Received April 03, 2025
Accepted February 20, 2026

Introduction: An increased risk of preeclampsia has been described when performing donor intrauterine insemination. One of the possible causes is immunological tolerance to semen. Both lesbian and single women, who have theoretically lower exposure to seminal fluid than heterosexual women requesting artificial insemination with donor, sperm should have a higher incidence of preeclampsia, although this fact has not been analyzed previously. Methods: The population under study consisted of 439 gestations <24 weeks, achieved with artificial insemination with donor sperm, performed in two different populations: heterosexual couples and SLTG (single women, lesbian women, women with transgender partner). Preeclampsia rates and other perinatal outcomes were compared. Results: No significant differences were found in the development of preeclampsia in the SLTG group 6.03% (12/199) vs. heterosexual patients 5.83% (14/240), p=0.93. In the SLTG group, compared with heterosexual group, age (36 vs. 35, p=0.002) and BMI (24.8 vs. 23.6, p=0.002) were somewhat higher. After adjusting for BMI, age and multiplicity of gestation, there were no significant differences in the risk of preeclampsia between SLTG group and heterosexual women. As expected, in women with preeclampsia, gestational ages and newborn weights (quantitative markers of preeclampsia severity) were significantly lower than in women without preeclampsia. Conclusion: Our study suggests that neither sexual orientation nor previous sperm exposure carries a higher risk of preeclampsia, especially after correction for age and weight. Artificial insemination with donor sperm performed on single women, lesbians or women with transgender partners is a safe, simple and efficient technique, just as in heterosexual couples.