Lower Sperm Exposure among Participants Undergoing Intrauterine Insemination Associated with Increased Incidence of Gestational Hypertensive Disorders

Background: Gestational hypertensive disorders remain a major obstetric problem. Objectives: To evaluate the incidence of gestational hypertensive disorders among participants undergoing intrauterine insemination (IUI) after exposure to various levels of sperm from sperm donation (SD). Methods: A retrospective case-control study was conducted at a single tertiary medical center between 2011 and 2019. Participants conceived via IUI using SD from a single sperm bank and had a successful singleton birth. Group 1 conceived during 1 -2 cycles of IUI from the same sperm donor; whereas Group 2 after 3+ cycles. Results: Overall 171 patients (Group 1 = 81, Group 2 = 90) met inclusion criteria. Participants showed no differences in age, chronic medical conditions, or history of pregnancy complications. The groups differed in gravidity and parity. The factors positively associated with Group 1 included either preeclampsia or gestational hypertension (GH) (11 [13.5%] vs. 1 [ 1.1 %], P =0.001) and GH alone (8 [9.9%] vs. 1 [1.1%], P= 0.0U). Newborns from Group 1 had a statistically significant lower birth weight than those from Group 2 (3003 grams ± 564.21 vs. 3173 grams ± 502.59, P= 0.039). GH was more prevalent in Group 1 (P= 0.008) than a control group of 45,278 participants who conceived spontaneously. No significant differences were observed between Group 2 and the control group. Conclusions: The incidence of GH and preeclampsia in participants was higher among those exposed to 1 -2 cycles than those exposed to 3+ cycles of IUI.