Impact of commercial donor sperm preparation on intrauterine insemination outcome

Objective: To assess the impact of commercial donor sperm preparation (ICI-ready and IUI-ready) on intrauterine insemination outcome. Design: Retrospective cohort study Setting: Tertiary-care fertility unit in a major metropolitan area Materials and Methods: All women aged 18-44 years who underwent intrauterine insemination with anonymous donor sperm between January 2007 and December 2011 were assessed for potential inclusion. Cycles were excluded if they were a result of a canceled IVF cycle, the outcome was unknown, the sperm preparation type was unknown, and if they were in a series of back-to-back IUIs. The study sample included 1068 cycles contributed by 317 women; 400 cycles were performed with ICI-ready donor sperm and 668 cycles were performed with IUI-ready donor sperm. Chi-square and t-tests were used to compare baseline characteristics. Binary logistic regression using generalized estimating equation methodology was used to account for within-patient correlation. Statistical significance was set at p<0.05. Primary Outcome Measures: Clinical intrauterine pregnancy Results: Overall, 12.3% of the IUI procedures included in this study resulted in clinical intrauterine pregnancies. Clinical intrauterine pregnancies resulted from 10.2% and 13.5% of IUI procedures performed with ICI-ready and IUI-ready donor sperm, respectively. There was insufficient evidence to suggest a statistically significant association between commercial sperm preparation and pregnancy (Adjusted RR=1.31, 95% CI=0.93-1.86). The baseline characteristics between groups were comparable. Conclusion: The use of lower cost sperm processing methods should not compromise the chance of a successful IUI cycle, as there were not statistically significant differences in the pregnancy rates. However, further investigation is warranted due to a trend toward higher pregnancy rates in cycles performed with IUI-ready samples.