Is donor sperm associated with a higher incidence of pre-eclampsia as compared to insemination with partner's sperm?

Abstract

OBJECTIVE: To evaluate the incidence of pre-eclampsia after intrauterine insemination (IUI) with either donor or partner's sperm in women with primary infertility. DESIGN: Retrospective cohort study. MATERIALS AND METHODS: Between January 2005 and December 2006, 191 women who achieved pregnancy after IUI and delivered at ≥24 weeks were reviewed. Only women with primary infertility and no known medical disorders were included. IUI with donor sperm was performed in 110 women, while in the remaining 81, partner's sperm was used. Medical record information recorded included baseline maternal data (age at conception, etiology of infertility, body mass index-BMI, infertility duration, numbers of previous cycles performed) and outcome data (number of fetuses, pregnancy complications and gestational age at delivery). Pre-eclampsia was defined as the occurrence of blood pressure ≥140/90mm Hg on at least two occasions and at least 4-6 h apart, accompanied by proteinuria ≥300 mg/24h after 20 weeks of gestation. The data were analyzed using the Chi-square and Fisher's exact tests where appropriate. A p value < 0.05 was considered to be statistically significant. RESULTS: In the donor group, indications for IUI included azoospermia (14.5%), severe oligoasthenozoospermia (4.5%), lesbian couple (59.1%) and single mother (21.8%). The indications for IUI with partner's sperm included idiopathic infertility (29.6%), moderate oligoasthenozoospermia (50.6%) and dysovulation (19.8%). No significant differences were present between the donor and the partner insemination group regarding maternal age (31.30 ±4.33 vs 30.67 ± 3.75, respectively), BMI (25.89 ± 4.49 vs 25.44 ±4.15, respectively), duration of infertility (1.99 ± 1.46 vs 2.09 ± 1.44, respectively) and number of cycles previously performed (2.92 ± 2.26 vs 2.25 ± 1.35, respectively). Although the incidence of pre-eclampsia in pregnancies resulting from donor sperm IUI (12.7%,14/110) was more than double compared to that resulting from IUI with partner's sperm (6.2%,5/81), difference was not statistically significant (p=0.13). CONCLUSIONS: Although the current data suggest that an increased incidence of pre-eclampsia is present when donor as compared to partner's sperm is used for IUI, the difference did not reach statistical significance. The study is ongoing with the aim to triple the number of patients included, covering the period between 1999 until 2006, and thus provide adequate power to draw definite conclusions.