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

González-Comadran, Mireia; Avila, Julio Urresta; Tascón, Alejandro Saavedra; Jimenéz, Radhanari; Solà, Iván; Brassesco, M.; Carreras, Ramón; Checa, Miguel Ángel

doi:10.1016/j.ejogrb.2014.09.022

Cited by 59 publications

(38 citation statements)

References 46 publications

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“…This study represents a comprehensive analysis of perinatal outcomes of neonates conceived with cryopreserved donated sperm in a population. Despite the potential for adverse perinatal outcomes due to the increased occurrence of PE and oxidative stress‐induced DNA fragmentation reported elsewhere, significantly increased adverse outcomes were generally not observed in this cohort. There were, however, two exceptions.…”

Section: Discussioncontrasting

confidence: 75%

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Sperm donation perinatal outcomes in an Australian population cohort

Adams

Fernandez

Moore

et al. 2017

J of Obstet and Gynaecol

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Aim: To compare perinatal outcomes for neonates conceived with donated sperm with those for neonates conceived spontaneously in an Australian population cohort. Methods: Perinatal outcomes for all births in South Australia for the period January 1986-December 2002 were linked with assisted reproductive treatment records to determine those conceived from donated sperm. Birth outcome measures were analyzed using Student's t-test and logistic regression using generalized estimating equations to determine statistical significance. Results: Donor sperm neonates were not significantly different from their spontaneously conceived counterparts in terms of mean birthweight, low birthweight, preterm delivery, small for gestational age, or large for gestational age. They were, however, significantly more likely to be born at lower mean gestational age (P = 0.012), and to have preterm delivery with low birthweight (P = 0.008), when controlling for maternal age, parity, ethnicity, socioeconomic quartile and baby's sex. These associations were not apparent when singletons and twins were considered separately. Conclusion: There was some evidence of compromised perinatal outcomes for donor sperm neonates compared with their spontaneously conceived counterparts, which appeared to be partly attributable to multiplicity.

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Section: Discussioncontrasting

confidence: 75%

“…Second, donor sperm represents an immunological challenge to the woman that may lead to increased occurrence of pre‐eclampsia (PE) . PE represents a significant morbidity and mortality burden to not only the mother, but also to the fetus .…”

Section: Introductionmentioning

confidence: 99%

Sperm donation perinatal outcomes in an Australian population cohort

Adams

Fernandez

Moore

et al. 2017

J of Obstet and Gynaecol

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“…In the study of González-Comadran and colleagues, [305], conception using donor sperm was again associated with an increased risk of preeclampsia (OR 1.63, 95% CI 1.36-1.95).…”

Section: Pe In a First Pregnancy Increases Its Likelihood In Subsequementioning

confidence: 94%

Immunological tolerance, pregnancy and pre-eclampsia: the roles of semen microbes and the father¹

Kenny

Kell

2017

Preprint

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Although it is widely recognised as involving two stages (poor placentation followed by oxidative stress/inflammation), the precise originating causes of pre-eclampsia (PE) remain elusive. We have previously brought together some of the considerable evidence that a (dormant) microbial component is commonly a significant part of its aetiology. However, apart from recognising, consistent with this view, that the many inflammatory markers of PE are also increased in infection, we had little to say about immunity, whether innate or adaptive. In addition, we focussed on the gut, oral and female urinary tract microbiomes as the main sources of the infection. We here marshall further evidence for an infectious component in PE, focussing on the immunological tolerance characteristic of pregnancy, and the well-established fact that increased exposure to the father’s semen assists this immunological tolerance. As well as these benefits, however, semen is not sterile, microbial tolerance mechanisms may exist, and we also review the evidence that semen may be responsible for inoculating the developing conceptus with microbes, not all of which are benign. It is suggested that when they are not, this may be a significant cause of preeclampsia. A variety of epidemiological and other evidence is entirely consistent with this, not least correlations between semen infection, infertility and PE. Our view also leads to a series of other, testable predictions. Overall, we argue for a significant paternal role in the development of PE through microbial infection of the mother via insemination. “In one of the last articles which he wrote, the late Professor F J Browne (1958) expressed the opinion that all the essential facts about pregnancy toxaemia are now available and that all that is required to solve the problem is to fit them together in the right order, like the pieces of a jigsaw puzzle” [1]“It appears astonishing how little attention has been given in reproductive medicine to the maternal immune system over the last few decades.” [2]

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“…However, this may simply be attributed to a higher risk of preeclampsia as a consequence of longer duration to the next pregnancy according to one large study (Skjaerven et al 2002 ). Furthermore, the use of donor sperm instead of partner (homologous) sperm in intrauterine insemination treatments seems to increase the risk of developing preeclampsia indicating a partner-specifi c dimension in a possible immunological "priming" of the woman (Gonzalez-Comadran et al 2014 ). Finally, the sexual relationship with the father before preeclampsia seems to infl uence the risk of developing preeclampsia.…”

Section: Epidemiological Observations Support Immune Maladaptation Asmentioning

confidence: 99%

Human Leukocyte Antigen-G Within the Male Reproductive System: Implications for Reproduction

Hviid

2015

Advances in Experimental Medicine and Biology

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In sexual reproduction in humans, a man has a clear interest in ensuring that the immune system of his female partner accepts the semi-allogenic fetus. Increasing attention has been given to soluble immunomodulatory molecules in the seminal fluid as one mechanism of ensuring this, possibly by "priming" the woman's immune system before conception and at conception. Recent studies have demonstrated the presence of the immunoregulatory and tolerance-inducible human leukocyte antigen (HLA)-G in the male reproductive organs. The expression of HLA-G in the blastocyst and by extravillous trophoblast cells in the placenta during pregnancy has been well described. Highly variable amounts of soluble HLA-G (sHLA-G) in seminal plasma from different men have been reported, and the concentration of sHLA-G is associated with HLA-G genotype. A first pilot study indicates that the level of sHLA-G in seminal plasma may even be associated with the chance of pregnancy in couples, where the male partner has reduced semen quality. More studies are needed to verify these preliminary findings.

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

Cited by 59 publications

References 46 publications

Sperm donation perinatal outcomes in an Australian population cohort

Sperm donation perinatal outcomes in an Australian population cohort

Immunological tolerance, pregnancy and pre-eclampsia: the roles of semen microbes and the father¹

Human Leukocyte Antigen-G Within the Male Reproductive System: Implications for Reproduction

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

Cited by 59 publications

References 46 publications

Sperm donation perinatal outcomes in an Australian population cohort

Sperm donation perinatal outcomes in an Australian population cohort

Immunological tolerance, pregnancy and pre-eclampsia: the roles of semen microbes and the father1

Human Leukocyte Antigen-G Within the Male Reproductive System: Implications for Reproduction

Contact Info

Product

Resources

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Immunological tolerance, pregnancy and pre-eclampsia: the roles of semen microbes and the father¹