Does Donor Sperm IVF Increase the Risk of Preeclampsia?
A 2026 study published in the Journal of Assisted Reproduction and Genetics examined whether pregnancies conceived through donor sperm IVF carry a higher risk of hypertensive disorders of pregnancy, including preeclampsia.
This question has circulated in reproductive medicine for decades, largely because preeclampsia is thought to involve abnormal immune adaptation to paternal genetic material in the placenta. Earlier research focused mostly on donor insemination and partner change. IVF-specific findings have been more limited and mixed. This study contributes additional IVF data to that ongoing discussion.
Study Overview
Researchers retrospectively analyzed:
855 donor sperm IVF pregnancies
4,816 partner sperm IVF pregnancies
All resulted in live births after 20 weeks
Patients with chronic hypertension and major medical confounders were excluded
The outcome measured was new-onset hypertensive disorders of pregnancy (HDP), including gestational hypertension and preeclampsia.
Key Findings
Overall rate of HDP: 1.7%
Donor sperm IVF: 2.7%
Partner sperm IVF: 1.6%
After adjusting for maternal age, BMI, gravidity, and twin pregnancy, donor sperm use remained independently associated with hypertensive disorders (Odds Ratio 2.06).
Other independent risk factors:
Higher BMI
Twin pregnancy
Within donor sperm pregnancies specifically, BMI and twin gestation were the strongest predictors of HDP.
Why Might This Occur?
The authors reference the paternal antigen tolerance hypothesis.
The theory suggests that repeated exposure to a partner’s semen before pregnancy may promote immune adaptation. With donor sperm, there has been no prior exposure to that specific genetic material. Some researchers propose this could influence placental development and vascular remodeling, which are central to preeclampsia.
This remains a biologically plausible theory rather than a proven mechanism.
What This Does and Does Not Mean
The absolute risk remains low. Even in donor sperm IVF, HDP occurred in 2.7% of pregnancies.
This was a retrospective, single-center study.
Only fresh embryo transfers were included.
The study did not break down severity subtypes or long-term maternal outcomes.
Prior IVF literature has shown mixed findings.
This study suggests a modest association. It does not establish causation.
Clinical Takeaway
This research should not deter someone from using donor sperm.
What it does offer is awareness:
If there are additional risk factors such as elevated BMI or twin pregnancy, closer attention to blood pressure monitoring is reasonable.
Standard prenatal care already includes surveillance for hypertensive disorders.
Patients with individual risk factors should review their history with their OB or maternal-fetal medicine provider.
For most donor sperm IVF pregnancies, outcomes remain uncomplicated.
As assisted reproduction evolves, research like this helps refine counseling and monitoring. It adds nuance, not alarm.
Curious to learn more? You can explore blog reflections on infertility or dive into more fertility research insights .
