Comparison of the sperm quality necessary for successful intrauterine insemination with World Health Organization threshold values for normal sperm
Open accessAbstract
Objective To compare World Health Organization threshold values for normal sperm with the initial sperm quality necessary for successful IUI. Design Retrospective study. Setting Private fertility clinic. Patient(s) One thousand eight hundred forty-one couples undergoing 4,056 cycles of IUI. Intervention(s) Intrauterine insemination. Main outcome measure(s) Relation of initial sperm quality to fecundity. Result(s) Progressive motility and total motile sperm count were the initial sperm characteristics most closely related to pregnancy on discriminant analysis. The per-cycle pregnancy rate averaged 11.1% during the first three IUI cycles. Pregnancy rates were > or = 8.2% per cycle when the initial sperm values were a concentration of > or = 5 X 10(6)/mL, a total count of > or = 10 X 10(6), progressive motility of > or = 30%, or a total motile sperm count of > or = 5 x 10(6). Minimal increases in fecundity occurred when initial values were greater than these threshold levels. The lowest initial values that resulted in pregnancy were a concentration of 2 x 10(6)/mL, a total count of 5 x 10(6). motility of 17%, and a total motile sperm count of 1.6 X 10(6). Pregnancy rates were <3.6% when initial values were between the threshold levels and the lowest levels. Conclusion(s) The sperm quality that is necessary for successful IUI is lower than World Health Organization threshold values for normal sperm. Intrauterine insemination is effective therapy for male factor infertility when initial sperm motility is > or = 30% and the total motile sperm count is > or = 5 X 10(6). When initial values are lower, IUI has little chance of success.
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Written from the paper’s full text.
TL;DR
In a retrospective private-clinic study of 4,056 IUI cycles, initial sperm progressive motility and total motile sperm count were most closely related to pregnancy, and successful IUI occurred at sperm quality below WHO normal thresholds. The authors propose IUI threshold values of ≥5 × 10⁶/mL concentration, ≥10 × 10⁶ total count, ≥30% progressive motility, and ≥5 × 10⁶ total motile sperm count.
Key findings
- Among 1,841 patients undergoing 4,056 first, second, or third IUI cycles, there were 449 pregnancies, for an average per-cycle pregnancy rate of 11.1%.
- Per-cycle pregnancy rates were ≥8.2% when initial values were concentration ≥5 × 10⁶/mL, total count ≥10 × 10⁶, progressive motility ≥30%, or total motile sperm count ≥5 × 10⁶.
- The lowest initial values resulting in pregnancy were concentration 2 × 10⁶/mL, total count 5 × 10⁶, motility 17%, and total motile sperm count 1.6 × 10⁶; pregnancy rates were <3.6% between these lowest values and the threshold levels.
- Swim-down processing yielded a 16% per-cycle pregnancy rate versus 11.7% for wash (P<.004), and no relation between sperm morphology and IUI outcome was found.
Methods
- Retrospective analysis of semen quality before and after processing for IUI from January 1983 to March 1998 at a private fertility clinic; analysis was limited to the first three IUI cycles.
- Patients were 1,841 couples (average female age 32.5 years) undergoing 4,056 cycles for WHO-defined male factor infertility or absence of motile sperm on postcoital tests; 255 cycles were spontaneous, and the rest used clomiphene citrate, hMG, or both.
- Main analyses used standardized canonical discriminant function coefficients to assess semen characteristics related to pregnancy, Pearson correlation for distribution checks, Fisher’s exact test for processing/insemination effects, and per-cycle pregnancy rates.
Limitations
- The authors state that in natural-cycle male fertility studies sperm quality at conception cannot be known, and that it rarely can be known with absolute certainty that conception did not result from prior intercourse or intercourse with a different partner.
- The study was retrospective and conducted in a single private fertility clinic; institutional review board approval was not obtained because all interventions were standard practice.
- Treatment methods changed over the 15-year study period (sperm wash to swim-down; split insemination, IUI, and tubal perfusion), and morphology criteria became stricter over time, though the authors report these factors were distributed evenly across sperm values or analyzed separately.
Model-written summary. Check it against the paper before relying on it.
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Cites
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Claims the paper makes
0 of 8 cited sources checked · 0 supported · 0 flagged
- Findingown data
No relation between sperm morphology and IUI outcome was found.
“No relation between sperm morphology and IUI outcome was found in the present study, whereas the WHO threshold for normal forms is 30%.”
- Also stated in: § Threshold and Lowest Values · plain
“we analyzed the relation between normal morphology and pregnancy separately for the periods 1983-1985, 1986 -1995, and 1996 -1998, and still found no effect (rϽ.06).”
Quote in the paperSubstantial claim - Also stated in: § Threshold and Lowest Values · plain
- Findingown data
Initial sperm concentration ≥5×10^6/mL is associated with a per-cycle pregnancy rate ≥8.2% for IUI.
“Pregnancy rates were Ն8.2% per cycle when the initial sperm values were a concentration of Ն5 ϫ 10 6 /mL, a total count of Ն10 ϫ 10 6 , progressive motility of Ն30%, or a total motile sperm count of Ն5 ϫ 10 6 .”
Quote in the paperSubstantial claim - Findingown data
When initial motility was <30%, the pregnancy rate was 4.5% (2/44) after swim-down, compared with 1.7% (2/119) after wash, in IUI or tubal perfusion cycles (not statistically significant).
“When initial motility was Ͻ30%, the PR was 4.5% (2/44) after swim-down, compared with 1.7% (2/119) after wash, in IUI or tubal perfusion cycles (not statistically significant).”
Quote in the paperNot a substantial claim - Findingown data
No pregnancies occurred when the initial normal morphology was <6%.
“No pregnancies occurred when the initial sperm concentration was Ͻ2 ϫ 10 6 /mL, the initial total sperm count was Ͻ5.5 ϫ 10 6 , the initial progressive motility was Ͻ17%, the initial normal morphology was Ͻ6%, or the initial total motile sperm count was Ͻ1.6 ϫ 10 6 .”
Quote in the paperSubstantial claim - Findingown data
The lowest initial progressive motility that resulted in pregnancy was 17%.
“The lowest initial values that resulted in pregnancy were a concentration of 2 ϫ 10 6 /mL, a total count of 5 ϫ 10 6 , motility of 17%, and a total motile sperm count of 1.6 ϫ 10 6 .”
Quote in the paperSubstantial claim
- Findingown data
Minimal increases in fecundity occurred when initial sperm values were greater than the threshold levels.
“Minimal increases in fecundity occurred when initial values were greater than these threshold levels.”
- Also stated in: § Threshold and Lowest Values · plain
“When the initial sperm characteristics were above these threshold levels, the highest PRs did not exceed 12.9%.”
Quote in the paperSubstantial claim - Also stated in: § Threshold and Lowest Values · plain
- Findingown data
No pregnancies occurred when the postprocessing total motile sperm count was <0.3×10^6.
“No pregnancies occurred when the postprocessing total motile sperm count was Ͻ0.3 ϫ 10 6 .”
Quote in the paperSubstantial claim - Findingown data
The per-cycle pregnancy rate was 16% for swim-down, compared with 11.7% for wash (P<.004), when insemination was performed by IUI or tubal perfusion.
“The per-cycle PR was 16% for swim-down, compared with 11.7% for wash (PϽ.004), when insemination was performed by IUI or tubal perfusion (Table 2).”
