Research question

What is the cumulative live birth rate (LBR) following donor intrauterine insemination (IUI-D) treatment in a large, retrospective, single-centre cohort of single women, same-sex couples and heterosexual patients?

Design

Outcomes from 8922 treatments performed in 3333 consecutive women (45% single, 43% from same-sex and 12% from heterosexual couples) were analysed in a 13-year retrospective study from a private, HFEA-regulated UK centre between January 2004 and December 2016.

Results

A total of 795 live births resulted in an overall delivery rate of 8.9% per cycle, including 24 (3%) twins. Age-specific crude and expected cumulative LBR calculated in four age groups (<35, 35–37, 38–39 and 40–42 years) were 29, 23, 21, 12% and 66, 49, 54, 28%, respectively. A plateau was reached after six cycles, beyond which there were few additional live births. There was no significant difference in cumulative LBR between single women and same-sex couples. In a multivariate analysis, female age (adjusted odds ratio [aOR] 0.92; 95% confidence interval [CI] 0.90–0.93; P < 0.0001), previous live birth following IUI-D (aOR 2.15; 95% CI 1.69–2.73; P < 0.0001) and mild stimulation (aOR 1.27; 95% CI 1.09–1.48; P = 0.02) had a significant effect on outcome, but relationship status or cycle rank did not.

Conclusions

These results indicate there is little benefit performing more than six cycles of IUI-D in all women up to 40 years old, including those from same-sex relationships, while only three attempts seem reasonable in those aged 40–42 years. These results do not reflect current clinical guidelines in the UK. The authors found that consecutive IUI cycles, especially with mild stimulation, were an efficient treatment in all indications.

中文翻译：

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在单身女性、同性伴侣和异性恋患者中用供体精子授精后的累积活产率

研究问题

在由单身女性、同性伴侣和异性恋患者组成的大型回顾性单中心队列中，供体宫内人工授精 (IUI-D) 治疗后的累积活产率 (LBR) 是多少？

设计

2004 年 1 月至 12 月期间，在 3333 名连续女性（45% 单身，43% 来自同性和 12% 来自异性伴侣）中进行的 8922 次治疗的结果在一项为期 13 年的回顾性研究中进行了分析，该研究在 HFEA 监管的私人英国中心进行2016 年。

结果

共有 795 名活产婴儿，每个周期的总分娩率为 8.9%，其中包括 24 (3%) 对双胞胎。在四个年龄组（<35、35-37、38-39 和 40-42 岁）中计算的特定年龄粗略和预期累积 LBR 分别为 29、23、21、12% 和 66、49、54、28% . 六个周期后达到了平台期，在此之后几乎没有额外的活产。单身女性和同性伴侣之间的累积 LBR 没有显着差异。在多变量分析中，女性年龄（调整后的比值比 [aOR] 0.92；95% 置信区间 [CI] 0.90–0.93；P  < 0.0001）、IUI-D 后既往活产（aOR 2.15；95% CI 1.69–2.73；P  < 0.0001）和轻度刺激（aOR 1.27；95% CI 1.09–1.48；P = 0.02) 对结果有显着影响，但关系状态或周期等级没有。

结论

这些结果表明，对所有 40 岁以下的女性（包括来自同性关系的女性）进行超过 6 个周期的 IUI-D 几乎没有任何好处，而在 40-42 岁的女性中，只有 3 次尝试似乎是合理的。这些结果并不反映英国当前的临床指南。作者发现连续的 IUI 周期，尤其是在轻度刺激的情况下，在所有适应症中都是一种有效的治疗方法。