Immunologic and clinical consequences of oocyte donation pregnancies

Abstract

Oocyte donation pregnancies are a result of in vitro fertilization of a donated oocyte by either a relative or more commonly an unrelated donor. In contrast to normal pregnancy, where the fetus is a semi-allograft expressing both maternal (self) and paternal (nonself) genes, in oocyte donation both fetal haplotypes are foreign to the gestational carrier. The placenta and fetal membranes are directly exposed to maternal tissue. Therefore, during an uncomplicated pregnancy, specific local immune adaptations are necessary at the fetal-maternal interface. It is possible that the genetic dissimilarity reflected by the number of human leukocyte antigen (HLA) mismatches results in an altered immunological reaction in oocyte donation pregnancies compared to naturally conceived pregnancies. This chapter, based on two publications by the authors discusses the maternal and fetal complications of oocyte donation pregnancies. Furthermore, the immunogenetic and immunological similarities between oocyte donation pregnancies and transplantation are discussed. Pregnancy conceived after oocyte donation reflects an interesting model to study immunological reactions.