Pregnancy and Neonatal Outcomes for Women Without Male Partners Undergoing Fertility Care via Intrauterine Insemination: A Retrospective Cohort Study
Abstract
1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Study Outcomes
2.3. IUI Protocol
2.4. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. IUI Outcomes
3.3. Pregnancy and Neonatal Outcomes
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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| Women Without Male Partners (n = 149 *) | Reference: Women with Male Partners (n = 2265 *) | p-Value | |
|---|---|---|---|
| Age (years) | 42 [37, 44] | 38 [35, 41] | <0.0001 |
| Maternal BMI (kg/m2) | 24.7 [21.1, 31.1] | 24.2 [21.8, 27.5] | 0.35 |
| Cycle type | <0.0001 | ||
| Clomiphene citrate | 41 (27.5) | 883 (39.0) | |
| Letrozole | 42 (28.2) | 919 (40.6) | |
| Natural cycle | 49 (32.9) | 270 (11.9) | |
| Gonadotropins | 17 (11.4) | 182 (8.0) | |
| Unknown | 0 (0.0) | 11 (0.5) | |
| Race/Ethnicity | <0.0001 | ||
| Caucasian | 26 (50.0) | 236 (26.9) | |
| Asian American | 9 (17.3) | 465 (53.0) | |
| Hispanic/Latino | 8 (15.4) | 60 (6.8) | |
| African American | 3 (5.8) | 13 (1.5) | |
| Middle Eastern | 1 (1.9) | 6 (0.7) | |
| Other | 3 (5.8) | 51 (5.8) | |
| Unknown | 2 (3.8) | 47 (5.4) | |
| Infertility Diagnosis | |||
| Male factor | 0 (0.0) | 162 (18.5) | 0.001 |
| Diminished ovarian reserve | 7 (13.5) | 229 (26.1) | 0.04 |
| PCOS | 0 (0.0) | 62 (7.1) | 0.05 |
| Ovulatory dysfunction | 1 (1.9) | 84 (9.6) | 0.08 |
| Endometriosis | 0 (0.0) | 30 (3.4) | 0.41 |
| Uterine factor | 1 (1.9) | 23 (2.6) | 1.00 |
| Tubal disease | 0 (0.0) | 21 (2.4) | 0.63 |
| Recurrent pregnancy loss | 0 (0.0) | 32 (3.6) | 0.25 |
| Sexual dysfunction | 0 (0.0) | 15 (1.7) | 1.00 |
| Congenital adrenal hyperplasia | 0 (0.0) | 1 (0.1) | 1.00 |
| Unexplained | 0 (0.0) | 289 (33.0) | <0.0001 |
| Baseline antral follicle count (n) | 9 [6, 15] | 11 [5, 17] | 0.12 |
| Cycle day at trigger | 12 [11, 13] | 12 [11, 14] | 0.39 |
| Endometrial thickness at trigger (mm) | 7.8 [7.1, 8.9] | 8.0 [7.0, 9.0] | 0.59 |
| Presence of trilaminar pattern at trigger | 102 [82.9] | 1593 [79.1] | 0.30 |
| Size of leading follicle at trigger (mm) | 19 [17, 21] | 19 [17, 21] | 0.55 |
| Sperm concentration (millions/mL) | 45.4 [32.0, 71.2] | 46.3 [19.8, 100.1] | 0.90 |
| Percent motility (%) | 50 [39, 58] | 85 [70, 92] | <0.0001 |
| Total motile sperm count (millions) | 10.4 [6.8, 17.2] | 18.5 [6.5, 45.2] | <0.0001 |
| Women Without Male Partners (n = 149) | Reference: Women with Male Partners (n = 2265) | p-Value | |
|---|---|---|---|
| Positive βhCG | 18 (12.1) | 316 (14.9) | 0.52 |
| Clinical pregnancy | 17 (11.4) | 282 (12.5) | 0.56 |
| Biochemical miscarriage | 1(5.6) | 28(8.9) | 0.30 |
| Ectopic pregnancy | 0 (0.0) | 4 (1.3) | 1.00 |
| Clinical miscarriage | 5(27.8) | 94(29.8) | 0.50 |
| Live birth | 12 (8.1) | 186 (8.2) | 0.95 |
| Multiple pregnancy (twins) | 1(5.9) | 8(2.8) | 0.23 |
| Number of IUI cycles completed | 2 [1, 4] | 2 [1, 3] | 0.05 |
| Number of IUI cycles until pregnancy | 2 [1, 5] | 2 [1, 3] | 0.07 |
| Number of IUI cycles until live birth | 2 [2, 4] | 2 [1, 3] | 0.26 |
| Cumulative pregnancy rate: | 11 (21.2) | 257 (29.3) | 0.21 |
| Cycle 1 | 9.6 | 14.8 | 0.30 |
| Cycle 2 | 17.3 | 23.3 | 0.31 |
| Cycle 3 | 21.2 | 29.3 | 0.21 |
| Cycle 4 | 23.1 | 32.6 | 0.15 |
| Cycle 5 | 26.9 | 34.6 | 0.26 |
| Cumulative live birth rate: | |||
| Cycle 1 | 5.8 | 8.3 | 0.79 |
| Cycle 2 | 13.5 | 13.6 | 0.99 |
| Cycle 3 | 17.3 | 17.1 | 0.97 |
| Cycle 4 | 17.3 | 19.2 | 0.74 |
| Cycle 5 | 19.2 | 20.4 | 0.84 |
