title: Perinatal outcomes in 6,338 singletons born after intrauterine insemination in Denmark, 2007 to 2012: the influence of ovarian stimulation.
abstract: OBJECTIVE
  To study perinatal outcomes in singletons born after intrauterine insemination (IUI) compared with children born after in vitro fertilization (IVF), intracytoplasmic sperm injection, and spontaneous conception (SC), and to assess predictors of poor outcome in singletons born after IUI, exploring the effect of ovarian stimulation.
  
  
  METHODS
  National cohort study, 2007-2012.
  
  
  METHODS
  Danish national registries.
  
  
  METHODS
  Four thousand two hundred twenty-eight singletons born after insemination with partner semen (IUI-H) and 1,881 singletons born after insemination with donor semen.
  
  
  METHODS
  None.
  
  
  METHODS
  Preterm birth (PTB), low birth weight (LBW), small for gestational age (SGA).
  
  
  RESULTS
  Children born after IUI-H had higher risks of PTB, LBW, and SGA vs. SC singletons (adjusted odds ratios [aOR] 1.3; 95% confidence interval (CI), 1.1-1.5; 1.4; 95% CI, 1.2-1.7; and 1.4; 95% CI, 1.2-1.6), respectively. Compared with IVF, risk of SGA was similar, but risks of PTB and LBW were lower (aOR 0.6; 95% CI, 0.5-0.8; and 0.8; 95% CI, 0.6-0.9). Compared with intracytoplasmic sperm injection, no differences were found. For children born after IUI with donor semen, results were similar to those for IUI-H. Risks of LBW and SGA were higher in IUI singletons born after ovarian stimulation with clomiphene citrate, compared with natural-cycle IUI (aOR 1.5; 95% CI, 1.1-2.1 and 1.6; 95% CI, 1.1-2.4). Treatment with follicle-stimulating hormone vs. natural-cycle IUI did not seem to affect perinatal outcomes.
  
  
  CONCLUSIONS
  Singletons born after IUI had higher risk of adverse perinatal outcomes compared with SC children, similar to ICSI, but favorable outcomes compared with IVF. Stimulation with clomiphene citrate was associated with higher risk of SGA compared with natural-cycle IUI, but follicle-stimulating hormone treatment did not seem to be associated with adverse outcomes.
authors: Fertility Clinic, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Obstetrics and Gynecology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark. Electronic address: smalchau@hotmail.com.
authors: Sara Sofia
authors: SS
authors: Malchau
authors: Fertility Clinic, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors: Anne
authors: A
authors: Loft
authors: Fertility Clinic, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors: Anna-Karina Aaris
authors: AK
authors: Henningsen
authors: Fertility Clinic, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors: Anders
authors: A
authors: Nyboe Andersen
authors: Department of Obstetrics and Gynecology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark.
authors: Anja
authors: A
authors: Pinborg
mesh_terms: D001724:Birth Weight; D016009:Chi-Square Distribution; D002996:Clomiphene / Q000009:adverse effects; D003718:Denmark; D005300:Fertility Agents, Female / Q000009:adverse effects; D005307:Fertilization in Vitro / Q000009:adverse effects; D005317:Fetal Growth Retardation / Q000209:etiology; D005865:Gestational Age; D006801:Humans; D007230:Infant, Low Birth Weight; D007315:Insemination, Artificial / Q000009:adverse effects; D050498:Live Birth; D016015:Logistic Models; D015999:Multivariate Analysis; D016017:Odds Ratio; D010062:Ovulation Induction / Q000009:adverse effects; D047928:Premature Birth / Q000209:etiology; D012042:Registries; D012307:Risk Factors; D020554:Sperm Injections, Intracytoplasmic / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005300:Fertility Agents, Female; D002996:Clomiphene
keywords: Intrauterine insemination; clomiphene citrate; ovarian stimulation; perinatal outcome; preterm birth; small for gestational age