Efficacy of sperm motility after processing and incubation to predict pregnancy after intrauterine insemination in normospermic individuals (original) (raw)
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Decoding the effect of time interval between hCG and IUI and sperm preparation and IUI
International journal of reproduction, contraception, obstetrics and gynecology, 2018
Intrauterine Insemination (IUI) along with controlled ovarian stimulation has been a widely used method in management of women with infertility. IUI remains a relatively inexpensive, less invasive and easy to perform procedure, which if timed well can give favorable results. It is used in male factor infertility, minimal to mild endometriosis, PCOS, cervical factor or unexplained infertility. IUI has various determinants of success. Of these, sperm morphology, method of sperm preparation, cause of infertility, ovulation induction regime used, agent for ovulation trigger, etc. are important. Along with these, time interval between ovulation induction and IUI and time interval between sperm preparation and IUI are of definite clinical relevance.
2014
Objective The aim of this article was to determine digital levels of the association of factors of pregnancy success after the first cycle of intrauterine insemination (IUI) with 300 infertile couples. Methods The IUI procedure was followed at 36 h after triggering the ovulation, if at least one follicle measured [15 mm. Endometrium thickness (ET) and serum luteinizing hormone (LH) levels were measured at day 10 for each patient. The post-wash total motile fraction (TMF) of semen of the partner of each patient was also evaluated. The principal component analysis (PCA) was done with the data to quantify the associations of related factors. Results The clinical pregnancy rate of first cycle IUI attempts was 17.3 %, observed in females, aged 20-39 years and men with TMF [5 million spermatozoa. The ovarian stimulation enabled the development of follicles measuring [16 mm, with LH levels \10 mIU/L and ET [5 mm for success. The PCA revealed that with the female-age parameter, three factors, NF, ET, and LH were related in the component 1; similarly, NF, LH, and RFS were related in component 2; age, NF, ET, LH, LFS, and TMF were related in component 3; and NF, ET, LH, RFS, and LFS in component 4 were related, i.e., the best correlation. Conclusions Associated principal determinative factors, LH, female-age, NF and LFS values were highly significant, but the factors, ET, RFS and TMF were statistically insignificant for success through IUI in pregnancy. Keywords Intrauterine insemination Á Endometrium thickness Á Luteinizing hormone Á Number of follicles Á Fallopian tube Á Total motile fraction of semen
Human Reproduction, 1997
Another substantial advantage of these techniques is the removal of non-motile spermatozoa, leukocytes and immature 4 To whom correspondence should be addressed germ cells. This might contribute to enhanced sperm quality This retrospective study aimed to evaluate the prognostic by decreased release of lymphokines and/or cytokines and a value of the inseminating motile count (IMC) and sperm reduction in the formation of free oxygen radicals after sperm morphology (using strict criteria) on success rates after preparation. This results in better sperm fertilizing ability homologous intrauterine insemination (IUI) combined with in vitro and in vivo (Aitken and Clarkson, 1987). Finally, this clomiphene citrate (CC) stimulation. A total of 373 couples may lead to higher success rates after IUI in male subfertility underwent 792 IUI cycles in a predominantly (87.4%) male cases, as described previously by and subfertility group. The overall cycle fecundity (CF) and Ombelet et al. (1995b). baby take-home rate (BTH) was 14.6 and 9.9% respectively.
Sperm motility is a major determinant of pregnancy outcome following intrauterine insemination
Journal of assisted reproduction and genetics, 1998
Our purpose was to assess whether one or more sperm parameters have predictive value for the outcome of intrauterine insemination treatment. Infertile couples whose normoovulatory and normomechanical female partners underwent superovulation and intrauterine insemination were investigated. The semen profile of the male partner was discounted. In 160 couples, 544 cycles were obtained, resulting in 59 ongoing pregnancies (10.84%/cycle, 36.87%/patient). The only parameter found to be significantly correlated with a positive outcome was the degree of sperm motility following preparation for intrauterine insemination. Close to half (47.5%) of the couples with a very good or an excellent degree of sperm motility conceived, whereas only 8.3% of those patients who had poor or fair sperm motility conceived. None of the semen characteristics, such as volume, count, percentage motility, or percentage normal morphology, were found to correlate with cycle outcome. Although there was a progressive...