| Pregnancy Outcomes | Adjusted Odds Ratio (aOR) | 95% Confidence Interval | p-Value |
|---|---|---|---|
| Pregnancy rate per cycle a | 1.11 | 0.61, 2.02 | 0.73 |
| Clinical miscarriage b | 0.75 | 0.15, 3.76 | 0.73 |
| Live birth c | 1.47 | 0.74, 3.09 | 0.31 |
| Rate Ratio (RR) | 95% Confidence Interval | p-Value | |
| Cumulative pregnancy rate | 0.96 | 0.60, 1.55 | 0.87 |
| Neonatal Outcomes d | Adjusted Mean Difference | 95% Confidence Interval | p-Value |
| Gestational age at delivery (days) | −0.9 | −7.6, 5.9 | 0.80 |
| Birthweight (grams) | 148.0 | −190.9, 487.0 | 0.39 |
| Women Without Male Partners (n = 18) | Reference: Women with Male Partners (n = 316) | p-Value | |
|---|---|---|---|
| Pregnancy complications | |||
| Any hypertensive disorder of pregnancy | 3 (16.7) | 23 (7.3) | 0.16 |
| Gestational hypertension | 0 (0.0) | 9 (2.9) | 0.27 |
| Pre-eclampsia without severe features | 0 (0.0) | 7 (2.2) | 0.19 |
| Pre-eclampsia with severe features | 2 (11.1) | 6 (1.9) | 0.06 |
| Eclampsia | 0 (0.0) | 0 (0.0) | -- |
| HELLP syndrome | 1 (5.6) | 0 (0.0) | 0.05 |
| Chronic hypertension with superimposed preeclampsia | 0 (0.0) | 1 (0.3) | 1.00 |
| Placenta disorder (abruption, previa, accreta spectrum) | 1 (5.6) | 3 (1.0) | 0.20 |
| Gestational diabetes | 2 (11.1) | 34 (10.8) | 1.00 |
| Preterm premature rupture of membranes | 0 (0.0) | 5 (1.6) | 1.00 |
| Postpartum hemorrhage | 0 (0.0) | 14 (4.4) | 1.00 |
| Cesarean section | 4 (22.2) | 56 (17.8) | 0.54 |
| Neonatal outcomes | |||
| Gestational age at delivery (days) | |||
| Mean ± SD | 269.5 ± 10.3 | 270.9 ± 13.5 | 0.67 |
| Median [IQR] | 273 [262, 275] | 274 [266, 279] | 0.31 |
| Preterm birth (<37 weeks) | 2 (16.7) | 15 (8.1) | 0.27 |
| Birth weight (grams) | 3200 [2530, 3600] | 3140 [2807, 3445] | 0.69 |
| Low birth weight (<2500 g) | 2 (16.7) | 18 (9.7) | 0.35 |
| Very low birth weight (<1500 g) | 0 (0.0) | 2 (1.1) | 1.00 |
| Neonate’s sex | 0.79 | ||
| Female | 6 (50.0) | 92 (49.5) | |
| Male | 5 (41.7) | 83 (44.6) | |
| Unknown | 1 (8.3) | 11 (5.9) | |
| Apgar score at 1 min | 8 [8, 9] | 8 [8, 9] | 0.25 |
| Apgar score at 5 min | 9 [9, 9] | 9 [9, 9] | 0.94 |
| NICU admissions | 0 (0.0) | 20 (10.8) | 0.61 |
| Neonatal morbidity | 0 (0.0) | 6 (3.2) | 1.00 |
| Congenital anomaly | 0 (0.0) | 8 (4.3) | 1.00 |
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Zhang, W.Y.; McCracken, M.; Zhang, A.; Dominguez, L.V.; Aghajanova, L. Pregnancy and Neonatal Outcomes for Women Without Male Partners Undergoing Fertility Care via Intrauterine Insemination: A Retrospective Cohort Study. J. Pers. Med. 2025, 15, 589. https://doi.org/10.3390/jpm15120589
Zhang WY, McCracken M, Zhang A, Dominguez LV, Aghajanova L. Pregnancy and Neonatal Outcomes for Women Without Male Partners Undergoing Fertility Care via Intrauterine Insemination: A Retrospective Cohort Study. Journal of Personalized Medicine. 2025; 15(12):589. https://doi.org/10.3390/jpm15120589
Chicago/Turabian StyleZhang, Wendy Y., Megan McCracken, Amy Zhang, Lisandra Veliz Dominguez, and Lusine Aghajanova. 2025. "Pregnancy and Neonatal Outcomes for Women Without Male Partners Undergoing Fertility Care via Intrauterine Insemination: A Retrospective Cohort Study" Journal of Personalized Medicine 15, no. 12: 589. https://doi.org/10.3390/jpm15120589
APA StyleZhang, W. Y., McCracken, M., Zhang, A., Dominguez, L. V., & Aghajanova, L. (2025). Pregnancy and Neonatal Outcomes for Women Without Male Partners Undergoing Fertility Care via Intrauterine Insemination: A Retrospective Cohort Study. Journal of Personalized Medicine, 15(12), 589. https://doi.org/10.3390/jpm15120589

