Intrauterine insemination: evaluation of the results according to the woman's age, sperm quality, total sperm count per insemination and life table analysis

Campana, A.; Sakkas, Denny; Stalberg, A.; Bianchi, Patrizia; Comte, Isabelle; Pache, Thierry D.; Walker, Dilys

doi:10.1093/oxfordjournals.humrep.a019244

Cited by 143 publications

(112 citation statements)

References 19 publications

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“…But, when NSMI exceeded 10 million, our results showed a slight non-significant decrease in pregnancy rate, which could be related to excessive production of free radicals by the spermatozoa. Most authors recommend IVF when the number of motile sperm is <1 × 10 6 [11, 12, 16 and 17]Some authors suggested using the total number of motile spermatozoa of the initial sperm count (before semen treatment) as the criterion for choosing between IUI and IVF, and have recommended threshold values ranging from 5 to 10 × 10 6 [18,19]. In other studies, total sperm motility before semen treatment was mentionedwith a cut-off level between 30 and 50% [20, 21, 22 and 23].The usefulness of this criterion, however, is limited by the variability of quality from one ejaculation to another, as well as the variable results of sperm preparations.Our study shows no significant difference in sperm motility before sperm treatment, between patients who achieved pregnancy and those who failed Sperm morphology using strict criteria is well known as one of the best predictors of IVF outcome [24, 25 and 26].…”

Section: Discussionmentioning

confidence: 99%

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

Kdous¹

2015

JGO

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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.

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Section: Discussionmentioning

confidence: 99%

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

Kdous¹

2015

JGO

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“…Others have reported that the cumulative pregnancy rate plateaus by the ninth IUI cycle (16). As in most forms of infertility treatment, the success of IUI is largely influenced by the etiology of the infertility and the sperm quality.…”

Section: Discussionmentioning

confidence: 99%

Impact of Semen Characteristics on the Success of Intrauterine Insemination

Zhao

Vlahos

Wyncott

et al. 2004

J Assist Reprod Genet

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Purpose : To evaluate the influence of sperm characteristics on the outcome of infertility treatment using intrauterine insemination (IUI). Methods : Retrospective study of 431 infertility couples who underwent 1007 IUI treatment cycles from June 1999 to October 2002. Sperm parameters before and after preparation for IUI were evaluated and correlated with pregnancy outcome. Results : Clinical pregnancy occurred in 12% of cycles and 28% of patients. Initial sperm motility and processed forward progression were independently associated with pregnancy after IUI. The mean number of cycles per patient was 4.3. Although pregnancy rate per cycle did not differ from cycle to cycle, the cumulative pregnancy rate approached plateau after five cycles. Conclusions : Sperm motility is an independent factor influencing IUI-related pregnancy. A forward progression score of 3 to 4 in a processed specimen is necessary for IUI success. The number of IUI attempts per patient should be individualized depending upon the needs of patients.

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“…The per cycle pregnancy rate is influenced by various factors and is typically in the range of 5-20%. Cumulative pregnancy rate after 3-4 treatments is in the range of 25-40% [1,[3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

The role of hyaluronic acid binding assay in choosing the fertilization method for patients undergoing IVF for unexplained infertility

Kovács

Kováts

Sajgo

et al. 2010

J Assist Reprod Genet

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Purpose Patients with unexplained infertility may have fertilization problems. Split fertilization (ICSI and conventional IVF on sibling oocytes) is often used to avoid poor fertilization. Our aim was to assess the ability of hyaluronic acid binding (HA-binding) assay to predict spontaneous fertilization during IVF. Methods Prospective, blinded, controlled trial. Patients undergoing their first IVF cycle for unexplained infertility were eligible. Split fertilization was used. IVF and ICSI fertilization rates and embryo development based on 3 HAbinding cut-offs (< 60%; 60-80%; >80%) were compared. Results ICSI fertilization was higher than IVF, but none of the HA-binding cut-off levels predicted those cases where IVF was less effective, therefore ICSI only would have lead to improved outcome. Embryo development and morphology were similar in all cut-off groups. Conclusions HA-binding did not predict spontaneous fertilization in patients with unexplained infertility undergoing IVF treatment. When it was used for "screening" it did not help to select the method of fertilization.

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Intrauterine insemination: evaluation of the results according to the woman's age, sperm quality, total sperm count per insemination and life table analysis

Cited by 143 publications

References 19 publications

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

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

Impact of Semen Characteristics on the Success of Intrauterine Insemination

The role of hyaluronic acid binding assay in choosing the fertilization method for patients undergoing IVF for unexplained infertility

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