- Also stated in: § Effect of Sperm Processing Method · plain
“Wash 99/949 (10.4) 115/882 (13.0) 214/1,831 (11.7)Swim-down 45/373 (12.1)* 89/465 (19.1)* 134/833 (16.0)*”
Quote in the paperSubstantial claim - Also stated in: § Effect of Sperm Processing Method · plain
- Findingown data
Initial total motile sperm count ≥5×10^6 is associated with a per-cycle pregnancy rate ≥8.2% for IUI.
“Pregnancy rates were Ն8.2% per cycle when the initial sperm values were a concentration of Ն5 ϫ 10 6 /mL, a total count of Ն10 ϫ 10 6 , progressive motility of Ն30%, or a total motile sperm count of Ն5 ϫ 10 6 .”
Quote in the paperSubstantial claim - Findingown data
The lowest initial total sperm count that resulted in pregnancy was 5×10^6.
“The lowest initial values that resulted in pregnancy were a concentration of 2 ϫ 10 6 /mL, a total count of 5 ϫ 10 6 , motility of 17%, and a total motile sperm count of 1.6 ϫ 10 6 .”
Quote in the paperNot a substantial claim - Findingown data
Pregnancy rates were <3.6% when initial sperm values were between the threshold levels and the lowest levels that resulted in pregnancy.
“Pregnancy rates were Ͻ3.6% when initial values were between the threshold levels and the lowest levels.”
- Also stated in: § Threshold and Lowest Values · plain
“Pregnancy rates were Ͻ3.6% when initial values were between the lowest values that resulted in pregnancy and the threshold levels.”
Quote in the paperSubstantial claim - Also stated in: § Threshold and Lowest Values · plain
- Findingnone given
Lower pregnancy rates did not occur in patients who underwent split insemination if they had received hMG for as few as 3 days.
“Therefore, the finding that lower PRs did not occur in patients who underwent split insemination, if they had received hMG for as few as 3 days, was unexpected.”
Quote in the paperNot a substantial claim - Findingown data
The lowest initial total motile sperm count that resulted in pregnancy was 1.6×10^6.
“The lowest initial values that resulted in pregnancy were a concentration of 2 ϫ 10 6 /mL, a total count of 5 ϫ 10 6 , motility of 17%, and a total motile sperm count of 1.6 ϫ 10 6 .”
Quote in the paperSubstantial claim - Findingcitation
As stricter criteria for normal morphology were used, the percentage of normal forms decreased from 63% in 1983-1985, to 52% in 1986-1995, and to 38% in 1996-1998.
“As stricter criteria for normal morphology were used (24), the percentage of normal forms decreased from 63% in the period 1983-1985, to 52% in the period 1986 -1995, and to 38% in the period 1996 -1998.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [24] Kahn, 1993, Fallopian tube sperm perfusion versus intrauterine insemination in the treatment of unexplained infertility, Hum Reprod source
- Findingown data
Progressive motility and total motile sperm count were the initial sperm characteristics most closely related to pregnancy on discriminant analysis.
“Progressive motility and total motile sperm count were the initial sperm characteristics most closely related to pregnancy on discriminant analysis.”
- Also stated in: § RESULTS · plain
“Using discriminant analysis, we found that the significant factors responsible for pregnancy were initial and postprocessing sperm motility and initial total motile sperm count.”
Quote in the paperSubstantial claim - Also stated in: § RESULTS · plain
- Findingown data
The per-cycle pregnancy rate averaged 11.1% during the first three IUI cycles.
“The per-cycle pregnancy rate averaged 11.1% during the first three IUI cycles.”
- Also stated in: § Threshold and Lowest Values · plain
“Four hundred forty-nine pregnancies occurred in 1,841 patients during 4,056 first, second, or third cycles of IUI, for a 11.1% PR per cycle.”
Quote in the paperNot a substantial claim - Also stated in: § Threshold and Lowest Values · plain
- Findingown data
The lowest initial sperm concentration that resulted in pregnancy was 2×10^6/mL.
“The lowest initial values that resulted in pregnancy were a concentration of 2 ϫ 10 6 /mL, a total count of 5 ϫ 10 6 , motility of 17%, and a total motile sperm count of 1.6 ϫ 10 6 .”
Quote in the paperSubstantial claim - Findingown data
No difference in threshold levels for total sperm count or total motile sperm count was found between initial specimens processed by swim-down and wash.
“Although we found that PRs were higher when sperm were processed by swim-down than by wash, we found no difference in threshold levels for total sperm count or total motile sperm count in initial specimens after semen processing by either swim-down or wash.”
Quote in the paperSubstantial claim - Findingown data
Initial progressive motility ≥30% is associated with a per-cycle pregnancy rate ≥8.2% for IUI.
“Pregnancy rates were Ն8.2% per cycle when the initial sperm values were a concentration of Ն5 ϫ 10 6 /mL, a total count of Ն10 ϫ 10 6 , progressive motility of Ն30%, or a total motile sperm count of Ն5 ϫ 10 6 .”
Quote in the paperSubstantial claim - Findingown data
Initial total sperm count ≥10×10^6 is associated with a per-cycle pregnancy rate ≥8.2% for IUI.
“Pregnancy rates were Ն8.2% per cycle when the initial sperm values were a concentration of Ն5 ϫ 10 6 /mL, a total count of Ն10 ϫ 10 6 , progressive motility of Ն30%, or a total motile sperm count of Ն5 ϫ 10 6 .”
Quote in the paperSubstantial claim - Findingown data
The split insemination technique resulted in lower pregnancy rates compared with the use of the entire specimen for IUI.
“The practice of splitting the final specimen between IUI and cervical insemination, which had been advocated by some investigators (42), was abandoned in 1986, when we found that the split insemination technique resulted in lower PRs compared with the use of the entire specimen for IUI (data not shown).”
Quote in the paperNot a substantial claim - Premiseown data
The present study is the first to establish threshold values for initial sperm quality for IUI similar to WHO threshold values for sperm.
“The present study is the first to establish threshold values for initial sperm quality for IUI similar to WHO threshold values for sperm.”
Quote in the paperSubstantial claim - Interpretationown data
When initial sperm values are lower than the thresholds, IUI has little chance of success.
“When initial values are lower, IUI has little chance of success.”
Quote in the paperSubstantial claim- Rests on an assumption: Pregnancies occurring in IUI cycles were the result of the IUI procedure rather than intercourse.
- Premisecitation
Standards for acceptable initial sperm quality, before processing for IUI, have not been established.
“Although IUI has been used since 1957 (3), standards for acceptable initial sperm quality, before processing for IUI, have not been established.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [3] Mastroianni, 1957, Appraisal of the efficacy of artificial insemination with husband’s sperm and evaluation of insemination technics, Fertil Steril source
- Interpretationown data
The sperm quality necessary for successful IUI is lower than World Health Organization threshold values for normal sperm.
“The sperm quality that is necessary for successful IUI is lower than World Health Organization threshold values for normal sperm.”
- Also stated in: § FERTILITY & STERILITY · plain
“Our findings that IUI threshold fertility levels of a sperm concentration of 5 ϫ 10 6 /mL and a total sperm count of 10 ϫ 10 6 are considerably below WHO threshold levels for normal sperm should not be surprising, because the entire specimen, except for minor losses caused by processing and transfer, is placed in the uterus.”
