Influence of the number of motile spermatozoa inseminated and of their morphology on the success of intrauterine insemination

Author: Wainer Robert  

Publisher: Oxford University Press

ISSN: 1460-2350

Source: Human Reproduction, Vol.19, Iss.9, 2004-09, pp. : 2060-2065

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Abstract

BACKGROUND: Although intrauterine insemination (IUI) is one of the most common assisted reproductive technology methods in the world, the relative influence of various semen characteristics on the likelihood of a successful outcome is controversial. The aim of our study was to assess the results of IUI as a function of both the number of motile spermatozoa inseminated (NMSI) and the percentage of morphologically normal spermatozoa after preparation. METHODS: This was a retrospective study of 889 couples who underwent 2564 IUI cycles of ovarian stimulation with HMG or recombinant FSH in our centre between January 1991 and December 2000. RESULTS: A total of 331 clinical pregnancies were obtained, for a pregnancy rate/cycle of 12.91%. When the NMSI was <>6, the pregnancy rate/cycle was significantly lower (3.13%) than in any of the subgroups with NMSI ≥2 × 106. Sperm morphology, assessed before or after preparation, was not in itself a significant factor that affected the likelihood of IUI success. Nonetheless, when the post-migration rate of normal sperm was <30%, the="" pregnancy="" rate/cycle="" was="" 5.43%="" when="" nmsi="" was=""><>6 and 18.42% when NMSI was ≥5 × 106 (P=0.008). Pregnancy rates did not differ significantly according to NMSI when the percentage of normal sperm after preparation was ≥30%, or according to percentage of normal sperm when the NMSI was ≥5 × 106. CONCLUSIONS: Our results show that a minimum of 5 × 106 motile spermatozoa should be inseminated when the normal morphology of the sperm after preparation is <30%; the="" quantity="" compensates="" at="" least="" in="" part="" for="" the="" defective="" quality.="" if="" this="" threshold="" of="" nmsi="" cannot="" be="" obtained,="" ivf="" should="" be="" recommended.="">

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