Perinatal outcomes of 221,709 singleton and twin pregnancies after the use of donor versus partner sperm

Objective: To study the association of donor sperm on perinatal outcomes of livebirths conceived via in vitro fertilization (IVF) when compared with partner sperm.Design:Retrospective cohort study Setting: National Human Fertilisation and Embryology Authority assisted reproductive technology registry Patients: All live born singletons and twins conceived through IVF with or without intracytoplasmic sperm injection in the United Kingdom between 1991 and 2016Intervention(s): Donor sperm compared to partner spermMain Outcome Measure(s): Perinatal outcomes were assessed. The primary outcomes were preterm and very preterm birth; low, very low, high, and very high birthweight; Secondary outcomes were congenital anomaly and health baby. These were assessed for single-tons and twins separately.Results: For singleton livebirths, compared to partner sperm, those conceived with donor sperm were at reduced odds of very preterm (odds ratio [OR], 0.76; 95% confidence interval [CI], 0.63-0.91; adjusted OR [aOR], 0.80; 95% CI, 0.66-0.96), and preterm (OR, 0.90; 95% CI, 0.83-0.98; aOR, 0.93; 95% CI, 0.85-1.01) birth. For birthweight outcomes, donor sperm showed a reduced odds of low (OR, 0.83; 95% CI, 0.76-0.91; aOR, 0.86; 95% CI, 0.78-0.94) and an increased odds of high (OR, 1.15; 95% CI, 1.07-1.23; aOR, 1.09; 95% CI, 1.01-1.17) birthweight. There was no confirmed difference in the odds ratios of very low (OR, 0.88; 95% CI, 0.74-1.06; aOR, 0.94; 95% CI, 0.78- 1.13) or very high (OR, 1.21; 95% CI, 1.04-1.40; aOR, 1.15; 95% CI, 0.98-1.34) birthweight.Liveborn twins conceived with donor sperm, compared to partner sperm, were at reduced odds of very low (OR, 0.76; 95% CI, 0.66- 0.88; aOR, 0.83; 95% CI, 0.72-0.96) and low (OR, 0.87; 95% CI, 0.81-0.93; aOR, 0.91; 95% CI, 0.85-0.98) birthweight. There was a sug-gestion of a reduced odds of very preterm (OR, 0.81; 95% CI, 0.70-0.95; aOR, 0.86; 95% CI, 0.74-1.01) and preterm (OR, 0.93; 95% CI, 0.86-1.01; aOR, 0.96; 95% CI, 0.88-1.04) birth. There was considerable uncertainty around the ORs for high (OR, 0.73; 95% CI, 0.31- 1.72; aOR, 0.72; 95% CI, 0.29-1.80) and very high (OR, 1.02; 95% CI, 0.39-2.67; aOR, 1.34; 95% CI, 0.50-3.60) birthweight.Conclusion: Although unmeasured confounding remains a possibility, as paternal age, body mass index, and smoking status were unavai-lable for analysis, women, couples, service providers can be reassured that IVF livebirths conceived with donor sperm have no greater chance of adverse outcomes when compared to partner sperm. (Fertil Sterile 2022;118:948-58. (c) 2022 by American Society for Reproductive Medicine.) El resumen esta disponible en Espanol al final del articulo.

Automated summary

This study analyzed the association between donor sperm and perinatal outcomes of live births conceived via IVF. The results showed that singleton live births conceived with donor sperm had a lower risk of very preterm and preterm birth, while the risk of low and high birthweight was also affected. For liveborn twins conceived with donor sperm, there was a lower risk of very low and low birthweight, and a suggestion of a reduced risk of very preterm and preterm birth. The study concludes that there is no greater chance of adverse outcomes for IVF live births conceived with donor sperm compared to partner sperm.