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Human Reproduction, Vol. 14, No. 8, 2110-2115, August 1999
© 1999 European Society of Human Reproduction and Embryology

Obstetric and perinatal outcome of pregnancies after intrauterine insemination

Sinikka Nuojua-Huttunen1,4, Mika Gissler2, Hannu Martikainen3 and Leena Tuomivaara1

1 Infertility Clinic, The Family Federation of Finland, Kiviharjuntie 11 A, FIN-90220 Oulu, 2 STAKES, National Research and Development Centre for Welfare and Health, PO Box 220,FIN-00531 Helsinki and 3 Department of Obstetrics and Gynaecology, University of Oulu, Kajaanintie, FIN-90220 Oulu, Finland

The main aim of this study was to evaluate the obstetric and perinatal outcome of pregnancies after intrauterine insemination (IUI) with the partner's spermatozoa combined with ovarian stimulation. Information concerning the antenatal care and obstetric and perinatal outcome of IUI pregnancies (n = 111), spontaneous (n = 333) and in-vitro fertilization (IVF) (n = 333) was obtained from the Finnish Medical Birth Register (MBR). The multiple birth rate in the IUI group was 17% (19/111). Significantly less antenatal care was required by the IUI group than the IVF group. The frequency of Caesarean section was 25% for IUI singletons and 58% for IUI multiples, similar to the other groups. The mean (SD) gestational age for IUI singletons at birth was 39.5 (1.8) weeks, with a mean birth weight of 3285 (575) g, compared with 3448 (600) g in non-assisted singletons (P < 0.05). For IUI multiples the mean gestational age at birth was 36.0 (2.8) weeks and the mean birth weight was 2449 (678) g. The incidence of preterm birth, low birth weight or low Apgar scores and the need for neonatal care were similar in all groups. One case of major malformation and two perinatal deaths were recorded in the IUI group. In conclusion, IUI treatment did not appear to increase obstetric or perinatal risks compared with matched spontaneous or IVF pregnancies. Most problems were associated with patient characteristics and multiple pregnancy. Reduction of the high incidence of multiple pregnancies after assisted reproductive technology is essential to improve its outcome.

Key words: antenatal care/intrauterine insemination/in-vitro fertilization/obstetric outcome/perinatal outcome

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