Quote in the paperSubstantial claim- Rests on an assumption: Pregnancies occurring in IUI cycles were the result of the IUI procedure rather than intercourse.
- Also stated in: § FERTILITY & STERILITY · plain
- Interpretationown data
Many couples with male factor infertility, as defined by the WHO, can become pregnant with IUI.
“We conclude that many couples with male factor infertility, as defined by the WHO, can become pregnant with IUI.”
Quote in the paperSubstantial claim- Rests on an assumption: Pregnancies occurring in IUI cycles were the result of the IUI procedure rather than intercourse.
- Interpretationreasoning
Analyses of the initial sperm specimen used for LH- or hCG-timed IUI eliminate the problem that sperm quality at conception cannot be known in natural cycles.
“Analyses of the initial sperm specimen used for LH-or hCG-timed IUI eliminates this problem.”
Quote in the paperSubstantial claim - Premisecitation
Recent studies have limited their investigation to sperm quality after processing for IUI.
“Recent studies have limited their investigation to sperm quality after processing for IUI (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23).”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [13] Berger, 1985, Comparison of techniques for selection of motile spermatozoa, Fertil Steril source
- cites [14] Cruz, 1986, A prospective study of intrauterine insemination of processed sperm from men with oligoasthenospermia in superovulated women, Fertil Steril source
- cites [15] Arny, 1987, Semen quality before and after processing by a swim-up method, Fertil Steril source
- Premisecitation
In a single cycle, IUI always will be less effective than IVF or GIFT.
“In a single cycle, IUI always will be less effective than IVF or GIFT (45,46).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [45] Abyholm, 1992, In vivo fertilization procedures in infertile women with patent fallopian tubes, J Assist Reprod Genet source
- cites [46] Kaplan, 1989, Gamete intrafallopian transfer versus superovulation with intrauterine insemination for the treatment of infertility, J In Vitro Fert Embryo Transfer source
- May combine two claims. 13
- Classified as probably not a substantial claim. 3
May combine two claims.
Findingown dataThe wash procedure did not change motility, but it caused a small decrease in the total motile sperm count from 107×10^6 to 74×10^6.
“The wash procedure did not change motility, but it caused a small decrease in the total motile sperm count, from 107 ϫ 10 6 to 74 ϫ 10 6 .”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataThe pregnancy rate was 11.5% when the final wash specimen was inseminated by tubal perfusion, compared with 11.8% when the final wash specimen was inseminated by IUI.
“The PR was 11.5% when the final wash specimen was inseminated by tubal perfusion, compared with 11.8% when the final wash specimen was inseminated by IUI.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataThe maximum pregnancy rate with IUI was 12.9%, 50% higher than IUI threshold levels, but this was achieved only when the initial sperm concentration was 40×10^6/mL and the total sperm count was 80×10^6, double WHO threshold levels.
“The maximum PR with IUI was 12.9%, 50% higher than IUI threshold levels, but this was achieved only when the initial sperm concentration was 40 ϫ 10 6 /mL and the total sperm count was 80 ϫ 10 6 , double WHO threshold levels.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataThreshold levels for processed sperm specimens used for insemination were nearly the same as for initial specimens, except that the threshold for motility after swim-down was 50% and the threshold for total motile sperm count was 4×10^6.
“Threshold levels for the processed sperm specimens used for insemination were nearly the same as for the initial specimens, with the exceptions that the threshold for motility after swim-down was 50% and the threshold for total motile sperm count was 4 ϫ 10 6 .”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThe pregnancy rate was 11.8% per cycle when the entire postwash specimen was used for IUI, compared with 7.2% when the wash specimen was split between IUI and intracervical insemination, in spontaneous and CC-stimulated cycles (P<.0001), but not in hMG-stimulated or hMG and CC-stimulated cycles.
“The PR was 11.8% per cycle when the entire postwash specimen was used for IUI, compared with 7.2% when the wash specimen was split between IUI and intracervical insemination, in spontaneous and CC-stimulated cycles (PϽ.0001), but not in hMG-stimulated or hMG and CCstimulated cycles (Table 3).”
- Also stated in: § DISCUSSION · plain
“Split* 49/1,014 (4.8) † 50/354 (14.1) 99/1,368 (7.2) † IUI ‡ 70/640 (10.9) 68/528 (12.9) 138/1,168 (11.8)”
Quote in the paperSubstantial claim- Also stated in: § DISCUSSION · plain
May combine two claims.
Findingown dataWhen the total motile sperm count after processing was <10^6, the pregnancy rate was 5.3% after swim-down and 4.2% after wash.
“There was 1 pregnancy (5.3%) in 19 attempts after swim-down, compared with 2 pregnancies (4.2%) in 4 attempts after wash, when the total motile sperm count was Ͻ10 6 .”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataDuring the 15-year study period, there was no appreciable change in the initial sperm concentration (average, 75×10^6/mL), total sperm count (average, 203×10^6), progressive motility (average, 49%), or total motile sperm count (average, 106×10^6).
“During the 15-year study period, there was no appreciable change in the initial sperm concentration (average, 75 ϫ 10 6 /mL), total sperm count (average, 203 ϫ 10 6 ), progres-sive motility (average, 49%), or total motile sperm count (average, 106 ϫ 10 6 ).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataSwim-down resulted in an increase in motility from 52.7% to 84.5%, but a decrease in the total motile sperm count from 143×10^6 to 41×10^6.
“Swim-down resulted in an increase in motility from 52.7% to 84.5%, but a decrease in the total motile sperm count from 143 ϫ 10 6 to 41 ϫ 10 6 .”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationOnly one previous study attempted to define threshold values for initial sperm quality for IUI, and it was limited to a single characteristic.
“Several studies (4 -11) reported IUI pregnancy rates (PRs) when initial sperm quality was above or below WHO-defined normal values, but only one study (12) attempted to define threshold values, and this was limited to a single characteristic.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [12] McGovern, 1989, Relationship of within patient semen variability to outcome of intrauterine insemination, Fertil Steril source
Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).
Interpretationnone givenIt rarely can be known with absolute certainty that conception did not occur as a result of a previous act of intercourse or intercourse with a different partner.
“However, it rarely can be known with absolute certainty that conception did not occur as a result of a previous act of intercourse or intercourse with a different partner.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataThe threshold levels for initial semen quality found in the present study may be used to distinguish between couples with male infertility factors who could become pregnant with IUI and should undergo IUI before IVF, and those who should proceed directly to IVF, intracytoplasmic sperm injection, or the use of donor sperm.
“The threshold levels for initial semen quality found in the present study may be used to distinguish between those couples with male infertility factors who could become pregnant with IUI and, therefore, should undergo IUI before IVF, and those couples who should proceed directly to IVF, intracytoplasmic sperm injection, or the use of donor sperm.”
Quote in the paperSubstantial claim- Rests on an assumption: Pregnancies occurring in IUI cycles were the result of the IUI procedure rather than intercourse.
May combine two claims.
Study design and conductown dataThe type of medication used for ovulation induction, use of hCG, method of sperm preparation, insemination technique, and cycle of insemination were distributed evenly over the full range of sperm values (r<.12).
“The type of medication used for ovulation induction, use of hCG, method of sperm preparation, insemination technique, and cycle of insemination were distributed evenly over the full range of sperm values (rϽ.12).”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationown dataIUI is effective therapy for male factor infertility when initial sperm motility is ≥30% and the total motile sperm count is ≥5×10^6.
