Pregnancy After IUI Using Donor Sperms Associated with Higher Incidence of Preeclampsia

Intrauterine insemination (IUI), the placement of washed and concentrated male partner or donor sperms into the uterine cavity, is commonly used to treat infertility that is unexplained or associated with endometriosis and certain male factor conditions. Now, a recent study published in the journal, Fertility and Sterility, suggests that IUI, using donor sperms, increases the risk of preeclampsia during pregnancy.

The retrospective cohort study led by Dimitra Kyrou from the Center for Reproductive Medicine, Free University of Brussels (Dutch speaking), Belgium, determined the effect of IUI with donor’s or partner’s sperms on the occurrence of preeclampsia in 823 women with primary infertility. Subjects who conceived following IUI and gave birth at ≥24 gestation weeks during the period, January 1999 and December 2006, were evaluated. A total of 713 pregnancies were considered for the final analysis, which included 438 using donor and 275 using partner sperms.

Results showed that women inseminated with donor sperms (10.9%) as opposed to the partner sperms (7.2%) had higher occurrence of preecclampsia (difference, 3.7; 95% confidence interval −0.8 to +7.8). The investigators performed logistic regression by considering parameters such as type of sperm, number of previous cycles, and number of babies. Among the variables, sperm type and the number of IUI cycles predicted the risk of developing preecclampsia and its incidence was inversely proportional to the number of cycles performed. Based on the findings, it was concluded that usage of donor sperms in IUI is associated with enhanced incidence of preeclampsia.

Inspite of the advancements in the understanding of pathogenic mechanisms and risk factors associated with preeclampsia, the exact etiology is still unclear. Few studies propose the involvement of partner-specific immune maladaptation as the probable cause for condition, while other researches contradicted this hypothesis. Earlier, Wang, et al. (Lancet, 2002) conducted a study to determine the effect of exposure or non-exposure of the genital tracts of women to their partner’s sperms, on the rates of preeclampsia and gestational hypertension. The primary objective was to establish that the sperms, compared to the seminal fluid, provided the protective partner-specific immune-tolerance.

Findings suggested that women who had undergone ICSI with surgically obtained sperms, with no previous exposure to the partner’s sperms had 2 and 3-times the risk of hypertension and preeclampsia, respectively. This was in comparison to those treated with IVF or ICSI using ejaculated sperms, i.e., the group who were exposed to partner’s sperm cells and seminal fluid. The scientists thus suggested that ART procedures in women, conceiving through donor’s sperms and not exposed to partner’s sperms, are at an enhanced risk of preeclampsia.

Since artificial insemination is less invasive and inexpensive than IVF, many couples choose IUI over IVF. The identification of the potential risk of preeclampsia associated with donor sperm usage in IUI aids physicians to take precautionary measures like regular obstetric surveillance in such patients to prevent the related complications. However, further larger studies are warranted to elucidate the exact mechanism underlying the condition, which in turn may also facilitate the understanding of the human reproductive disorders related to failed implantation.

References

1. Kyrou D, Kolibianakis EM, Devroey P, Fatemi HM. Is the use of donor sperm associated with a higher incidence of preeclampsia in women who achieve pregnancy after intrauterine insemination? Fertil Steril. 2009 Feb 14. [Epub ahead of print]

2. Wang JX, Knottnerus AM, Schuit G, Norman RJ, Chan A, Dekker GA. Surgically obtained sperm, and risk of gestational hypertension and pre-eclampsia. Lancet. 2002 Feb 23;359(9307):673-4.

2 Responses to “Pregnancy After IUI Using Donor Sperms Associated with Higher Incidence of Preeclampsia”

  1. James Afriyie says:

    I like the report. Good. I would wish to study from the results and how they were analyzed. I find it difficult to see associations.

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