Introduction: Egg donation has become a crucial alternative for couples experiencing infertility, providing them with the opportunity to achieve conception and pregnancy. Nevertheless, this approach is linked to numerous clinical, physiological, and psychological difficulties that can have a substantial impact on both the parents and the results of the pregnancy. This systematic study seeks to identify and assess the clinical characteristics, as well as the physiological and psychological problems, seen during pregnancies among couples who are eligible for egg donation. The main goal is to offer a thorough comprehension of these complexities in order to enhance clinical care and patient counseling. Search Strategy: In accordance with PRISMA standards, a thorough literature search was performed on several databases such as PubMed, Scopus, Web of Science, and Embase. The search encompassed articles without limitation until ۲۰۲۴. The search utilized the following keywords: 'egg donation,' 'pregnancy complications,' 'psychological impact' and 'physiological outcomes'. The inclusion criteria consisted of studies that particularly examined the clinical, physiological, or psychological outcomes of pregnancy in candidates considering egg donation. Studies that focused on unrelated fields were excluded. The Cochrane Risk of Bias tool was used to evaluate the potential bias in the chosen studies. The data were synthesized by applying a combination of thematic analysis for qualitative data and meta-analysis for quantitative outcomes. The results were reported in the form of estimates along with confidence intervals (CI) and significance levels (P-value). Results: A total of ۳۸ studies were analyzed, which included a wide range of participants and healthcare settings. The review found that pregnancies resulting from
egg donation had higher risks of hypertensive disorders (P < ۰.۰۱, CI ۹۵%), gestational diabetes (P < ۰.۰۵, CI ۹۵%), and preterm birth (P < ۰.۰۵, CI ۹۵%). Couples undergoing
egg donation also experienced more psychological complications, such as increased levels of anxiety and depression, compared to those conceiving naturally (P < ۰.۰۱, CI ۹۵%). The analysis emphasized the importance of providing psychological support, as individuals who received such interventions showed better mental health outcomes. Conclusion and Discussion: This Systematic Review identifies notable clinical, physiological, and psychological difficulties related to pregnancies via egg donation. The results emphasize the necessity of customized medical and psychological treatment to successfully address these issues. Medical professionals should be cognizant of the heightened hazards and offer thorough assistance to maximize results. Additional research is advised to investigate the long-term consequences and devise methods to reduce these hazards, guaranteeing safer and more favorable encounters for couples participating in egg donation.