“Intrauterine insemination is effective therapy for male factor infertility when initial sperm motility is Ն30% and the total motile sperm count is Ն5 ϫ 10 6 .”
Quote in the paperSubstantial claim- Rests on an assumption: Pregnancies occurring in IUI cycles were the result of the IUI procedure rather than intercourse.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
InterpretationreasoninghMG may act indirectly either to improve cervical mucus or to enhance sperm transport.
“Because the mucus factor was a primary reason for performing IUI in many patients, this suggests to us that hMG may act indirectly either to improve cervical mucus or to enhance sperm transport.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
PremisereasoningThe initial sperm quality necessary for achieving pregnancy may be lower for IUI than WHO threshold values.
“Because sperm is concen-trated, introduced past the cervical mucus barrier, and may have immotile forms and impurities removed by processing, the initial quality necessary for achieving pregnancy may be lower for IUI than WHO threshold values.”
Quote in the paperSubstantial claim
The paper relies on this without support.
Pregnancies occurring in IUI cycles were the result of the IUI procedure rather than intercourse.
“However, it rarely can be known with absolute certainty that conception did not occur as a result of a previous act of intercourse or intercourse with a different partner.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Discussion claims higher sperm counts are necessary to exceed 8% pregnancy rate
MajorThe discussion says counts of 40 × 106/mL and 80 × 106 were necessary for a per-cycle rate above 8%. Table 1 instead reports rates of 8.6% at 5-10 × 106/mL and 8.2% at total counts of 10-20 × 106.
“To attain PRs of Ͼ8% per cycle, which we used as our threshold, sperm counts of 40 ϫ 10 6 /mL and total sperm counts of 80 ϫ 10 6 (double WHO threshold levels) were necessary.”
“Sperm concentration (ϫ10 6 /mL) Ͻ5 121 3 2.5 5-10 † 221 19 8.6 Ͻ.04 10-20 434 38 8.8 20-40 794 83 10.4 Ն40 2,486 306 12.3 Total sperm count (ϫ10 6 ) Ͻ10 102 1 1.0 10-20 † 183 15 8.2”
Subgroups do not add up to the reported number of cycles
MinorThe two groups listed as having semen quality below one or more WHO thresholds total 2,359 cycles, not 2,395.
Reported 2395 · recomputed 2359
“In 2,395 cycles (59%), initial semen quality was below one (n ϭ 1,329) or more (n ϭ 1,030) WHO threshold values”
Two pregnancies in four attempts is not 4.2%
MinorThe reported wash pregnancy rate is inconsistent with its stated numerator and denominator: 2 out of 4 is 50%.
Reported 4.2 · recomputed 50
“compared with 2 pregnancies (4.2%) in 4 attempts after wash”
Table 1 morphology pregnancy rate is incorrect
MinorThree pregnancies in 34 cycles give a pregnancy rate of 8.8%, not 10.7%.
Reported 10.7 · recomputed 8.823529
“5-10 † 34 3 10.7”
Lowest total sperm count resulting in pregnancy conflicts with the stated cutoff
MinorThe abstract says a pregnancy occurred at a total sperm count of 5 × 106, but the results say no pregnancies occurred below 5.5 × 106.
“The lowest initial values that resulted in pregnancy were a concentration of 2 ϫ 10 6 /mL, a total count of 5 ϫ 10 6 , motility of 17%, and a total motile sperm count of 1.6 ϫ 10 6 .”
“No pregnancies occurred when the initial sperm concentration was Ͻ2 ϫ 10 6 /mL, the initial total sperm count was Ͻ5.5 ϫ 10 6”
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Research works printed but not linked: 1
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Cited by
Sorted by citations
Merviel, P., Heraud, M. H., Grenier, N., Lourdel, E., Sanguinet, P., & Copin, H. (2008) · Fertility and Sterility · doi:10.1016/j.fertnstert.2008.09.058 · Cited by 295 · see citing works
Letrozole, Gonadotropin, or Clomiphene for Unexplained Infertility
Diamond, M. P., Legro, R. S., Coutifaris, C., Alvero, R. J., Robinson, R. D., Casson, P. R., Christman, G. M., Ager, J. W., Huang, H., Hansen, K. R., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1414827 · Cited by 285 · see citing works
Voorhis, B. J. V., Barnett, M. J., Sparks, A. E., Syrop, C. H., Rosenthal, G. E., & Dawson, J. D. (2001) · Fertility and Sterility · doi:10.1016/s0015-0282(00)01783-0 · Cited by 252 · see citing works
Marca, A. L., Malmusi, S., Giulini, S., et al. (2004) · Human Reproduction · doi:10.1093/humrep/deh508 · Cited by 191 · see citing works
“patients with male factor infertility if the total motile sperm count was $5 £ 10(6)/ml (Dickey et al., 1999).”
BackgroundMethodRanjbari, S., Khatibi, T., Vosough, A., Sajadi, H., Totonchi, M., & Ghaffari, F. (2021) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-020-01362-0 · Cited by 183 · see citing works
Semen quality and prediction of IUI success in male subfertility: a systematic review
Ombelet, W. U. A. M., Dhont, N., Thijssen, A., Bosmans, E., & Kruger, T. F. (2013) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2013.10.023 · Cited by 179 · see citing works
Measuring apoptosis in human spermatozoa: a biological assay for semen quality?
Oosterhuis, G., Mulder, A. B., Kalsbeek-Batenburg, E., Lambalk, C. B., Schoemaker, J., & Vermes, I. (2000) · Fertility and Sterility · doi:10.1016/s0015-0282(00)00623-3 · Cited by 163 · see citing works
Dickey, R. P., Taylor, S. N., Lu, P. Y., Sartor, B. M., Rye, P. H., & Pyrzak, R. (2002) · Fertility and Sterility · doi:10.1016/s0015-0282(02)04212-7 · Cited by 149 · see citing works
Self-citationBelloc, S., Cohen-Bacrie, P., Benkhalifa, M., Cohen-Bacrie, M., de Mouzon, J., Hazout, A., & Ménézo, Y. (2008) · Reproductive Biomedicine Online · doi:10.1016/s1472-6483(10)60223-4 · Cited by 138 · see citing works
“Semen quality, in terms of World Health Organization parameters, has an obvious impact on IUI outcome, as classically observed (Dickey et al., 1999; Badawy et al., 2008).”
BackgroundSemen quality and intrauterine insemination
Ombelet, W., Deblaere, K., Bosmans, E., Cox, A., Jacobs, P., Janssen, M., & Nijs, M. (2003) · Reproductive BioMedicine Online · doi:10.1016/s1472-6483(10)61894-9 · Cited by 133 · see citing works
“Total sperm motility before sperm preparation was mentioned four times with a cut-off level between 30 and 50% (Ombelet et al., 1996; Dickey et al., 1999; Montanaro et al., 2001; Lee et al., 2002).”
BackgroundWainer, R. (2004) · Human Reproduction · doi:10.1093/humrep/deh390 · Cited by 131 · see citing works
“2063 Downloaded from https://academic.oup.com/humrep/article-abstract/19/9/2060/782317 by guest on 30 July 2018 (Matorras et al., 1995; Karabinus and Gelety, 1997; Dickey et al., 1999).”
