Blood Group Mismatch in Donor Egg IVF: A+ Recipient with O+ Donor
There are no medical contraindications to proceeding with an O+ donor for your A+ recipient in donor egg IVF—this blood group combination is completely safe and poses no immunological risk to the mother or resulting pregnancy.
Why This Blood Group Combination Is Safe
The critical distinction here is that donor egg IVF is fundamentally different from solid organ or hematopoietic stem cell transplantation where blood group compatibility matters significantly. The evidence you may encounter regarding blood group matching pertains exclusively to transplantation contexts involving HLA matching and immune compatibility 1.
Key Immunological Principles
The egg donor's blood type does not transfer to the recipient mother. The recipient maintains her own blood type (A+) throughout pregnancy regardless of the donor's blood type 2.
ABO blood group antigens are not expressed on oocytes or early embryos. The immunological concerns that apply to organ transplantation simply do not exist in gamete donation 2.
The fetus will develop its own blood type based on the genetic contribution from the egg donor and sperm source, which is independent of maternal blood type compatibility concerns 3.
What Actually Matters in Donor Egg IVF
The evidence base for donor egg IVF focuses on entirely different risk factors than blood group matching:
Embryo quality and number transferred are the primary determinants of success and multiple pregnancy risk, not blood group compatibility 3.
Maternal age affects pregnancy outcomes but the donor's younger age (and thus egg quality) is actually advantageous, regardless of blood group 3.
Multiple pregnancy prevention through limiting embryo transfer numbers is the main safety concern, with single embryo transfer significantly reducing complications while maintaining acceptable birth rates 4.
Potential Fetal Blood Type Considerations
The only blood group consideration that may arise is if the resulting fetus is Rh positive and the mother is Rh negative—but this is not your scenario:
Both your patient (A+) and donor (O+) are Rh positive, so there is no risk of Rh incompatibility 2.
Even if there were ABO incompatibility between mother and fetus (which can occur naturally in any pregnancy), this is a manageable neonatal issue unrelated to the donor egg process itself 3.
Common Pitfall to Avoid
Do not conflate transplantation medicine guidelines with reproductive medicine. The extensive literature on HLA matching, blood group compatibility, and immune matching in the context of stem cell or organ transplantation 1, 5, 6, 7 is completely irrelevant to donor egg IVF. These are separate medical domains with entirely different immunological considerations.
What You Should Focus On Instead
Infectious disease screening of the donor per standard reproductive tissue banking protocols 8.
Genetic screening compatibility between donor and intended father/sperm source 2.
Embryo transfer strategy to minimize multiple pregnancy risk while optimizing live birth rates 4, 3.
Standard prenatal care including routine blood type and antibody screening during pregnancy 2.