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Threshold Levels of Sperm Parameters Impacting on Pregnancy Rate in an Intrauterine Insemination Programme

Received: 10 August 2015     Accepted: 20 August 2015     Published: 5 September 2015
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Abstract

Objectives. Intrauterine insemination (IUI) is frequently used as a first line strategy in the treatment of male and unexplained infertility. Threshold levels of sperm parameters associated with IUI success are controversial. The aim of this study was to evaluate the influence of sperm parameters on the outcome of IUI. Study Design. A prospective observational study. Patients and methods. This study included 295 IUI cycles. All IUI cycles were preceded by ovarian superovulation with clomiphene citrate 50 mg tablets orally twice daily for 5 days starting on the second day of menses and recombinant FSH 150 units IM on the 6th, 8th, and 10th day. Cycles were monitored by transvaginal ultrasound. The IUI was performed with a catheter 36 ± 4 hours after hCG injection. Sperm parameters before and after semen treatment for IUI were evaluated and correlated with pregnancy outcome. Results. A total of 29 clinical pregnancies were obtained, for a pregnancy rate per cycle of 9.83%. No pregnancy was obtained when less than one million spermatozoa were inseminated (p = 0.022). A statically significant increase in pregnancy rate was observed when normal sperm morphology was > 20% before semen treatment (p = 0.01) and> 25% after semen treatment (p = 0.034). NTSI (number of typical spermatozoa inseminated) and NTMSI (number of typical and mobile spermatozoa inseminated) significantly influence the clinical pregnancy rate. A 65% decrease in pregnancy rate was observed when the NTSI <2 106 compared to the NTSI ≥ 2 106 (5.16% vs 15%, p =0.004). Similarly, a 54% decrease in pregnancy rate was observed when the NTMS <106” compared to the NTMS ≥ 106 (6.12% vs 13.5%, p =0.026). Conclusion. IUI used for treating male factor infertility seems to have little chance of success when NMSI <1 × 106, NTSI < 2 million, NTMSI < 1 million. If theses thresholds cannot be obtained, IVF should be recommended.

Published in Journal of Gynecology and Obstetrics (Volume 3, Issue 5)
DOI 10.11648/j.jgo.20150305.11
Page(s) 98-102
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

Intrauterine Insemination, Sperm Parameters, Morphology, Motility, Pregnancy Rate

References
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    Moez Kdous, Fethi zhioua, Amel Zhioua. (2015). Threshold Levels of Sperm Parameters Impacting on Pregnancy Rate in an Intrauterine Insemination Programme. Journal of Gynecology and Obstetrics, 3(5), 98-102. https://doi.org/10.11648/j.jgo.20150305.11

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    ACS Style

    Moez Kdous; Fethi zhioua; Amel Zhioua. Threshold Levels of Sperm Parameters Impacting on Pregnancy Rate in an Intrauterine Insemination Programme. J. Gynecol. Obstet. 2015, 3(5), 98-102. doi: 10.11648/j.jgo.20150305.11

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    AMA Style

    Moez Kdous, Fethi zhioua, Amel Zhioua. Threshold Levels of Sperm Parameters Impacting on Pregnancy Rate in an Intrauterine Insemination Programme. J Gynecol Obstet. 2015;3(5):98-102. doi: 10.11648/j.jgo.20150305.11

