Pregnancy and offspring outcomes after artificial insemination with donor sperm: A retrospective analysis of 1805 treatment cycles performed in Northwest China

Artificial insemination with donor sperm (AID) is a widely used procedure, but its success rate in China remains uncharacterized. This study investigated the factors associated with occurrence of clinical pregnancy and live birth and evaluated the birth outcomes in the offspring after AID in Northwest China. We retrospectively reviewed the results of 1805 AID courses in 1046 couples during 2006–2015. We analyzed whether the number of AID cycles, age of the female patient, and number of sperm with progressive motility were associated with the occurrence of clinical pregnancy and live birth. We also evaluated the birth outcomes in the offspring. Among the 1805 cycles, 447 (24.8%) resulted in clinical pregnancy and 384 (21.3%) resulted in a live birth. Miscarriage occurred in 57 of the 447 cases of clinical pregnancy (12.8%). The proportion of cycles resulting in a live birth decreased significantly with age (P < .001). The proportion of clinical pregnancies that resulted in miscarriage increased with age (P < .001). Cumulative pregnancy rate (the proportion of patients achieving a clinical pregnancy) increased progressively from 23.0% after 1 cycle to 42.7% after ≥5 cycles. The proportion of cycles resulting in clinical pregnancy did not vary with the total number of sperm with progressive motility administered per cycle. Multivariate logistic regression analysis revealed that superovulation treatment and number of cycles were factors associated with clinical pregnancy, while superovulation treatment, number of cycles, and patient age were factors associated with live birth. Among the 384 live births, only one case (0.3%) of birth defect (hexadactyly) was observed. In patients undergoing AID, clinical pregnancy is associated with superovulation treatment and number of cycles, and live birth is associated with superovulation treatment, number of cycles, and patient age. The risk of birth defects in the offspring after AID is low.