ABSTRACT
OBJECTIVE: Intra-uterine insemination (IUI) is widely used for different indications. The aim of the present study was to evaluate the efficiency of intra-uterine insemination as a function of indication and origin of the inseminated spermatozoa. STUDY DESIGN: The retrospective study involved 827 first attempts of IUI in 827 couples between January 2011 and July 2017 in the Toulouse university hospital. Of these, 642 used fresh sperm from the husband, 40 frozen sperm from the husband and 145 frozen sperm from donors. The measured outcome parameter was live birth rate per attempt. RESULTS: When comparing couples lacking functional gametes (due to male or female causes), to couples who could potentially conceive spontaneously, i.e. subfertile, the latter were found to have a significantly lower live birth rate (18% vs 26%; P < 0.05). Even when adjusted for demographic parameters, which differed significantly between the 2 groups (female age, percentage of women suffering from primary infertility, BMI, number of inseminated motile spermatozoa and stimulation duration), this difference remained statistically significant (OR = 0.639 [0.425-0.961]; P = 0.0316). CONCLUSION: When compared to couples lacking functional gametes, subfertile couples have poor IUI outcomes, suggesting a hidden cause of infertility, despite no apparent differences in ovarian reserve, tubal potency, results of ovarian stimulation and normal conventional sperm parameters. Further studies are required to better characterise and identify this subgroup of women with poor IUI outcomes.
ABSTRACT
OBJECTIVE: To analyze the obstetric outcomes, the incidence of congenital malformations and chromosomal anomalies of neonates born after intracytoplasmic sperm injection (ICSI) according to the origin of sperm. METHODS: A total of 103 neonates born from ICSI between January 1995 and January 2004 was included. They were divided into three groups: ejaculated (n=73), epididymal (n=17) and testicular (n=13) groups. We compared obstetric outcomes such as pregnancy rates, preterm birth rates, abortion rates, multiple pregnancy rates, gestational age at birth, birth-weight, and the incidence of congenital malformations and chromosomal anomalies. RESULTS: There were no differences among the three groups in terms of pregnancy rates, preterm birth rates, abortion rates, multiple pregnancy rates, gestational age at birth and birth-weight. There were no differences in the incidence of low birth-weight babies and very low birth-weight babies. Major malformations were observed in two cases of ejaculatory group (2.7%) and one of testicular group (7.7%). Major malformations included two gastrointestinal malformations and one cleft lip. Minor malformations were observed in three cases of ejaculatory group (4.1%) and one of testicular group (7.7%). Chromosomal anomalies were observed in 6 cases of 105 pregnancies (5.7%), and all of them were from the ejaculatory group. Two cases had autosomal numerical anomalies and 4 cases autosomal structural anomalies. However, sex chromosomal anomalies were not detected in this study. CONCLUSION: The obstetric outcomes, the incidence of congenital malformations and chromosomal anomalies in ICSI babies were not different according to the origin of sperm. These findings should be further investigated in larger long-term studies.
