Is the use of donor sperm associated with a higher incidence of preeclampsia in women who achieve pregnancy after intrauterine insemination?

A balancing act: mechanisms by which the fetus avoids rejection by the maternal immune system

“…Preeclampsia, a multi-system human pregnancyspecific disorder characterized by de novo hypertension and proteinuria, is a condition that involves insufficient invasion of the maternal uterine vasculature by extravillous trophoblast (EVT). Epidemiological observations that preeclampsia is more likely with first pregnancies, and in women undergoing IVF with donor sperm, compared with those using partner sperm (Kyrou et al 2010), support the view that risk is attributed to the assumed minimal pre-exposure to paternal antigens . While the clinical symptoms of preeclampsia do not appear prior to 20 weeks gestation, placental histology indicates impaired trophoblast invasion and spiral artery remodeling in early pregnancy.…”

The impact of donor insemination on the risk of preeclampsia: a systematic review and meta-analysis

“…Three of the studies assessed women who were using ART and compared cycles using donor sperm with either cycles using a partner's sperm [24,25] or spontaneous pregnancies among the general population [26]. The remaining four studies [27][28][29][30] compared women who were undergoing IUI using donor sperm with those using partner sperm, as shown in Table 2. Three of the studies excluded patients with medical disorders such as pre-existing hypertension and diabetes mellitus [28][29][30] that could increase the risk of gestational hypertensive disorders (see Table 2).…”

“…The remaining four studies [27][28][29][30] compared women who were undergoing IUI using donor sperm with those using partner sperm, as shown in Table 2. Three of the studies excluded patients with medical disorders such as pre-existing hypertension and diabetes mellitus [28][29][30] that could increase the risk of gestational hypertensive disorders (see Table 2). …”

“…All studies reported the rate of preeclampsia, although three of them did not provide information regarding the rate of gestational hypertension in their published data [26,29,30].…”

Conceptualising a Child-Centric Paradigm

“…There is an increased risk of pre-eclampsia occurring in women that have become pregnant with the assistance of donated gametes or embryos (Smith et al 1997, 457;Salha et al 1999Salha et al , 2270. These studies show that there is an underlying immune response to becoming pregnant with on oocyte that is not your own and to being impregnated with sperm that is not your partners as is supported by further evidence whereby further exposure to the same donor sperm reduces the risk of preeclampsia as the immune system has become tolerant of the novel antigen (Kyrou et al 2010(Kyrou et al , 1126(Kyrou et al -1127.…”