Comparison of Intrauterine Insemination Success Rates Using Donor Sperm Between Heterosexual and Female Couples: A Retrospective Cohort Study.

Objective: To compare the success rates of intrauterine insemination with donated sperm between heterosexual and female couples.

Methods: This was a retrospective cohort study involving 519 women who underwent intrauterine insemination with donated sperm over a 5-year period. The sample included 193 women in heterosexual relationships and 326 women in female relationships. Participants were between 18 and 38 years old, undergoing their first reproductive treatment, and had no known female fertility disorders.

Results: No significant differences were found between the two groups in reproductive outcomes. Positive pregnancy test rates were 35.8% for heterosexual couples and 29.1% for female couples (p=0.12). Ongoing pregnancy rates were 31.6% and 27.3%, respectively (p=0.37). Live birth rates were 29.5% for heterosexual couples and 24.8% for female couples (p=0.2).

Conclusions: This study found no significant differences in intrauterine insemination with donated sperm outcomes between heterosexual and female couples. These findings suggest that the absence of seminal fluid exposure in female couples may not negatively impact reproductive success. However, the role of immune tolerance in assisted reproduction outcomes remains unclear. Further multicenter studies with larger samples are needed to explore the potential influence of seminal fluid and possible clinical interventions that may replicate its effects.