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  • @article{10.11648/j.jgo.20150305.11,
      author = {Moez Kdous and Fethi zhioua and Amel Zhioua},
      title = {Threshold Levels of Sperm Parameters Impacting on Pregnancy Rate in an Intrauterine Insemination Programme},
      journal = {Journal of Gynecology and Obstetrics},
      volume = {3},
      number = {5},
      pages = {98-102},
      doi = {10.11648/j.jgo.20150305.11},
      url = {https://doi.org/10.11648/j.jgo.20150305.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20150305.11},
      abstract = {Objectives. Intrauterine insemination (IUI) is frequently used as a first line strategy in the treatment of male and unexplained infertility. Threshold levels of sperm parameters associated with IUI success are controversial. The aim of this study was to evaluate the influence of sperm parameters on the outcome of IUI. Study Design. A prospective observational study. Patients and methods. This study included 295 IUI cycles. All IUI cycles were preceded by ovarian superovulation with clomiphene citrate 50 mg tablets orally twice daily for 5 days starting on the second day of menses and recombinant FSH 150 units IM on the 6th, 8th, and 10th day. Cycles were monitored by transvaginal ultrasound. The IUI was performed with a catheter 36 ± 4 hours after hCG injection. Sperm parameters before and after semen treatment for IUI were evaluated and correlated with pregnancy outcome. Results. A total of 29 clinical pregnancies were obtained, for a pregnancy rate per cycle of 9.83%. No pregnancy was obtained when less than one million spermatozoa were inseminated (p = 0.022). A statically significant increase in pregnancy rate was observed when normal sperm morphology was > 20% before semen treatment (p = 0.01) and> 25% after semen treatment (p = 0.034). NTSI (number of typical spermatozoa inseminated) and NTMSI (number of typical and mobile spermatozoa inseminated) significantly influence the clinical pregnancy rate. A 65% decrease in pregnancy rate was observed when the NTSI <2 106 compared to the NTSI ≥ 2 106 (5.16% vs 15%, p =0.004). Similarly, a 54% decrease in pregnancy rate was observed when the NTMS <106” compared to the NTMS ≥ 106 (6.12% vs 13.5%, p =0.026). Conclusion. IUI used for treating male factor infertility seems to have little chance of success when NMSI <1 × 106, NTSI < 2 million, NTMSI < 1 million. If theses thresholds cannot be obtained, IVF should be recommended.},
     year = {2015}
    }
    

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  • TY  - JOUR
    T1  - Threshold Levels of Sperm Parameters Impacting on Pregnancy Rate in an Intrauterine Insemination Programme
    AU  - Moez Kdous
    AU  - Fethi zhioua
    AU  - Amel Zhioua
    Y1  - 2015/09/05
    PY  - 2015
    N1  - https://doi.org/10.11648/j.jgo.20150305.11
    DO  - 10.11648/j.jgo.20150305.11
    T2  - Journal of Gynecology and Obstetrics
    JF  - Journal of Gynecology and Obstetrics
    JO  - Journal of Gynecology and Obstetrics
    SP  - 98
    EP  - 102
    PB  - Science Publishing Group
    SN  - 2376-7820
    UR  - https://doi.org/10.11648/j.jgo.20150305.11
    AB  - Objectives. Intrauterine insemination (IUI) is frequently used as a first line strategy in the treatment of male and unexplained infertility. Threshold levels of sperm parameters associated with IUI success are controversial. The aim of this study was to evaluate the influence of sperm parameters on the outcome of IUI. Study Design. A prospective observational study. Patients and methods. This study included 295 IUI cycles. All IUI cycles were preceded by ovarian superovulation with clomiphene citrate 50 mg tablets orally twice daily for 5 days starting on the second day of menses and recombinant FSH 150 units IM on the 6th, 8th, and 10th day. Cycles were monitored by transvaginal ultrasound. The IUI was performed with a catheter 36 ± 4 hours after hCG injection. Sperm parameters before and after semen treatment for IUI were evaluated and correlated with pregnancy outcome. Results. A total of 29 clinical pregnancies were obtained, for a pregnancy rate per cycle of 9.83%. No pregnancy was obtained when less than one million spermatozoa were inseminated (p = 0.022). A statically significant increase in pregnancy rate was observed when normal sperm morphology was > 20% before semen treatment (p = 0.01) and> 25% after semen treatment (p = 0.034). NTSI (number of typical spermatozoa inseminated) and NTMSI (number of typical and mobile spermatozoa inseminated) significantly influence the clinical pregnancy rate. A 65% decrease in pregnancy rate was observed when the NTSI <2 106 compared to the NTSI ≥ 2 106 (5.16% vs 15%, p =0.004). Similarly, a 54% decrease in pregnancy rate was observed when the NTMS <106” compared to the NTMS ≥ 106 (6.12% vs 13.5%, p =0.026). Conclusion. IUI used for treating male factor infertility seems to have little chance of success when NMSI <1 × 106, NTSI < 2 million, NTMSI < 1 million. If theses thresholds cannot be obtained, IVF should be recommended.
    VL  - 3
    IS  - 5
    ER  - 

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Author Information
  • Department of Gynecology and Obstetrics, Aziza Othmana Hospital, Medicine School of Tunis, University of Tunis El Manar, Tunis, Tunisia

  • Department of Gynecology and Obstetrics, Aziza Othmana Hospital, Medicine School of Tunis, University of Tunis El Manar, Tunis, Tunisia

  • Department of Reproductive Biology, Aziza Othmana Hospital, Medicine School of Tunis, University of Tunis El Manar, Tunis Tunisia

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