Donor sperm IVF pregnancies exhibit elevated risk of new-onset hypertensive disorders: a retrospective cohort study

Abstract Purpose To evaluate the incidence of new-onset Hypertensive Disorders of Pregnancy (HDP) in donor sperm IVF (DS-IVF) compared with partner sperm IVF (PS-IVF) pregnancies. Methods We retrospectively analyzed a total of 855 DS-IVF cycles and 4,816 PS-IVF cycles of pregnancies delivering after 20 weeks’ gestation achieved live birth between January 2010 and December 2022. All patients underwent fresh embryo transfer after oocyte retrieval. The incidence of new-onset HDP was compared between the two groups. Results The overall incidence of new-onset HDP was 1.7%, with rates of 2.7% in DS-IVF group and 1.6% in PS-IVF group. Multivariate Analysis of risk factors in the entire cohort identified twin pregnancy (OR, 2.483: 95%CI: 1.649–3.739, P < 0.001), elevated body mass index (BMI) (OR, 1.150: 95%CI: 1.095–1.209, P < 0.001), and the use of donor sperm (OR, 2.063: 95%CI: 1.229–3.463, P = 0.006) as independent risk factors for new-onset HDP. In subgroup analyses of both DS-IVF and PS-IVF cohorts, twin pregnancy DS-IVF: OR, 2.575: 95%CI: 1.085–6.115, P = 0.032; PS-IVF: OR, 2.454: 95%CI: 1.542–3.906, p < 0.001 and elevated BMI DS-IVF: OR, 1.152: 95%CI: 1.026–1.292, P = 0.016; PS-IVF: OR, 1.150: 95%CI: 1.089–1.215, p < 0.001 were identified as independent risk factors for new-onset HDP. Conclusion The use of donor sperm is an independent risk factor for new-onset HDP in IVF-conceived pregnancies.