The sperm parameters and prediction of IUI success
Annals of Medical Research, 2020
We aimed to compare the different sperm motility parameters in pregnant and non-pregnant patients who underwent IUI in our tertiary center. Material and Methods: Total of 110 gonadotrophin plus IUI patients were evaluated between 2017 January and January 2020 in this retrospective study. Some demographic features and infertility time, post-wash sperm parameters and basal hormone levels were compared between pregnant and non-pregnant patients and the regression analysis method was used to evaluate IUI success between other parameters. Results: Endometrial thickness (9.1±1.4 vs.7.6±1.4) on hCG triggering day and , post-wash progressive sperm motility value together with the a ratio and infertility time were correlated well with IUI success (ie pregnacy result) between 38 pregnant and 72 non pregnant patients. Conclusion: After wash progressive sperm ratio may predict IUI success with infertility time and endometrial thickness.
Human Reproduction, 1996
We report on 332 infertile couples who underwent 1115 cycles of intrauterine insemination (IUI) with washed husband's semen. The indication for IUI was an abnormal post-coital test due to either a male or cervical infertility factor. The mean number of IUI cycles per patient was 3.4, the overall pregnancy rate 18.7%, and the pregnancy rate per cycle 5.6%. The cumulative pregnancy rate calculated by life table analysis showed that 16.0% of pregnancies occurred in the first three treatment cycles, while the cumulative pregnancy rate was 26.9% by the sixth cycle. The outcome of the therapy was adversely affected if the woman's age was >39 years and/or total motile sperm count per insemination was <1X1O*. No pregnancy occurred in women older than 44 years or in cases with a total motile sperm count before semen preparation of <1X1O*.
Scholars Journal of Applied Medical Sciences, 2020
Original Research Article Introduction: Intrauterine insemination (IUI) could be the first-line option in the treatment of infertile couples with different aetiologies before moving to the more sophisticated, expensive and time-consuming techniques. Therefore, this study was conducted to evaluate prognostic factors for IUI success. Material and method: a prospective study conducted between August/2015 and January/ 2019, 188 IUI cycles were done during the study period for infertile couples attending Albayda Fertility Centre/Libya. The baseline clinical and biological characteristics were compared between the pregnant and non-pregnant groups. The pre-and post-preparation semen parameters for the husbands of both groups were also compared. Regression analyses were performed to identify the most explanatory factor for the occurrence of the clinical pregnancy after Controlled ovarian hyperstimulation (COH) and IUI. Results: the clinical pregnancy rate was 17% per cycle and 19.6% per couple. The clinical pregnancy rate was significantly and positively associated with the endometrial thickness (OR=1.4, p=0.023), and shows a significant inverse correlation with wives'age (OR=0.90, p=0.016). Conclusion: this study confirms the efficacy of IUI as an effective modality of infertility treatment. Wifes , age and endometrial thickness were the strongest predictors for IUI success.
Human Reproduction, 2020
STUDY QUESTIONAre intrauterine insemination (IUI) performance characteristics and post-processing total motile sperm count (TMC) related to live birth rate in couples with unexplained infertility?SUMMARY ANSWERPatient discomfort with IUI and lower inseminate TMC were associated with a reduced live birth rate, while time from hCG injection to IUI, sperm preparation method and ultrasound guidance for IUI were not associated with live birth success.WHAT IS ALREADY KNOWNWe previously determined that some baseline characteristics of couples with unexplained infertility, including female age, duration of infertility, history of prior loss and income, were related to live birth rate across a course of ovarian stimulation and IUI treatment. However, the relationship between treatment outcomes and per-cycle characteristics, including ultrasound guidance for IUI, timing of IUI relative to hCG injection, difficult or painful IUI and inseminate TMC, are controversial, and most prior investigations have not evaluated live birth outcome.STUDY DESIGN, SIZE, DURATIONThis was a secondary analyses of 2462 cycles from the Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation (AMIGOS) clinical trial. This prospective, randomised, multicentre clinical trial determined live birth rates following IUI after ovarian stimulation with clomiphene citrate, letrozole or gonadotropins in 854 couples with unexplained infertility. It was conducted between 2011 and 2014, and couples could undergo up to four consecutive treatment cycles.PARTICIPANTS/MATERIALS, SETTING, METHODSAMIGOS was an NIH-sponsored Reproductive Medicine Network trial conducted at 12 clinical sites. Participants were women with unexplained infertility who were between 18 and 40 years of age. Cluster-weighted generalised estimating equations (GEE), which account for informative clustering of multiple IUI treatment cycles within the same patient, were used to determine associations between IUI performance characteristics, including inseminate TMC, and live birth rate. Efficiency curves were also generated to examine the relationship between inseminate TMC and live