A controlled study to assess the use of in vitro fertilization with donor semen after failed therapeutic donor insemination.

OBJECTIVE

To assess the outcome of in vitro fertilization and embryo transfer (IVF-ET) with donor semen in patients who have failed to achieve conception with therapeutic donor insemination (TDI).

DESIGN

Retrospective, controlled study.

SETTING

All patients were managed and treated at the in vitro fertilization unit, John Radcliffe Hospital, Oxford, United Kingdom.

PATIENTS, PARTICIPANTS: Thirty-eight patients undergoing 63 cycles of IVF with donor semen were compared with a control group of patients undergoing the same treatment during the same time period for tubal disease (the subgroup with the best success rates in our program), matched for age, type of infertility (primary or secondary), and number of attempts at treatment.

MAIN OUTCOME MEASURES

We compared number of follicles produced, number of oocytes retrieved, fertilization rates, number of embryos obtained, number of embryos transferred, quality of embryos transferred, blastocyst formation in sibling embryos produced, clinical pregnancy rates (PRs), pregnancy loss, and pregnancy outcome.

STATISTICS

Chi-squared test statistic with Yates' correction for continuity.

RESULTS

There was a statistically significant difference between the number of livebirths in the donor IVF-ET group (37) and the control group (18). The cumulative PR after four cycles for the donor IVF-ET group (83%) was statistically greater than that of the control group (59%). There was no significant difference in all other parameters compared.

CONCLUSION

Patients undergoing IVF-ET with donor semen have an excellent outcome. With the decline in PR after six cycles of TDI, early recourse to IVF-ET should be considered in this group of patients.