Pregnancy rates after intrauterine insemination higher for same-sex couples, single women
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Key takeaways:
- Same-sex couples and unpartnered women had more success with intrauterine insemination (IUI) vs. heterosexual couples.
- Unpartnered women were older at first IUI cycle vs. heterosexual and same-sex couples.
NEW ORLEANS — Same-sex female couples and unpartnered women had better rates of first pregnancy success after intrauterine insemination compared with heterosexual couples, researchers reported at the ASRM Scientific Congress & Expo.
“Data looking at the effectiveness of [intrauterine insemination] for same-sex couples and unpartnered females are lacking,” Quetrell Heyward, MD, MBA, clinical fellow at Boston IVF and ASRM member, said during a presentation.
Heyward and colleagues assessed data from 4,200 heterosexual couples, 795 same-sex female couples and 355 unpartnered women who underwent their first intrauterine insemination (IUI) cycle from 2017 to 2021 at a single U.S. center. Researchers collected demographics and cycle data from medical records and calculated the cumulative incidence of the first clinical pregnancy.
The primary outcome was the number of IUI cycles until first clinical pregnancy.
Heterosexual couples completed 9,870 IUI cycles, same-sex female couples completed 2,713 IUI cycles and unpartnered women completed 1,160 IUI cycles. The unpartnered female group had a higher mean age at first IUI cycle compared with the heterosexual couple and same-sex female couple groups (37.4 vs. 33.6 and 32.9 years, respectively).
Overall, 92.4% of heterosexual couples, 45.9% of same-sex female couples and 53.6% of unpartnered women used ovarian stimulation/ovarian induction medications.
After 10 IUI cycles, 29.7% of same-sex female couples and 20.8% of unpartnered women had successful first clinical pregnancies compared with 17.5% of heterosexual couples.
Among all successful pregnancies, researchers reported that 97.1% of heterosexual couples, 85.6% of same-sex female couples and 87.8% of unpartnered women achieved their first clinical pregnancy within four IUI cycles.
“This study was eye-opening and demonstrates intrauterine insemination and therapeutic donor insemination are viable options in heterosexual couples, same-sex female couples and unpartnered females, but there’s a limit to it’s worth in all three groups and then marginal benefit after four cycles,” Heyward said. “It’s important for counseling groups, but also for advocating on behalf of the insurance companies for more coverage and legislative requirements given the trends assessment because, as we all know, the longer we wait for IVF, especially in older women, the worst outcomes are.”