BackgroundResultInfluentialLee, T., Liu, C.-H., Shih, Y.-T., et al. (2010) · Human Reproduction · doi:10.1093/humrep/deq009 · Cited by 124 · see citing works
“Furthermore, the increase in sperm quality parameters above a minimal threshold of sperm concentration (5 10(6)/ml) and motility (30%) is not associated with a corresponding increase in the likelihood of pregnancy by IUI (Dickey et al., 1999).”
BackgroundInfluentialIntra-uterine insemination for male subfertility
Bensdorp, A. J., Cohlen, B., Heineman, M. J., & Vandekerckhove, P. (2007) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000360.pub3 · Cited by 114 · see citing works
Bouloux, P.-M. G., Nieschlag, E., Burger, H., Skakkebæk, N. E., Wu, F. C. W., Handelsman, D. J., Baker, G., Ochsenkuehn, R., Syska, A., McLachlan, R. I., et al. (2003) · Journal of Andrology · doi:10.1002/j.1939-4640.2003.tb02712.x · Cited by 107 · see citing works
Outcomes From Assisted Reproductive Technology
Voorhis, B. J. V. (2006) · Obstetrics and Gynecology · doi:10.1097/01.aog.0000194207.06554.5b · Cited by 101 · see citing works
Dickey, R. P., Taylor, S. N., Lu, P. Y., Sartor, B. M., Rye, P. H., & Pyrzak, R. (2001) · Fertility and Sterility · doi:10.1016/s0015-0282(00)01631-9 · Cited by 98 · see citing works
Self-citationDickey, R. P., Taylor, S. N., Lu, P. Y., Sartor, B. M., Rye, P. H., & Pyrzak, R. (2005) · Fertility and Sterility · doi:10.1016/j.fertnstert.2004.10.030 · Cited by 94 · see citing works
Self-citationBenoff, S. H., Auborn, K. J., Marmar, J. L., & Hurley, I. R. (2008) · Fertility and Sterility · doi:10.1016/j.fertnstert.2007.12.035 · Cited by 90 · see citing works
Endometrial thickness and pregnancy outcome after intrauterine insemination
Esmaeilzadeh, S., & Faramarzi, M. (2007) · Fertility and Sterility · doi:10.1016/j.fertnstert.2006.12.010 · Cited by 84 · see citing works
Auger, J., Sermondade, N., & Eustache, F. (2016) · Basic and Clinical Andrology · doi:10.1186/s12610-016-0031-x · Cited by 82 · see citing works
“Beyond discussion about minimal NMSPS required for ART [36, 37], when evaluating the theoretical use of those straws, decreased NMSPS in cancer patients leads to a less frequent use of IUI and a more frequent use of IVF with or without ICSI, regardless of the female fertility check-up or the number of available straws.”
Liu, C.-H., Tsao, H., Cheng, T., Wu, H., Huang, C., Chen, C.-I., Lin, D. P., & Lee, M. (2004) · Journal of Assisted Reproduction and Genetics · doi:10.1023/b:jarg.0000029495.22787.83 · Cited by 79 · see citing works
“For example, it is shown that no difference could be concluded among parameters of spermatozoa concentration and motility in relation to the outcome of pregnancy, if the parameters of sperm were above certain minimum levels (31, 32 ).”
BackgroundPredictive factors for intrauterine insemination outcomes: a review
Starosta, A., Gordon, C. E., & Hornstein, M. D. (2020) · Fertility Research and Practice · doi:10.1186/s40738-020-00092-1 · Cited by 71 · see citing works
“ples with TMC < 10 million [7] while two retrospective studies of 4,056 [8] and 2,062 [9] natural and OI/IUI cycles, respectively, showed a lower threshold of 5 million.”
BackgroundHelli, B., Kavianpour, M., Ghaedi, E., Dadfar, M., & Haghighian, H. K. (2020) · Human Fertility · doi:10.1080/14647273.2020.1824080 · Cited by 71 · see citing works
“According to the WHO, the lower limit of normal sperm motility is 32% of progressively motile sperm and 40% of total motile sperm (Dickey et al., 1999).”
RetractedKamath, M. S., Chittawar, P. B., Aleyamma, T. K., Nair, R., Chandy, A., Mangalaraj, A. M., Muthukumar, K., & George, K. (2010) · Journal of Human Reproductive Sciences · doi:10.4103/0974-1208.74154 · Cited by 65 · see citing works
“[4,5] Generally, four cycles of COH/IUI are recommended depending on the female age prior to moving on to assisted reproductive technology (ART)- in vitro fertilization (IVF).”
Impact of Semen Characteristics on the Success of Intrauterine Insemination
Zhao, Y., Vlahos, N., Wyncott, D., Petrella, C., García, J. E., Zacur, H. A., & Wallach, E. E. (2004) · Journal of Assisted Reproduction and Genetics · doi:10.1023/b:jarg.0000031246.76666.f6 · Cited by 63 · see citing works
“Although the World Health Organization’s (WHO) reference values for semen analysis are often used to assess sperm quality, more often than not successful pregnancies with IUI have been achieved in subfertile couples with sperm parameters below reference values listed in the WHO manual (3, 4 ).”
MethodOry, J., Tradewell, M. B., Blankstein, U., et al. (2022) · The World Journal of Men s Health · doi:10.5534/wjmh.210159 · Cited by 62 · see citing works
“Men were pre-sorted into categories based on sperm concentration levels that have been used previously to determine which forms of ART are available to couples: 1–5 million (IVF), 5–15 million (IUI), and >15 million (natural conception) [21,22].”
MethodAssisted reproductive technologies for male subfertility
Cissen, M., Bensdorp, A. J., Cohlen, B. J., Repping, S., de Bruin, J. P., & van Wely, M. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000360.pub5 · Cited by 62 · see citing works
Preoperative semen analysis as a predictor of seminal improvement following varicocelectomy
Matkov, T. G., Zenni, M. K., Sandlow, J. I., et al. (2001) · Fertility and Sterility · doi:10.1016/s0015-0282(00)01644-7 · Cited by 62 · see citing works
Management Strategies for Male Factor Infertility
Haidl, G. (2002) · Drugs · doi:10.2165/00003495-200262120-00004 · Cited by 58 · see citing works
“In this situation, pregnancy rates of 15% per cycle have been observed.[60,61] IUI can”
BackgroundThe Diagnostic and Prognostic Value of Traditional Semen Parameters
Tomlinson, M. J., Kessopoulou, E., & Barratt, C. L. R. (1999) · Journal of Andrology · doi:10.1002/j.1939-4640.1999.tb02559.x · Cited by 57 · see citing works
Clinical experience with flow cytometric separation of human X- and Y-chromosome bearing sperm
Fugger, E. F. (1999) · Theriogenology · doi:10.1016/s0093-691x(99)00228-9 · Cited by 57 · see citing works
Loskutoff, N. M., Huyser, C., Singh, R., et al. (2005) · Fertility and Sterility · doi:10.1016/j.fertnstert.2005.03.082 · Cited by 55 · see citing works
Effect of semen characteristics on pregnancy rate following intrauterine insemination
Dorjpurev, U., Kuwahara, A., Yano, Y., Taniguchi, T., Yamamoto, Y., Suto, A., Tanaka, Y., Matsuzaki, T., Yasui, T., & Irahara, M. (2011) · The Journal of Medical Investigation · doi:10.2152/jmi.58.127 · Cited by 51 · see citing works
Learning Something From Nothing: The Critical Importance of Rethinking Microbial Non-detects
Chik, A. H. S., Schmidt, P. J., & Emelko, M. B. (2018) · Frontiers in Microbiology · doi:10.3389/fmicb.2018.02304 · Cited by 50 · see citing works
“These estimates are required for decision making, during which they are typically evaluated against concentration-based criteria or targets (Dickey et al., 1999; Lund et al., 2000; Havelaar et al., 2001; Gerba and Rose, 2003; Gracias and McKillip, 2004; Koepke et al., 2007; Schijven and de Roda Husman, 2011; Davis, 20…”
BackgroundAbdelkader, A. M., & Yeh, J. (2009) · Obstetrics and Gynecology International · doi:10.1155/2009/584837 · Cited by 46 · see citing works
“Briefly, in these studies, total motile sperm of 30–50% before sperm preparation was found to be associated with positive IUI outcomes [54, 56, 57].”
