Pregnancy outcome, health of children, and family adjustment after donor insemination.

Abstract

We evaluated the pregnancies of 427 women who conceived through artificial insemination by donor (AID) at our clinic over a 12-year period. Initial phone contact was followed by a questionnaire. Outcome was known for 594 of the 606 pregnancies, with a total of 502 live-born children including 15 sets of twins. The spontaneous abortion rate was 16.5%, with no difference between fresh- and frozen-semen pregnancies. Significant correlations were found between spontaneous abortion rate and maternal age (P less than .001) and spontaneous abortion rate and cycle of conception (P less than .025). Follow-up was completed on 481 children, among whom the following were found: one chromosomal anomaly, 22 major congenital anomalies, four children with possibly syndromic conditions, and 38 with minor congenital anomalies. Of the school-aged children, 5.8% had recognized learning disabilities and 10.5% were considered gifted by their schools. We also investigated the psychological impact of AID on each family. The majority of couples (71.7%) informed their obstetricians of the AID. Half of the couples did not tell any family or friends. Many couples did not (47%) or probably did not (14%) plan to tell their children of their origins. The divorce rate among those with AID children was 7.2%, which was significantly less (P less than .01) than that in a matched population. Psychological counseling specifically related to AID was sought by 2.8% of the couples. We conclude that AID children are at similar risk for congenital anomalies as normally conceived children, but they experience lower rates of family dissolution.