Abstract:Objective To analyze the factors related to the pregnancy outcome of artificial insemination with donor semen (AID) and the strategies to improve the success rate of AID. Methods A retrospective analysis was made on the clinical data of female patients with 5 348 cycles infertility of AID-assisted pregnancy cyclein the Reproductive Medical Center of Second Nanning People′s Hospital from January 2013 to December 2016.The influencing factors of the pregnancy outcome of AID, including women age, duration of infertility, types of infertility and cycle, timing of insemination, whether to combine with endometriosis and the interval days between double insemination in the same cycle were analyzed.Taking α=0.05 as the test level, when using partition of chi-square statistics from R×C contingency tables, the correction was α=0.017. Results With the increase of age (four age groups:20-30, 31-35, 36-40 and >40 years old ) , the clinical pregnancy rate (30.0%, 23.0%, 16.8%, 7.1%) and the cycle live birth rate (26.9%, 18.9%, 12.3%, 3.1%) decreased in turn, and the abortion rate increased in turn (9.0%, 16.1%, 25.8%, 50.0%).There were significant differences among the four age groups (P<0.01).In double intrauterine insemination, single post-ovulation insemination, single pre-ovulation insemination and fertilization after follicular puncture, the clinical pregnancy rates were 26.8%, 22.3%, 5.9%, 0 respectively, and the live-birth rates per cycle were 23.0%, 18.7%, 4.4%, 0 respectively.There were significant differences in them among the four time point for artificial insemination (P<0.01＝.The clinical pregnancy rate of patients with interval of 1-2 days between two insemination was higher than that of 3-4 days interval (P<0.017) , but there was no statistical difference in it between intervals of 1 day and 2 days. (P>0.017). The patients with endometriosis had lower clinical pregnancy rate and live-birth rate per cycle compared with non-endometriosis patients (P=0.004). Conclusion Age is the most important factor affecting the pregnancy outcome of AID.Young patients can take a few attempts of AID, but the elder should shorten the time from the visit to the pregnancy.Vitro fertilization-embryo transfer (IVF-ET) is advisable to elderly patients, performed as soon as possible.The second factor is the timing of fertilization.The clinical pregnancy rate of double intrauterine insemination can achieve satisfactory results.Artificial insemination should be carried out one or two days before ovulation and 24 hours after ovulation.If artificial insemination is not arranged in time before ovulation, it can obtain the relatively satisfactory clinical pregnancy rate to perform single intrauterine insemination after ovulation.The success rate of patients with endometriosis is significantly lower, AID cycle numbers could be reduced before IVF-ET with donor sperm.The success rate of patients with endometriosis is significantly lower, and the number of AID cycles can be reduced before IVF-ET for these patients.