BackgroundThijssen, A., Creemers, A., Van der Elst, W., Creemers, E., Vandormael, E., Dhont, N., & Ombelet, W. (2017) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2017.01.016 · Cited by 45 · see citing works
Alborzi, S., Motazedian, S., Parsanezhad, M. E., et al. (2003) · Fertility and Sterility · doi:10.1016/s0015-0282(03)00980-4 · Cited by 45 · see citing works
Intra-uterine insemination for male subfertility
Bensdorp, A. J., Cohlen, B. J., Heineman, M. J., & Vanderkerchove, P. (2007) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000360.pub4 · Cited by 44 · see citing works
Vjugina, U., Zhu, X., Oh, E., Bracero, N. J., & Evans, J. P. (2009) · Biology of Reproduction · doi:10.1095/biolreprod.108.075275 · Cited by 39 · see citing works
Sperm swim-up: a simple and effective technique of semen processing for intrauterine insemination.
Jameel, T. (2008) · PubMed · Cited by 37 · see citing works
Seminal lead concentrations negatively affect outcomes of artificial insemination
Benoff, S. H., Hurley, I. R., Millan, C., et al. (2003) · Fertility and Sterility · doi:10.1016/s0015-0282(03)00981-6 · Cited by 33 · see citing works
Ola, B. (2003) · Human Reproduction · doi:10.1093/humrep/deg209 · Cited by 33 · see citing works
Prewash total motile count is a poor predictor of live birth in intrauterine insemination cycles
Mankus, E. B., Holden, A. E. C., Seeker, P., et al. (2019) · Fertility and Sterility · doi:10.1016/j.fertnstert.2018.12.025 · Cited by 32 · see citing works
“Recent studies have shown a significant increase in clinical pregnancy rates when TMC was >5 million (8, 16, 17).”
BackgroundCost-effectiveness of assisted conception for male subfertility
Moolenaar, L. M., Cissen, M., de Bruin, J. P., Hompes, P. G. A., Repping, S., van der Veen, F., & Mol, B. W. (2015) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2015.02.006 · Cited by 31 · see citing works
“Most studies showed pregnancy probabilities of IUI-COH with clomiphene citrate (CC) or follicle-stimulating hormone (FSH) (Voorhis et al., 2001; Cohlen et al., 1998; Dickey et al., 1999; Dorjpurev et al., 2011; Zhao et al., 2004; Campana et al., 1996).”
BackgroundMethodInfluentialDong, F. L., Sun, Y., Su, Y., Guo, Y., Hu, L., & Wang, F. (2011) · Systems Biology in Reproductive Medicine · doi:10.3109/19396368.2011.603792 · Cited by 30 · see citing works
“Others have argued that a PTMS of 10 × 10(6) can achieve a better pregnancy rate [Dickey et al. 1999; Horvath et al. 1989; Van Voorhis et al. 2001].”
BackgroundTonguc, E. A., Var, T., Önalan, G., Altınbaş, S., Tokmak, A., Karakas, N., & Gülerman, C. (2009) · Fertility and Sterility · doi:10.1016/j.fertnstert.2009.08.030 · Cited by 29 · see citing works
EFFECTS OF SEMEN CHARACTERISTICS ON IUI COMBINED WITH MILD OVARIAN STIMULATION
Yaltı, S., GÜRBÜZ, B., Sezer, H. D., et al. (2004) · Archives of Andrology · doi:10.1080/01485010490448435 · Cited by 29 · see citing works
“The exact TMS cutoff line for defining severe male factor has varied from study to study, but threshold values of 5 million and 10 million have been reported in recent studies [3, 5].”
BackgroundAssessment of gonadotropin therapy in male hypogonadotropic hypogonadism
Ishikawa, T., Ooba, T., Kondo, Y., Yamaguchi, K., & Fujisawa, M. (2007) · Fertility and Sterility · doi:10.1016/j.fertnstert.2006.11.022 · Cited by 29 · see citing works
Erdem, M., Erdem, A., Mutlu, M. F., Ozisik, S., Yildiz, S., Guler, I., & Karakaya, C. (2016) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2015.12.014 · Cited by 27 · see citing works
Aydın, Y., Hassa, H., Öge, T., et al. (2013) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2013.07.022 · Cited by 26 · see citing works
IUI in male subfertility: are we able to select the proper patients?
van Weert, J.-M., Repping, S., van der Steeg, J. W., Steures, P., van der Veen, F., & Mol, B. W. (2005) · Reproductive BioMedicine Online · doi:10.1016/s1472-6483(10)61172-8 · Cited by 26 · see citing works
Fertility treatment in spinal cord injury and other neurologic disease.
Trofimenko, V., & Hotaling, J. M. (2016) · PubMed · doi:10.3978/j.issn.2223-4683.2015.12.10 · Cited by 24 · see citing works
“3% if the TMSC was 5 to 10×10(6) per mL (91).”
Allamaneni, S. S. R., Bandaranayake, I., & Agarwal, A. K. (2004) · Fertility and Sterility · doi:10.1016/j.fertnstert.2004.02.113 · Cited by 23 · see citing works
Ombelet, W. U. A. M., Campo, R., Bosmans, E., & Nijs, M. (2008) · ESHRE Monographs · doi:10.1093/humrep/den165 · Cited by 23 · see citing works
“For total sperm motility before sperm preparation, cut-off levels vary between 30% and 50% (Ombelet et al., 1996; Dickey et al., 1999; Montanaro et al., 2001; Lee et al., 2002).”
BackgroundNaelitz, B. D., Jiang, T., Muñoz-López, C., Sigalos, J. T., Modiri, N., Cannarella, R., Mills, J. N., Parekh, N. V., Nowacki, A. S., Vij, S. C., et al. (2023) · Fertility and Sterility · doi:10.1016/j.fertnstert.2023.06.032 · Cited by 21 · see citing works
Cao, S., Zhao, C. L., Zhang, J., Wu, X., Zhou, L., Guo, X., Shen, R., & Ling, X. (2013) · Andrologia · doi:10.1111/and.12109 · Cited by 22 · see citing works
“Similarly, Horvath et al. (1989), Dickey et al. (1999) and Van Voorhis et al. (2001) reported that higher PRs were achieved after IUI when more than 10 9 106 ml 1 motile spermatozoa were inseminated.”
