used to compare categorical and continuous variables between the cohorts, respectively. Logistic and linear regressions controlling for GC age were constructed to determine the influence of GC cycle type on adverse perinatal outcomes.

Results

Commissioned cycles were significantly associated with adverse perinatal outcomes (25.6% vs. 9.9%; p = 0.02) and lower average gestational age (38.7 ± 1.5 vs. 39.4 ± 0.9; p < 0.001) compared with spontaneous cycles. Commissioned cycle increased the likelihood of adverse perinatal outcomes (OR 3.3; p = 0.03) and was a significant independent predictor of a lower average gestational age (β = 0.897; p < 0.001). There were no significant differences in the incidence of vaginal deliveries or cesarean sections between commissioned and spontaneous cycles.

Conclusions

Commissioned cycles confer a greater incidence of composite perinatal complications and were independently associated with a lower average gestational age when compared with spontaneous pregnancies carried by the same GC despite a confirmed healthy uterine environment, sperm samples, and donor oocytes.

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Acknowledgments

The authors thank the staff of the Fertility Centers of Illinois for their assistance with obtaining the necessary patient database and Louis Fogg, PhD, for his help with statistical analysis.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Rush University Medical Center, 1653 W. Congress Pkwy, Suite 218 Kellogg, Chicago, IL, 60612, USA

    Z. Pavlovic, K. C. Hammer & M. Raff

  2. Department of Obstetrics and Gynecology, Loyola University Medical Center, 2160 S. 1st Avenue, Building 103, Maywood, IL, 60153, USA

    P. Patel

  3. Rush Medical College, Rush University Medical Center, 600 S. Paulina St, Suite 202, Chicago, IL, 60612, USA

    K. N. Kunze

  4. Fertility Centers of Illinois, 900 N. Kingsbury St., Chicago, IL, 60610, USA

    B. Kaplan & J. Hirshfeld-Cytron

  5. aParent IVF Laboratory, 767 Park Avenue West, Suite 130, Highland Park, IL, 60035, USA

    C. Coughlin

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  1. Z. Pavlovic
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  8. J. Hirshfeld-Cytron
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Corresponding author

Correspondence to Z. Pavlovic.

Ethics declarations

The present study was approved by the New England Institutional Review Board as a retrospective research study and has a yearly renewal of IRB approval, the most recent of which was January 15, 2019.

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The authors declare that they have no conflict of interest.

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Pavlovic, Z., Hammer, K.C., Raff, M. et al. Comparison of perinatal outcomes between spontaneous vs. commissioned cycles in gestational carriers for single and same-sex male intended parents. J Assist Reprod Genet 37, 953–962 (2020). https://doi.org/10.1007/s10815-020-01728-3

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  • DOI: https://doi.org/10.1007/s10815-020-01728-3

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