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| Multivariate analysis of multiple pregnancies after artificial insemination with donor sperm |
| Reproductive Center of Guangdong Provincial Reproductive Science Institute, Key Laboratory of Male Reproduction and Genetics of National Health Commission, Guangzhou, Guangdong Province, 510600 |
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Abstract To analyze the influence factors of multiple pregnancies after artificial insemination with donor sperm (AID). Methods: A total of 6,171 pregnancy cycles of the women after AID from January 2011 to December 2020 were analyzed retrospectively. The relationship between the multiple pregnancies and the women's character, donor sperm quality, and cycle related factors was analyzed byχ2 and generalized estimated linear equation. Results: The risk of multiple pregnancies of the women with 2 dominant follicles was 6.467 times of that of women with 1 dominant follicle, and the risk of multiple pregnancies of the women with ≥3 dominant follicles was10.638 times of that of women with 1 dominant follicle. The risk of multiple pregnancies of the women after clomiphene (CC) treatment was 5.752 times of the women with natural cycle, that after gonadotropin (Gn) treatment was 6.023 times of the women with natural cycle, that after tamoxifen (TMX) treatment was 5.021 times of the women with natural cycle, and that after letrozole (LE) treatment was 4.206 times of the women with natural cycle. The multiple fetal rate (5.6%) of the women with ≥dominant follicles and age <35 years old after ovulation induction by LE was significantly lower than that (19.2%) by CC, that (18.7%) by Gn, or that (29.5%) by TMX. Among 12 women with multiple pregnancies and ≥35 years old, 6 cases were given ovulation induction by Gn, accounting for the highest proportion. In the women were given FSH protocol or hMG combined with FSH protocol, the highest multiple pregnancise rates was observed in the women with Gn starting dose> 75 IU. Conclusion: In AID, the treatment protocols and the numbers of dominant follicles of the women are the major factors of their multiple pregnancies. During AID, the women <35 years old should be given ovulation induction by LE to reduce their multiple pregnancies rate. For the women ≥35 years old, Gn is an important factor to cause their multiple pregnancies, so the starting dose of Gn should be reduced appropriately.
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