BackgroundSmith, J. P., Baker, S. E., Agbo, C., & Dahan, M. H. (2014) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2014.12.007 · Cited by 21 · see citing works
Dickey, R. P., Taylor, S. N., Lu, P. Y., et al. (2004) · Fertility and Sterility · doi:10.1016/j.fertnstert.2003.07.031 · Cited by 21 · see citing works
Self-citationDoes Catheter Type Effect Pregnancy Rate in Intrauterine Insemination Cycles?
Smith, K. L., Grow, D. R., Wiczyk, H. P., O’Shea, D. L., & Arny, M. (2002) · Journal of Assisted Reproduction and Genetics · doi:10.1023/a:1014414128905 · Cited by 21 · see citing works
Lee, V. M. S., Wong, J. S. Y., Loh, S. K. E., et al. (2002) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1016/s1470-0328(02)01034-0 · Cited by 21 · see citing works
The use of intrauterine insemination in Australia and New Zealand
Miskry, T. S. (2002) · Human Reproduction · doi:10.1093/humrep/17.4.956 · Cited by 21 · see citing works
“In order to reproduce these results it has been reported that initial sperm concentration should be at least 5 106/ml (Dickey et al., 1999), while following semen preparation at least 1 106 motile sperm should be available for insemination (Berg et al., 1997; Goverde et al., 2000), which is less…”
BackgroundCabry‐Goubet, R., Scheffler, F., Belhadri-Mansouri, N., Belloc, S., Lourdel, E., Devaux, A., Chahine, H., de Mouzon, J., Copin, H., & Benkhalifa, M. (2017) · BioMed Research International · doi:10.1155/2017/3512784 · Cited by 19 · see citing works
“This findingwas confirmed by two studies [9, 10] while others determined a higher threshold of TMS at 2 × 10(6) [68]; 3 × 10(6) [62, 76]; 5 × 10(6) [11, 77]; 10× 10(6) [63, 78].”
ResultPrognostic factors for pregnancy after intrauterine insemination
Ejzenberg, D., Gomes, T. J. D. O., Monteleone, P. A. A., Serafini, P. C., Soares, J. M., & Baracat, E. C. (2019) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.12898 · Cited by 18 · see citing works
Park, S. J., Alvarez, J. R., Weiss, G., et al. (2007) · Fertility and Sterility · doi:10.1016/j.fertnstert.2006.11.037 · Cited by 18 · see citing works
Prognostic factors influencing pregnancy rate after stimulated intrauterine insemination.
Tay, P. Y. S., Raj, V., Kulenthran, A., et al. (2007) · PubMed · Cited by 18 · see citing works
Is your andrology service up to scratch?
Tomlinson, M. J. (2010) · Human Fertility · doi:10.3109/14647273.2010.535089 · Cited by 17 · see citing works
“…IUI, IVF or ICSI on the results of a sperm migration test (swim up) or a trial density gradient preparation but often with different diagnostic thresholds (Francavilla et al., 1990; Berg et al., 1997, Dickey et al., 1999) and again, criteria are often adopted from others without proper validation.”
BackgroundMekhaimar, A., Goble, M., Brunckhorst, O., et al. (2020) · Urology Research and Practice · doi:10.5152/tud.2020.20228 · Cited by 17 · see citing works
“Conversion from IVF to IUI IUI is often offered to patients with a total motile sperm count (TMC) greater than 5×106.[42] The possibility of converting from IVF to IUI was assessed in six studies.”
Insémination intra-utérine : état des lieux chez l’humain
Royère, D. (2004) · Gynécologie Obstétrique & Fertilité · doi:10.1016/j.gyobfe.2004.08.015 · Cited by 17 · see citing works
Fertility outcomes after electroejaculation in men with spinal cord injury
Kolettis, P. N., Lambert, M. C., Hammond, K. R., et al. (2002) · Fertility and Sterility · doi:10.1016/s0015-0282(02)03214-4 · Cited by 17 · see citing works
Valeur prédictive de l’hormone antimüllérienne sur les issues des inséminations intra-utérines
Lamazou, F., Fuchs, F., Genro, V. K., et al. (2011) · Journal de gynécologie, obstétrique et biologie de la reproduction. Supplément/Journal de gynécologie obstétrique et biologie de la reproduction · doi:10.1016/j.jgyn.2011.08.005 · Cited by 15 · see citing works
Detection of a Short CCR5 Messenger RNA Isoform in Human Spermatozoa
Januchowski, R., Bręborowicz, A., Ofori, H., et al. (2004) · Journal of Andrology · doi:10.1002/j.1939-4640.2004.tb02852.x · Cited by 15 · see citing works
“Human ejaculates were obtained from 13 healthy volunteers of proven fertility, and normal semen quality as assessed by World Health Organization (1999) criteria (Dickey et al, 1999).”
MethodRepeated pulses of ultrasound maintain sperm motility
Vafaie, A., Shahali, S., Raveshi, M. R., et al. (2024) · Lab on a Chip · doi:10.1039/d4lc00826j · Cited by 14 · see citing works
Berker, B., Şükür, Y. E., Kahraman, K., et al. (2012) · Urology · doi:10.1016/j.urology.2012.07.004 · Cited by 14 · see citing works
Zhang, E., Tao, X., Xing, W., Cai, L., & Zhang, B. (2014) · Materia Socio Medica · doi:10.5455/msm.2014.26.321-323 · Cited by 14 · see citing works
Inaudi, P. (2002) · Human Reproduction · doi:10.1093/humrep/17.5.1288 · Cited by 14 · see citing works
Bedaiwy, M. A., Sharma, R. K., Al-Hussaini, T. K., Mohamed, M. S., Aleem, A. M. A., Nelson, D. R., Thomas, A. J., Jr., & Agarwal, A. K. (2003) · Journal of Andrology · doi:10.1002/j.1939-4640.2003.tb02682.x · Cited by 14 · see citing works
“In larger studies, pregnancy rates determined for couples with male-factor infertility were between 8% and 10% (Dickey et al, 1999; Stone et al, 1999).”
BackgroundHaim, D., Leniaud, L., Porcher, R., et al. (2009) · Gynécologie Obstétrique & Fertilité · doi:10.1016/j.gyobfe.2008.09.024 · Cited by 12 · see citing works
“Concernant la mobilité, tel que défini par l’Organisation mondiale de la santé (OMS) [7], certains auteurs ont retrouvé un impact significatif de la mobilité totale « a + b » du sperme entier [8,9], de la mobilité totale « a + b + c » du sperme entier [10–12] ou encore de la mobilité totale « a + b » du sperme après p…”
Bedeutung der Insemination in der Zeit von IVF und ICSI*
Katzorke, T., & Kolodziej, F. B. (2010) · Der Urologe · doi:10.1007/s00120-009-2219-6 · Cited by 11 · see citing works
Angell, N. F., Moustafa, H. F., Rizk, B., Nawar, M. G., Rizk, C. B., Huff, C., Kennedy, R., Holland, S. B., Hazelton, J. M., García-Velasco, J. A., et al. (2008) · Cambridge University Press eBooks · doi:10.1017/cbo9780511547287.049 · Cited by 11 · see citing works
Schulte, R. T., Keller, L., Hiner, M. R., et al. (2008) · Journal of Andrology · doi:10.2164/jandrol.107.004002 · Cited by 11 · see citing works
Ortiz, A., Ortíz, R., Soto, E., et al. (2016) · Daehan saengsik uihak hoeji/Clinical and experimental reproductive medicine · doi:10.5653/cerm.2016.43.2.102 · Cited by 10 · see citing works
“[10], who concluded that these values represent the threshold fertility levels for initial sperm specimens intended for use in IUI, because samples under these levels exhibited significantly lower pregnancy rates [10].”
