{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:48:18Z","timestamp":1787755698847,"version":"build-2784847793"},"reference-count":24,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,1,26]],"date-time":"2023-01-26T00:00:00Z","timestamp":1674691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82001634"],"award-info":[{"award-number":["82001634"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Purpose: To evaluate the effectiveness of donor in vitro fertilization (IVF-D) and donor artificial insemination (AI-D) in clinical outcomes, risks, and costs. Methods: This study analyzed the cycle changes and clinical outcomes in 20,910 IVF-D and 16,850 AI-D cycles between 2013 and 2021 in the Reproductive and Genetic Hospital of CITIC-Xiangya. A cost-effectiveness analysis was performed to evaluate the costs per couple and per live birth cycle in the two treatment groups. Results: IVF-D had higher pregnancy and live birth rates than AI-D (p &lt; 0.001). The cumulative pregnancy and live birth rates for three AI-D cycles were 41.01% and 32.42%, respectively, higher than the rates for one or two AI-D cycles. The multiple birth and birth defect rate of AI-D was lower than that of IVF-D significantly. IVF-D mean cost per couple was higher than that of AI-D (CNY32,575 vs. CNY11,062, p &lt; 0.001), with a mean cost difference of CNY21,513 (95% confidence interval, CNY20,517\u201322,508). The mean costs per live birth cycle for IVF-D and AI-D were CNY49,411 and CNY31,246, respectively. Conclusion: AI-D is more cost-effective and poses a lower risk for infertility couples than IVF-D, and patients should undergo three AI-D cycles to obtain the highest success rate.<\/jats:p>","DOI":"10.3390\/jcm12030954","type":"journal-article","created":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T02:30:38Z","timestamp":1674786638000},"page":"954","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Comparison of Clinical Outcomes, Risks, and Costs for 20,910 Donor In Vitro Fertilization and 16,850 Donor Artificial Insemination Treatment Cycles: A Retrospective Analysis in China"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9632-7224","authenticated-orcid":false,"given":"Xue-Feng","family":"Luo","sequence":"first","affiliation":[{"name":"Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410006, China"},{"name":"Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha 410000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui-Lan","family":"Wu","sequence":"additional","affiliation":[{"name":"Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410006, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi-Ren","family":"Ji","sequence":"additional","affiliation":[{"name":"Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410006, China"},{"name":"Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha 410000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Lin","family":"Tang","sequence":"additional","affiliation":[{"name":"Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha 410000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Jun","family":"Zhou","sequence":"additional","affiliation":[{"name":"Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha 410000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeng-Hui","family":"Huang","sequence":"additional","affiliation":[{"name":"Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha 410000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Liu","sequence":"additional","affiliation":[{"name":"Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha 410000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Qing","family":"Fan","sequence":"additional","affiliation":[{"name":"Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410006, China"},{"name":"Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha 410000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuan","family":"Huang","sequence":"additional","affiliation":[{"name":"Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410006, China"},{"name":"Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha 410000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Bing","family":"Zhu","sequence":"additional","affiliation":[{"name":"Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410006, China"},{"name":"Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha 410000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2497","DOI":"10.1016\/S0140-6736(20)32708-2","article-title":"A Lancet Commission on 70 years of women\u2019s reproductive, maternal, newborn, child, and adolescent health in China","volume":"397","author":"Qiao","year":"2021","journal-title":"Lancet"},{"key":"ref_2","first-page":"984","article-title":"CSRM consensus on diagnosis and treatment of unexplained infertility","volume":"28","author":"Yang","year":"2019","journal-title":"J. Reprod. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2019","DOI":"10.1136\/bmjopen-2019-034566","article-title":"Observational retrospective study of UK national success, risks and costs for 319,105 IVF\/ICSI and 30,669 IUI treatment cycles","volume":"10","author":"Bahadur","year":"2020","journal-title":"BMJ Open"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1016\/j.fertnstert.2017.03.028","article-title":"Intrauterine insemination with gonadotropin stimulation or in vitro fertilization for the treatment of unexplained subfertility: A randomized controlled trial","volume":"107","author":"Nandi","year":"2017","journal-title":"Fertil Steril."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1016\/j.rbmo.2013.10.021","article-title":"IVF with planned single-embryo transfer versus IUI with ovarian stimulation in couples with unexplained subfertility: An economic analysis","volume":"28","author":"Custers","year":"2014","journal-title":"Reprod Biomed. Online"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2331","DOI":"10.1093\/humrep\/dev193","article-title":"Is IVF-served two different ways-more cost-effective than IUI with controlled ovarian hyperstimulation?","volume":"30","author":"Bensdorp","year":"2015","journal-title":"Hum. Reprod."