Gestational carriers: A viable alternative for XXXX with medical contraindications to pregnancy.

@entity1 @entity249 @entity5 @entity1003 @entity53 @entity52 @entity65 @entity454
OBJECTIVE: Compare the efficacy of surrogate or gestational carrier (GC) cycles to that of autologous @entity52 ( @entity52 )/intracytoplasmic sperm injections (ICSI) in @entity1 with gynecologic or medical co-morbidities contraindicative to pregnancy. DESIGN: Retrospective cohort study. SETTING: @entity249 @entity1 from a single university hospital-based program from 1998-2009. INTERVENTIONS: 128 GC cycles from 80 intended parents were identified and compared with 15,311 @entity52 or ICSI cycles. MAIN OUTCOME MEASURES: The peak @entity53 (E2), number of oocytes retrieved, cycle cancellation, ongoing pregnancy, and live-birth were compared between GCs and autologous @entity52 carriers. Indications for GC use were also identified. Multiple cycles contributed by the same @entity1 were accounted for using multivariable generalized estimating equations and two-sided Wald p-values. RESULTS: Uterine factors (67%) was the most common indication for using a GC, followed by non-gynecologic medical conditions including @entity1003 (13%), @entity454 (10%), @entity65 (5%) and @entity5 (5%). Adjusting for age, ovulation induction in GC cycles had similar peak E2 levels and number of oocytes retrieved relative to @entity52 cycles (p = 0.23 and 0.43, respectively). Clinical pregnancy (49% vs. 42%, p = 0.28) and live-birth rates (31% vs. 32%, p = 0.74) were also comparable. A sub-analysis of GC cycles in those @entity1 with uterine factor indications, demonstrated significantly higher clinical pregnancy rates (OR = 2.0; CI = 1.2 - 3.5) with 60% greater odds of live-birth relative to @entity52 /ICSI cycles, however this odds was not statistically significant for differences in live-birth (CI = 0.9 - 2.9). Conclusions: GCs are a viable alternative to start families for @entity1 with medical co-morbidities precluding pregnancy.