Backgroundde Araújo, L. F. P., Filho, E. D. A., Fácio, C. L., Bossoni, M. C., Machado‐Paula, L. A., Corrente, J. E., Cavagna, M., Matheus, P. C., & Pontes, A. (2013) · Reproductive Biology and Endocrinology · doi:10.1186/1477-7827-11-101 · Cited by 10 · see citing works
Küçük, T., Sözen, E., & Buluç, B. (2008) · Journal of Andrology · doi:10.2164/jandrol.107.004754 · Cited by 10 · see citing works
“The cutoff values of between 5 6 106 and 10 6 106 motile sperm in the ejaculate (Cohlen et al, 1998; Dickey et al, 1999) and of about 0.8 6 106 to 1 6 106 motile sperm in the inseminate have been reported in some studies (Campana et al, 1996; Wainer et al, 2004).”
InfluentialFactors determining successful intrauterine insemination
Sinha, P., Pandey, K., & Srivastava, A. (2017) · International Journal of Reproduction Contraception Obstetrics and Gynecology · doi:10.18203/2320-1770.ijrcog20174028 · Cited by 8 · see citing works
Sandfoss, M., Whittington, O. M., Reichling, S., et al. (2021) · Cryobiology · doi:10.1016/j.cryobiol.2021.06.008 · Cited by 9 · see citing works
Shiraishi, K., Naito, K., & Takihara, H. (2003) · Archives of Andrology · doi:10.1080/01485010390236396 · Cited by 9 · see citing works
“Threshold levels of TM of 20 million and 5 million have been identified [4, 6].”
BackgroundEffect of total motile sperm count in intra-uterine insemination on ongoing pregnancy rate
Kleppe, M., van Hooff, M. H., & Rhemrev, J. P. T. (2014) · Andrologia · doi:10.1111/and.12212 · Cited by 8 · see citing works
“These numbers range from 0.3 to 20 million (Huang et al., 1996; Ombelet et al., 1997; Dickey et al., 1999; Van Voorhis et al., 2001; Miller et al., 2002; Van Weert et al., 2004; Daya, 2005; Badawy et al., 2009).”
BackgroundInfluentialYahyavi, S. K., Wall-Gremstrup, G., Probst-Drejer, B., Toft, F. B., Jorsal, M. J., Holt, R., Aksglæde, L., Jørgensen, N., Juul, A., & Jensen, M. B. (2024) · Human Reproduction · doi:10.1093/humrep/deae293 · Cited by 7 · see citing works
Association of Urinary Mycotoxins with Sperm Quality: A Case-Control Study in Southern Nigeria
Okonofua, F. E., Ntoimo, L. F. C., Unuabonah, E. I., Msagati, T. A. M., Ayodeji, O., Aziken, M. E., Omonkhua, A. A., Ohenhen, V., Olafusi, C., & Alfred, M. O. (2024) · Toxins · doi:10.3390/toxins16030119 · Cited by 7 · see citing works
“This is not unexpected since it is well known that men whose sperm parameters fall below the WHO standards can still attain pregnancies [39–41].”
BackgroundRuiter‐Ligeti, J., Agbo, C., & Dahan, M. H. (2017) · Minerva Obstetrics and Gynecology · doi:10.23736/s0026-4784.16.04002-8 · Cited by 7 · see citing works
Sorouri, Z. Z., Shomali, R. R., & Pourmarzi, D. (2016) · PubMed · Cited by 7 · see citing works
¿Existe asociación entre la morfología normal del espermatozoide y su cinética de desplazamiento?
Munuce, M. J., Maya, W. D. C., & Berta, C. L. (2006) · Actas Urológicas Españolas · doi:10.1016/s0210-4806(06)73499-4 · Cited by 6 · see citing works
An overview of intrauterine insemination and ovulation induction
Brinsden, P. R., & Dickey, R. P. (2009) · Cambridge University Press eBooks · doi:10.1017/cbo9780511642159.002 · Cited by 6 · see citing works
Self-citationFujisawa, Y., Kikuchi, S., Kuba, F., Oishi, K., Murayama, S., Sugiyama, T., Tokito, R., Ueno, H., Kashiwabara, S., Yumura, Y., et al. (2024) · Reproductive Medicine and Biology · doi:10.1002/rmb2.12602 · Cited by 5 · see citing works
Place des techniques d’assistance médicale à la procréation
Amar-Hoffet, A., Hedon, B., & Belaisch-Allart, J. (2010) · Journal de gynécologie, obstétrique et biologie de la reproduction. Supplément/Journal de gynécologie obstétrique et biologie de la reproduction · doi:10.1016/s0368-2315(10)70034-x · Cited by 5 · see citing works
Duvan, C. İ., Berker, B., Bayrak, Ö., Aydos, K., Turhan, N. Ö., & Şatıroğlu, H. (2009) · TURKISH JOURNAL OF MEDICAL SCIENCES · doi:10.3906/sag-0812-15 · Cited by 5 · see citing works
THE CORRELATION BETWEEN SEMEN PARAMETERS AND PREGNANCY OUTCOME AFTER INTRAUTERINE INSEMINATION
Mehrafza, M., Nobakhti, N., Roshan, Z. A., et al. (2003) · TSpace (University of Toronto) · Cited by 5 · see citing works
Relationship between semen regurgitation and pregnancy rates with intrauterine insemination
Craig, L. B., Arya, S., Burks, H. R., et al. (2021) · Fertility and Sterility · doi:10.1016/j.fertnstert.2021.07.1183 · Cited by 4 · see citing works
Patel, A. P., Patel, M. S., Shah, S. R., & Jani, S. K. (2016) · Journal of South Asian Federation of Obstetrics and Gynaecology · doi:10.5005/jp-journals-10006-1404 · Cited by 4 · see citing works
Cabello, Y., Belchin, P., González-Martínez, M., López‐Fernández, C., Johnston, S. D., & Gosálvez, J. (2022) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2022.11.002 · Cited by 4 · see citing works
- Authors
- Dickey, R. P., Pyrzak, R., Lu, P. Y., Taylor, S. N., & Rye, P. H.
- Affiliations
- Louisiana State University (US)
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 1999-04
- Volume
- 71
- Issue
- 4
- Pages
- 684-689
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2076818515
- Semantic Scholar
- bb0d3297a10ff7a187d082f63d62d8e7a84a6ece
- Cited by
- 163
- References
- 44
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 6 · 2023: 2 · 2022: 3 · 2021: 9 · 2020: 4 · 2019: 4 · 2018: 3 · 2017: 4 · 2016: 6 · 2015: 9 · 2014: 6 · 2013: 8 · 2012: 2
- FWCI
- 6.82
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Health Sciences › Health Professions › General Health Professions › Male Reproductive Health Studies
- Keywords
- intrauterine insemination, semen quality, progressive motility, total motile sperm count, sperm concentration, fecundity, pregnancy rate, male factor infertility, cut-off values
- MeSH terms
- Adult, Female, Humans, Infertility, Male, Insemination, Artificial, Homologous, Male, Pregnancy, Reference Values, Retrospective Studies, Specimen Handling, Sperm Count, Sperm Motility, Spermatozoa, World Health Organization
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