birth rate.MAIN RESULTS AND THE ROLE OF CHANCEAfter adjustment for treatment group and baseline factors previously associated with live birth across a course of OS-IUI treatment, patient discomfort during the IUI procedure was associated with a reduction in live birth rate (aRR 0.40 (0.16–0.96)). Time from hCG trigger injection to IUI was not significantly associated with outcome. Higher TMC was associated with greater live birth rate (TMC 15.1–20.0 million (14.8%) compared to ≤5 million (5.5%)) (aRR 2.09 (1.31–3.33)). However, live births did occur with TMC ≤ 1 million (5.1%).LIMITATIONS, REASONS FOR CAUTIONThis investigation is a secondary analysis, and AMIGOS was not designed to address the present question. Since timed intercourse was allowed as part of the AMIGOS trial, we cannot rule out the possibility that any given pregnancy resulted from intercourse rather than IUI.WIDER IMPLICATIONS OF THE FINDINGSMost factors associated with the performance of IUI were not significantly related to obtaining live birth. Our findings suggest that higher TMC inseminated leads to an increase in live birth rate up to TMC ~20 million. However, there may be no reasonable threshold below which live birth is not possible with IUI.STUDY FUNDING/COMPETING INTEREST(S)Funding was received through grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): U10 HD077680, U10 HD39005, U10 HD38992, U10 HD27049, U10 HD38998, U10 HD055942, HD055944, U10 HD055936 and U10 HD055925. This research was made possible by funding by the American Recovery and Reinvestment Act. Dr Hansen reports grants from NIH/NICHD and Yale University during the conduct of the study, grants from Roche Diagnostics and grants from Ferring International Pharmascience Center US outside the submitted work. Dr Peck reports support from Ferring Pharmaceuticals outside the submitted work. Dr Coward has nothing to disclose. Dr Wild reports grants from NICHD during the conduct of the study. Dr Trussell has nothing to disclose. Dr Krawetz reports grants from NICHD during the conduct of the study, grants from Merck and support from Taylor and Frances and from Springer, outside the submitted work. Dr Diamond reports grants from NIH/NICHD, Yale University, during the conduct of the study and support from Advanced Reproductive Care AbbVie, Bayer and ObsEva, outside the submitted work. Dr Legro reports support from Bayer, Kindex, Odega, Millendo and AbbVie and grants and support from Ferring, outside the submitted work. Dr Coutifaris reports grants from NICHD/NIH and personal fees from American Society for Reproductive Medicine, outside the submitted work. Dr Alvero has nothing to disclose. Dr Robinson reports grants from NIH during the conduct of the study. Dr Casson has nothing to disclose. Dr Christman reports grants from NICHD during the conduct of the study. Dr Santoro reports grants from NIH during the conduct of the study. Dr Zhang reports grants from NIH during the conduct of the study and support from Shangdong University outside the submitted work.TRIAL REGISTRATION NUMBERn/a
Background:Different techniques are used for separation of motile and morphologically normal spermatozoa to be used for artificial insemination (AI) and other assisted reproductive techniques.Sperm preparation is important because some component of seminal fluid may become obstacle to fertilization when IUI or IVF are performed. However the choice of sperm selection technique depend on the quality of the semen in order to obtain the higher number of normal spermatozoa. Objective: To assess the pregnancy rate for infertile couples undergoing IUI using Maxpure technique versus density gradient technique to prepare sperm from males with male infertility. Subjects, Materials and Methods: One hundred twenty seven (127) infertile couples participated in this study during their attendance to the infertility clinics at the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University. The period of study was from September 2015 to June 2016. The mean age for all males included in this study was 35.33±0.731 and the mean age for all females included in the study was 30.67±0.711 years. The mean duration of infertility was 6.18±0.403 ranged from 1- 21 years. Semen analysis was done on the collected semen samples according to WHO (2010). From each semen sample two mL was taken. One mL was prepared using density gradient centrifugation technique, and the other one mL prepared using sperm Maxpure technique. Then sperm parameters were assessed for these two techniques, and the part with the best result had been used for intrauterine insemination and finally the pregnancy results were statistically analyzed. Results: The reduction in sperm concentration was significantly (P<0.001) far more using Density gradients technique, mean progressive motile sperm (%) was significantly (P<0.001) more raised using sperm Max pure technique. However non-significant change (P=0.430)was observed regarding mean non progressive motile sperm (%). Mean immotile sperm (%) was far less using sperm Max pure technique (P<0.001).In contrast mean normal sperm morphology (%) was significantly higher using sperm Max pure technique (P<0.001). Finally, the round cell count/HPF was significantly (P<0.001) less using sperm Max pure technique.
Impact of Semen Characteristics on the Success of Intrauterine Insemination
Journal of Assisted Reproduction and Genetics, 2004
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.