OBJECTIVE: To demonstrate that the use of donor sperm leads to varying outcome rates and that its use has evolved. DESIGN: Retrospective observational cohort study. SETTING: University-affiliated private IVF setting. PATIENT(S): Women (2,934) undergoing donor insemination (DI) or IVF with donor sperm (IVF-D). INTERVENTION(S): None. MAIN OUTCOME MEASUREMENT(S): We evaluated the distribution of the clinical indications for the use of donated sperm, studying the reproductive outcome. RESULT(S): A total of 1,663 DI (57%) and 1,271 IVF-D (43%) were performed. There were significant differences in the indications for the use of donated sperm (DI vs. IVF-D). Regarding pregnancy rates (PR), cases of nonobstructive azoospermia presented the highest rate (29.1%), whereas cases of intracytoplasmic sperm injection (ICSI) failures and single women showed rates of 27.6% and 22.6%, respectively. Meanwhile, patients with ICSI failures achieved the highest PRs in IVF cycles (48.7%), whereas nonobstructive azoospermia and single women showed rates of 42.0% and 38.2%, respectively. There have been significant increases in the use of donated sperm in single women. CONCLUSION(S): Single women, which also represented the oldest group, show a lower probability of achieving pregnancy, and thus represent a subfertile population. Associated factors could include advanced maternal age.
OBJECTIVE: To demonstrate that the use of donor sperm leads to varying outcome rates and that its use has evolved. DESIGN: Retrospective observational cohort study. SETTING: University-affiliated private IVF setting. PATIENT(S): Women (2,934) undergoing donor insemination (DI) or IVF with donor sperm (IVF-D). INTERVENTION(S): None. MAIN OUTCOME MEASUREMENT(S): We evaluated the distribution of the clinical indications for the use of donated sperm, studying the reproductive outcome. RESULT(S): A total of 1,663 DI (57%) and 1,271 IVF-D (43%) were performed. There were significant differences in the indications for the use of donated sperm (DI vs. IVF-D). Regarding pregnancy rates (PR), cases of nonobstructive azoospermia presented the highest rate (29.1%), whereas cases of intracytoplasmic sperm injection (ICSI) failures and single women showed rates of 27.6% and 22.6%, respectively. Meanwhile, patients with ICSI failures achieved the highest PRs in IVF cycles (48.7%), whereas nonobstructive azoospermia and single women showed rates of 42.0% and 38.2%, respectively. There have been significant increases in the use of donated sperm in single women. CONCLUSION(S): Single women, which also represented the oldest group, show a lower probability of achieving pregnancy, and thus represent a subfertile population. Associated factors could include advanced maternal age.
Authors: Wendy S Vitek; Omar Galárraga; Peter C Klatsky; Jared C Robins; Sandra A Carson; Andrew S Blazar Journal: Fertil Steril Date: 2013-07-19 Impact factor: 7.329