Barda Shimi, Eliner Yael, Weizman Noga Fuchs, Amir Hadar, Kleiman Sandra E, Azem Foad, Hauser Ron
The Institute for the Study of Fertility and Racine IVF Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 6423906, Tel Aviv, Israel.
Israel Academic College in Ramat Gan, Ramat Gan, Israel.
J Assist Reprod Genet. 2025 Apr;42(4):1257-1263. doi: 10.1007/s10815-025-03464-y. Epub 2025 Mar 31.
Changing sperm donors after unsuccessful intrauterine insemination (IUI) cycles is a common yet understudied practice. This study evaluates whether switching sperm donors impacts the number of IUI cycles required to achieve pregnancy.
This retrospective cohort study analyzed 312 women undergoing donor sperm IUI at Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, from 1992 to 2020. Participants were divided into two groups: Group A (conceived using only one donor) and Group B (switched donors after initial unsuccessful attempts). The primary outcome was the number of IUI cycles until pregnancy. Statistical analyses included t-tests, ANOVA, and multivariate analysis of covariance (MANCOVA).
Women in Group A required fewer cycles (mean 3.78 ± 1.90) to achieve pregnancy compared to Group B (mean 6.07 ± 2.95, P < .001). However, after switching donors, the mean number of cycles needed in Group B (2.23 ± 1.61) was significantly lower than the total cycles required by Group A (P < .001). Cumulative live birth rates were higher in Group A (50.5% after three cycles; 81.5% after six cycles) compared to Group B (26.0% after three cycles; 61.9% after six cycles).
Switching sperm donors after repeated unsuccessful IUI attempts significantly reduces the additional number of cycles needed to achieve pregnancy. These findings suggest that sperm-oocyte compatibility may influence IUI success. Clinicians should consider donor replacement after multiple failures. Prospective studies are required to confirm these results and investigate underlying biological mechanisms.
在宫腔内人工授精（IUI）周期未成功后更换精子供体是一种常见但研究不足的做法。本研究评估更换精子供体是否会影响实现妊娠所需的IUI周期数。
这项回顾性队列研究分析了1992年至2020年在特拉维夫索拉科斯基医疗中心利斯妇产医院接受供体精子IUI的312名女性。参与者分为两组：A组（仅使用一名供体受孕）和B组（在最初尝试未成功后更换供体）。主要结局是直至妊娠的IUI周期数。统计分析包括t检验、方差分析和多变量协方差分析（MANCOVA）。
与B组（平均6.07±2.95，P<0.001）相比，A组女性实现妊娠所需的周期数更少（平均3.78±1.90）。然而，在更换供体后，B组所需的平均周期数（2.23±1.61）显著低于A组所需的总周期数（P<0.001）。A组的累积活产率高于B组（三个周期后为50.5%；六个周期后为81.5%）（三个周期后为26.0%；六个周期后为61.9%）。
在多次IUI尝试失败后更换精子供体可显著减少实现妊娠所需的额外周期数。这些发现表明精子-卵母细胞相容性可能会影响IUI的成功率。临床医生应在多次失败后考虑更换供体。需要进行前瞻性研究以证实这些结果并调查潜在的生物学机制。
