2183 THE USE OF SPERM PARAMETERS TO PREDICT CLINICAL PREGNANCY WITH INTRAUTERINE INSEMINATION

You have accessJournal of UrologyInfertility: Evaluation1 Apr 20112183 THE USE OF SPERM PARAMETERS TO PREDICT CLINICAL PREGNANCY WITH INTRAUTERINE INSEMINATION Michael Butcher, DO Pickens Gantt, MD Mike Broce, Dara Seybold, andMA Gary RandallPhD Michael ButcherMichael Butcher Charleston, WV , Pickens GanttPickens Gantt Charleston, WV , Mike BroceMike Broce Charleston, WV , Dara SeyboldDara Seybold Charleston, WV , and Gary RandallGary Randall Charleston, WV View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2421AboutPDF Cite Export CitationSelect Citation formatNLMAMAIEEEACMAPAChicagoMLAHarvardTips on citation downloadDownload citationCopy citation ToolsAdd to favoritesTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The purpose of the present study was to examine sperm morphology, motility and total number inseminated as predictors of clinical pregnancy (CP) in couples undergoing cycles of either single or double intrauterine insemination (IUI). METHODS Couples presenting to a private fertility clinic had infertility evaluations including a comprehensive semen analysis (using Kruger Strict criteria) on the male partner or donor sperm. Each couple had either a single IUI (SIUI) or double IUI (DIUI). Sperm morphology (Morph) and motility (Mot) were classified into low (L), medium (M) and high (H) categories: (L Morph ≤14%, M Morph 15–17%, and H Morph ≥18% and L Mot ≤49%, M Mot 50–68%, and H Mot ≥69%). The nine combinations (3 by 3) of these two groups were used in a logistic regression model to predict CP. RESULTS In this prospective registry, 1243 IUI cycles from 572 patients were collected and analyzed. Employing univariate analysis, it was found that the M Morph (OR:2.2; p=0.007), H Morph (OR:3.2; p<0.001)) and H Mot (OR:1.8; p=0.014) were found to be significant predictors of CP. Total number of inseminated sperm was not found to be significant. After multivariate analysis, it was found that M Morph/M Mot (OR:4.88; p=0.015), M Morph/H Mot (OR:5.16; p=0.012), H Morph/L Mot (OR:6.84; p=0.003), H Morph/M Mot (OR:4.47; p=0.019), and H Morph/H Mot (OR:7.12; p=0.002) along with DIUI (OR:8.96; p=0.003) were all significant independent predictors of CP. An interaction between DIUI and morphology/motility decreased the likelihood of CP in the presence of M Morph/M Mot (OR:0.1; p=0.017) and H Morph/L Mot (OR:0.09; p=0.011). CONCLUSIONS While sperm motility, morphology and DIUI are all significant predictors of CP, high morphology was found to overcome low motility but not vice versa. Using morphology as a clinical indicator for SIUI and/or DIUI could increase clinical pregnancy for couples. This can potentially lead to cost savings since certain couples can undergo a second IUI, rather than progress to in vitro fertilization, which is more invasive and expensive. These findings should assist in the guidance of fertility treatment options for urology, obstetric, and infertility professionals. Semen Parameters in Intrauterine Insemination Resulting in Clinical Pregnancy Semen Parameters Odds Ratio 95% Confidence Interval P Value Low Moph / Med Mot 1.59 0.35 - 7.28 0.551 Low Morph / High Mot 3.52 0.81 - 15.29 0.093 Med Morph / Low Mot 1.70 0.27 - 10.50 0.570 Med Morph / Med Mot 4.88 1.37 - 17.48 0.015 Med Morph / High Mot 5.16 1.43 - 18.66 0.012 High Morph / Low Mot 6.84 1.88 - 24.84 0.003 High Morph / Med Mot 4.47 1.28 - 15.63 0.019 High Morph / High Mot 7.12 2.12 - 23.97 0.002 Double IUI 8.96 2.10 - 38.28 0.003 * Low Morph/Low Mot was used as the reference point. Total number of inseminated sperm was not significant. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e875 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Metrics Author Information Michael Butcher Charleston, WV More articles by this author Pickens Gantt Charleston, WV More articles by this author Mike Broce Charleston, WV More articles by this author Dara Seybold Charleston, WV More articles by this author Gary Randall Charleston, WV More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...