Changing sperm donors-a shortcut to pregnancy or just a myth?

PURPOSE: Changing sperm donors after unsuccessful intrauterine insemination (IUI) cycles is a common yet understudied practice. This study evaluates whether switching sperm donors impacts the number of IUI cycles required to achieve pregnancy.

METHODS

This retrospective cohort study analyzed 312 women undergoing donor sperm IUI at Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, from 1992 to 2020. Participants were divided into two groups: Group A (conceived using only one donor) and Group B (switched donors after initial unsuccessful attempts). The primary outcome was the number of IUI cycles until pregnancy. Statistical analyses included t-tests, ANOVA, and multivariate analysis of covariance (MANCOVA).

RESULTS

Women in Group A required fewer cycles (mean 3.78 ± 1.90) to achieve pregnancy compared to Group B (mean 6.07 ± 2.95, P < .001). However, after switching donors, the mean number of cycles needed in Group B (2.23 ± 1.61) was significantly lower than the total cycles required by Group A (P < .001). Cumulative live birth rates were higher in Group A (50.5% after three cycles; 81.5% after six cycles) compared to Group B (26.0% after three cycles; 61.9% after six cycles).

CONCLUSION

Switching sperm donors after repeated unsuccessful IUI attempts significantly reduces the additional number of cycles needed to achieve pregnancy. These findings suggest that sperm-oocyte compatibility may influence IUI success. Clinicians should consider donor replacement after multiple failures. Prospective studies are required to confirm these results and investigate underlying biological mechanisms.