In a nutshell
This paper studied the perinatal effects on babies conceived through intrauterine insemination.
Intrauterine insemination is a fertility treatment where fast moving sperm are placed into the woman's womb close to the time when the egg is released from the ovary in the middle of the monthly cycle. Artificial reproductive technology increases the perinatal (period from 22nd week of gestation to 1 week after birth) risks for children. It is thought that ovarian stimulation (where medication stimulates the release of eggs) could cause these risks. The authors study the effects of intrauterine insemination and ovarian stimulation.
Methods & findings
Children born after intrauterine insemination were compared to those born after in-vitro fertilisation (IVF), intra-cytoplasmic sperm injection (injecting sperm into egg) and spontaneously conception (naturally conceived). Data on perinatal outcomes were obtained. Low birth weight, being small for gestational age (small compared to children with same gestation period) and preterm birth (less than 37 weeks of gestation) were the perinatal outcomes studied.
Children born after intrauterine insemination from partner semen had 30% increased risk of preterm birth, 40% increased risk of low birth weight and 40% increased risk of being small for gestational age compared to spontaneously conceived children. For children born after intrauterine insemination with donor semen, results were similar to those born from partner semen.
Compared with IVF, the risk of being small for gestational age after intrauterine insemination was similar. However, with intrauterine insemination there was a 40% decreased risk of preterm birth and 20% decreased risk of low birth weight compared to IVF.
No differences were found when intrauterine insemination was compared to intracytoplasmic sperm injection.
Where intrauterine stimulation was accompanied by ovarian stimulation, children born after clomiphene citrate (Clomid) treatment had a 50% increased risk of low birth weight and 60% increased risk of being small for gestational age than those born without medical stimulation. In contrast, children born after follicle stimulating hormone treatment (stimulates the ovaries to produce eggs) had similar risks compared to those born without medication.
The bottom line
The authors concluded that intrauterine insemination was associated with potentially higher risks of adverse perinatal outcomes compared with spontaneously conceived children.
Published By :
Fertility and Sterility
Jul 23, 2014