Immunological features in healthy and pre-eclamptic oocyte donation pregnancies

Abstract

Forty years after the first successful oocyte donation (OD), this technique has become a crucial part of assisted reproductive technology (ART). While OD has significantly improved pregnancy rates for infertile couples, it also brings a higher risk of complications like pre-eclampsia, which occurs two to four times more often in OD pregnancies than in standard IVF pregnancies. This research investigates the unique immune challenges in OD pregnancies, where the fetus inherits genes from the donor and father, leading to greater genetic differences between the mother and fetus. By studying pathology lesions, maternal immune cell composition and their microenvironment in the placenta, along with immune cells in maternal blood, I discovered that with high fetal-maternal gene dissimilarities in healthy OD pregnancies, an immune regulatory/tolerating environment may be established locally in the placenta, together with immune alterations in maternal peripheral blood. On the other hand, in OD pregnancies without sufficient immune regulation pre-eclampsia might occur. These findings enhance our understanding of the role of maternal immune cells in OD pregnancies and offer insights into both healthy and pre-eclamptic conditions, which could potentially lead to improved clinical management strategies for these complex pregnancies in the future.