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Cissen, M., Bensdorp, A., Cohlen, B.J., Repping, S., de Bruin, J.P., and van Wely, M. (2016). Assisted reproductive technologies for male subfertility. Cochrane Database Syst Rev., 26.","DOI":"10.1002\/14651858.CD000360.pub5"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1016\/j.fertnstert.2019.06.008","article-title":"Long-term cryostorage of semen in a human sperm bank does not affect clinical outcomes","volume":"112","author":"Huang","year":"2019","journal-title":"Fertil Steril."},{"key":"ref_9","unstructured":"(Bulletin of the Ministry of Health of the People\u2019s Republic of China, 2003). Notice of the Ministry of Health on the revision of technical specifications, basic standards and ethical principles related to human assisted reproductive technology and human sperm banks, Bulletin of the Ministry of Health of the People\u2019s Republic of China."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/j.rbmo.2018.08.002","article-title":"Assisted reproductive technology in Beijing, 2013-2015","volume":"37","author":"Zhou","year":"2018","journal-title":"Reprod Biomed Online."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.ejogrb.2018.05.032","article-title":"Conversion to IUI versus continuance with IVF in low responder patients: A systematic review","volume":"227","author":"Fujii","year":"2018","journal-title":"Eur J Obstet Gynecol Reprod Biol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.fertnstert.2010.05.030","article-title":"Poor response cycles: When should we cancel? Comparison of outcome between egg collection, intrauterine insemination conversion, and follow-up cycles after abandonment","volume":"95","author":"Nicopoullos","year":"2011","journal-title":"Fertil Steril."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2073","DOI":"10.1016\/j.fertnstert.2009.12.056","article-title":"Conversion from assisted reproductive technology to intrauterine insemination in low responders: Is it advantageous?","volume":"94","author":"Norian","year":"2010","journal-title":"Fertil Steril."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1001\/jama.2021.4788","article-title":"Diagnosis and Management of Infertility: A Review","volume":"326","author":"Carson","year":"2021","journal-title":"JAMA"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1002\/uog.18932","article-title":"Congenital heart defects in IVF\/ICSI pregnancy: Systematic review and meta-analysis","volume":"51","author":"Giorgione","year":"2018","journal-title":"Ultrasound Obs. Gynecol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"g7771","DOI":"10.1136\/bmj.g7771","article-title":"Prevention of multiple pregnancies in couples with unexplained or mild male subfertility: Randomised controlled trial of in vitro fertilisation with single embryo transfer or in vitro fertilisation in modified natural cycle compared with intrauterine insemination with controlled ovarian hyperstimulation","volume":"350","author":"Bensdorp","year":"2015","journal-title":"BMJ"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.rbmo.2020.03.004","article-title":"Impact of endometrial polyps detected during the follicular phase of intrauterine insemination treatments","volume":"41","author":"Schutyser","year":"2020","journal-title":"Reprod Biomed Online"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1016\/j.fertnstert.2011.08.005","article-title":"Couples with unexplained subfertility and unfavorable prognosis: A randomized pilot trial comparing the effectiveness of in vitro fertilization with elective single embryo transfer versus intrauterine insemination with controlled ovarian stimulation","volume":"96","author":"Custers","year":"2011","journal-title":"Fertil Steril."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.rbmo.2021.12.015","article-title":"IUI is a better alternative than IVF as the first-line treatment of unexplained infertility","volume":"45","author":"Homburg","year":"2022","journal-title":"Reprod Biomed Online."},{"key":"ref_20","first-page":"23","article-title":"cost-effectiveness of IVF versus intrauterine insemination","volume":"28","author":"Li","year":"2019","journal-title":"J. Reprod. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1016\/S1472-6483(10)61035-8","article-title":"Prevention of multiple pregnancy following IVF in Spain","volume":"13","author":"Tur","year":"2006","journal-title":"Reprod Biomed Online"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1007\/s10815-021-02112-5","article-title":"Reduction in multiple pregnancy rate in donor oocyte-recipient gestational carrier (GC) in vitro fertilization (IVF) cycles in the USA with single-embryo transfer and preimplantation genetic testing","volume":"38","author":"Makhijani","year":"2021","journal-title":"J. Assist. Reprod Genet."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1016\/j.ajem.2019.05.018","article-title":"Ovarian hyperstimulation syndrome: A review for emergency clinicians","volume":"37","author":"Timmons","year":"2019","journal-title":"Am. J. Emerg. Med."},{"key":"ref_24","first-page":"162","article-title":"IUI needs fairer appraisal to improve patient and stakeholder choices","volume":"25","author":"Bahadur","year":"2021","journal-title":"JBRA Assist. Reprod."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/3\/954\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:16:13Z","timestamp":1760120173000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/3\/954"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,26]]},"references-count":24,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["jcm12030954"],"URL":"https:\/\/doi.org\/10.3390\/jcm12030954","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,26]]}}}