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Patient Demographics and Cycle Characteristics and Outcomes
Similar publications
Across the world, infertility affects about 15% of couples. Males are found to be solely responsible for 20-30% of infertility cases and contribute to 50% of cases overall. In the Middle East, the male factor is involved in 60-70% of infertile couples. Infertility can also be due to female factors or a combination of low infertility in both partner...
Citations
... Importantly, the oldest woman included in this study was 39 years old. A separate study comparing same-sex or unpartnered women undergoing ovulation induction/IUI to heterosexual couples with any infertility diagnosis also found that both groups had similar pregnancy outcomes (Nazem et al., 2017). In this study, it was not specified whether the heterosexual couples were seeking ART due to male factor, female factor or unexplained infertility. ...
STUDY QUESTION
Do women ≥40 years old without a male partner who utilize donor sperm have the same reproductive outcomes as those who utilize their partner’s sperm?
SUMMARY ANSWER
After controlling for relevant confounders, women ≥40 years old using donor sperm for IVF have significantly higher odds of having a live birth compared to those utilizing their partner’s sperm.
WHAT IS KNOWN ALREADY
Women who are unpartnered or in same-sex relationships are by definition not infertile, but may choose to conceive using donor sperm. It is not known how IVF outcomes are affected with the use of donor sperm compared to women utilizing their partner’s sperm, particularly at very advanced maternal ages.
STUDY DESIGN, SIZE, DURATION
This is a retrospective cohort study conducted at a university-affiliated center of women undergoing IVF with fresh embryo transfer between 2008 and 2018.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Patients were divided into two groups based on the ejaculated sperm source utilized: donor or partner sperm. Live birth rate was the primary outcome. Pregnancy rate was the secondary outcome. Multivariable logistic regression was performed and adjusted for age, the developmental stage of the embryo, and the number of embryos transferred. Unadjusted odds ratio (OR) and adjusted OR (aOR) with 95% CI for pregnancy and live birth were estimated. Statistical significance was denoted by P < 0.05.
MAIN RESULTS AND THE ROLE OF CHANCE
A total of 3910 cycles in women ≥40 years old were analyzed, of which 307 utilized donor sperm and 3603 utilized their partner’s sperm to conceive. In the univariate analysis, patients utilizing donor sperm were found to have similar pregnancy rates as those utilizing partner sperm (41.0 vs 39.8%, OR: 0.95, 95% CI: 0.75–1.20). After adjusting for age, the number of embryos transferred and the developmental stage of the embryos, the model estimates did not vary (aOR: 1.22, 95% CI: 0.95–1.56). Similarly, the univariate analysis for live birth did not demonstrate a difference between groups (19.2 vs 17.8%, OR: 0.91, 95% CI: 0.67–1.22). However, after a similar adjustment was made for confounders, the use of donor sperm was associated with statistically significant increased odds of live birth (aOR: 1.38, 95% CI: 1.01–1.88).
LIMITATIONS, REASONS FOR CAUTION
As with any retrospective study, the potential for residual confounding exists, despite attempts to control for this with regression modeling.
WIDER IMPLICATIONS OF THE FINDINGS
Women ≥40 years old who are unpartnered or in same-sex relationships can be counseled that their odds of a live birth are slightly better than women in heterosexual relationships utilizing their partner’s sperm. These findings serve to further refine and individualize counseling on the expected IVF outcomes for women in this population.
STUDY FUNDING/COMPETING INTEREST(S)
No funding was sought for this study. The authors declare no competing interests.
TRIAL REGISTRATION NUMBER
N/A.
Background
Asthma has been linked with prolonged time to pregnancy compared to healthy controls, also asthma has been linked to a higher need for fertility treatment. However, knowledge of the possible association between allergy and need for fertility treatment is limited. Our aim was to explore a possible difference in having had fertility treatment in women with asthma and live births in those with perennial allergy (animals, fungi and dust mites) compared to no allergy/seasonal allergy. The primary outcome of interest was fertility treatment.
Patients and Methods
Women enrolled in the Management of Asthma during Pregnancy (MAP) program at Hvidovre Hospital, DK, were included in the present analysis provided they fulfilled the following criteria: 1) diagnosed with asthma and current anti-asthma therapy and 2) first visit to the respiratory outpatient clinic within the first 18 weeks of pregnancy. Participants were divided into two groups: asthma with perennial allergy (cases) and asthma with seasonal/no allergy (controls). Logistic regression analysis was applied, and findings expressed as odds ratios (OR).
Results
Among women with asthma and perennial allergy (n=544 cases), 13.8% (n=75) had fertility treatment, compared to only 10.1% (n=39) among women with asthma and seasonal/no allergy (n=388, controls) (OR 1.43, 95% CI 0.95–2.16, p=0.087). This association remained statistically insignificant after adjusting for confounders, including BMI (OR 1.19, 95% CI 0.77–1.84, p=0.433). In women ≥35 years of age, 28% (n=44) and 20% (n=19), respectively, among cases and controls had fertility treatment (OR 1.60, 95% CI 0.87–2.94, p=0.132), and likewise, statistically insignificant after adjusting for confounders (OR 1.41, 95% CI 0.74–2.69, p<0.293).
Conclusion
In women with asthma and live births, our study revealed a trend towards an association between perennial allergy and a higher need for fertility treatment compared to seasonal/no allergy.
