Researchers in a 2022 study compared perinatal outcomes after IVF using donor sperm and found a reduction in preterm births, low birth weights and congenital anomalies compared to babies conceived using partner sperm.
Many women undergoing IVF may have no choice but to use donor sperm, and itโs not clear if there are any associated adverse effects on perinatal outcomes.
Allen et al. (2022), in their retrospective study, compared perinatal outcomes from nearly over 200,000 cycles that used donor or partner sperm between 1991 and 2016 from the Human Fertilisation and Embryology Authority (HFEA) registry in the UK. Both singleton and twin pregnancies were included, and the sample sizes were:
- Donor sperm (singleton births): 9,576
- Partner sperm (singleton births): 167,200
- Donor sperm (twin births): 5,260
- Partner sperm (twin births): 84,606
Key information:
- Autologous eggs were used (no donor eggs).
- HFEA stopped reporting on congenital anomalies after 2008.
For baseline characteristics there were a number of differences that were adjusted for in their statistical analysis (maternal age, causes of infertility, treatment year, history of previous pregnancy, method of fertilization and fresh or frozen cycle).
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Donor vs partner sperm comparison for singleton births
The rate of very preterm births (<32 weeks) was lower from pregnancies involving donor sperm compared to partner sperm (1.3% vs 1.7%, adjusted odds ratio [95% CI]: 0.80 [0.66-0.96]). This means that after adjusting for confounders (maternal age, cause of infertility, etc. as shown above) the odds of women having a singleton very preterm birth using donor sperm is 0.80 times that of women using partner sperm.
Babies born from women who used donor sperm tended to be higher weight.
The rate of low birthweight babies (1,500-2,499 g) was decreased in women who used donor sperm compared to those who used partner sperm (5.6% vs 6.8%, adjusted odds ratio [95% CI]: 0.86 [0.78-0.94]), while the rate of high birthweight babies (4,000-4,499 g) was increased (9.2% vs 8.0%, adjusted odds ratio [95% CI]: 1.09 [1.01-1.17]). This means that after adjusting for confounders (maternal age, cause of infertility, etc. as shown above) the odds of women having a singleton low birthweight baby using donor sperm is 0.86 times that of women using partner sperm, and the odds of women having a singleton high birthweight baby using donor sperm is 1.09 times that of those using partner sperm.
The rate of congenital anomalies was lower from pregnancies involving donor sperm compared to partner sperm (2.2% vs 3.4%, adjusted odds ratio [95% CI]: 0.74 [0.59-0.92]). This means that after adjusting for confounders (maternal age, cause of infertility, etc. as shown above) the odds of women having a singleton birth with a congenital anomaly using donor sperm is 0.74 times that of women using partner sperm.
The odds of having a healthy baby, defined as babies born after 37 weeks with a birthweight between 2.5-4.0 kg, was similar between the groups.
Donor vs partner sperm comparison for twin births
Unlike the singleton live birth analysis, there were no differences in preterm birth or congenital anomalies between babies born from donor vs partner sperm.
The rate of twin very low birthweight babies (0-1,499 g) was decreased in women who used donor sperm compared to those who used partner sperm (7.4% vs 8.9%, adjusted odds ratio [95% CI]: 0.83 [0.72-0.96]), as well as the rate of twin low birthweight babies (1,500-2,499 g) for donor vs partner sperm (44.2% vs 46.8%, adjusted odds ratio [95% CI]: 0.91 [0.85-0.98]). This means that after adjusting for confounders (maternal age, cause of infertility, etc. as shown above) the odds of women having a twins with very low or low birthweights using donor sperm is 0.83 and 0.91 times that of women using partner sperm, respectively.
The odds of having a healthy baby was similar between the groups.
Conclusions
In singletons, this study found a reduction in very preterm births, low birthweights and congenital anomalies from the use of donor sperm compared to partner sperm. In twins, they found a reduction in low birthweights when donor sperm was used.
These reductions in adverse outcomes is likely due to a better prognosis in women needing to use donor sperm, who may not have infertility at all and are forced to use donor sperm because they donโt have a male partner or their partner has severe male factor infertility.
The authors point out that sperm donors undergo extensive screening, which may account for the reduction in congenital anomalies seen.
Reference
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About Embryoman
Embryoman (Sean Lauber) is a former embryologist and the founder of Remembryo, an IVF research and fertility education website. After working in an IVF lab in the US, he returned to Canada and now focuses on making fertility research more accessible. He holds a Masterโs in Immunology and launched Remembryo in 2018 to help patients and professionals make sense of IVF research. Sean shares weekly study updates on Facebook, Instagram, and Reddit regularly. He also answers questions on Reddit or in his private Facebook group.
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