Comparison of clinical outcome after intrauterine insemination with donor semen in single women, lesbian couples and heterosexual couples.

PURPOSE: The aim of this study was to compare clinical pregnancy rate after IUI-D in heterosexual couples (HC), lesbian couples (LC), and single women (SW). METHODS: This retrospective multicentric study was conducted in two university-based ART centers in France in all consecutive IUI-D cycles performed after stimulation with gonadotropins in 2021-2023. The primary outcome was clinical pregnancy rate (CPR). Cumulative clinical pregnancy rate was also calculated. Comparisons were made between groups taking HC as the control group and adjusting for age. RESULTS: A total of 962 patients undergoing 2737 IUI-D cycles were included in the analysis, 234 HC women (24.3%), 478 LC women (49.7%), and 250 (30%) single women (SW). SW were significantly older than HC and LC. Clinical pregnancy rate (CPR) per cycle was significantly lower in LC and SW than in HC in univariate analysis. Age was negatively associated with clinical pregnancy. After adjusting for age, no statistically significant relationship was found between category and clinical pregnancy (p = 0.07). Cumulative clinical pregnancy rates (CCPR) and the average number of cycles required to achieve pregnancy were not significantly different between HC, LC and SW. CONCLUSIONS: This first study conducted in France after change in law allowing ART access for LC and SW confirms that CPR after IUI-D is not significantly associated with relationship status after adjusting for age.