Resultados de la inseminación artificial conyugal en un centro hospitalario no especializado durante los años 2001 y 2017

Introduction

Homologous artificial insemination (HAI) is an assisted reproductive technology used as a first option in those couples that do not become pregnant. A study was performed on the outcomes of HAI cycles in this centre in order to compare the results with those of the SEF (Spanish Fertility society) and other studies. The degree of association between pregnancy and different variables related to male and female factors was also determined.

Material and method

The following variables were collected retrospectively about the HAI cycles carried out between 2001 and 2017: woman's age, percentage of progressively motile sperm, total motile sperm count (TMSC), percentage of morphologically normal sperm, pregnancy (yes or no), abortion (yes or no) and multiple pregnancy (yes or no). Rates of pregnancy / cycle, pregnancy / couple, abortion, live births / cycle, multiple pregnancy and accumulated pregnancy were calculated, depending on the different variables collected. In addition, a bivariate statistical analysis was carried out between pregnancy and different male and female variables in order to establish an association between them.

Results

A total of 3,477 HAI cycles were carried out. The pregnancy/cycle rate obtained was 10.18%, and per couple it was 29.70%. The total abortion rate was 22.60% and multiple pregnancy rate was 6.78%. The accumulated pregnancy rate was 38.56%. A statistically significant association (P < .05) was found between pregnancy and TMSC. No statistically significant relationship was found in the other variables studied (age of the woman, morphology, or initial progressive motility).

Discussion

Pregnancy/cycle rates were higher with TMSC ≥ 10 million/mL, with sperm morphology ≥ 4, with initial progressive motility ≥ 32%, and in women under 40 years, which coincide with the results published in other studies. However, only TMSC could be considered as a predictor of success in the HAI due to the statistically significant relationship obtained in this study between TMSC and pregnancy.

The total abortion rate was very similar to the SEF abortion rate in recent years. However, the multiple pregnancy rate in the present study is significantly lower than the rate of other Spanish centres.

Although the HAI has not shown major changes in recent years, it is a simple, cheap and safe technique with an accumulated pregnancy rate similar to the results obtained with other types of more complex and expensive assisted reproductive technology.