Cited by 163Sperm and Testicular FunctionReproductive Health and TechnologiesMale Reproductive Health Studies

The DOI matches its Crossref record; 48 of the 49 references it cites were found in a registry or an index; none of the 8 sources its claims cite is checked for support yet.

Comparison of the sperm quality necessary for successful intrauterine insemination with World Health Organization threshold values for normal sperm

Open access
Dickey, Richard P, Pyrzak, Roman, Lu, Peter Y, Taylor, Steven N, Rye, Philip H·1999·Fertility and Sterility

Abstract

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.

Overview

AI snapshot

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.

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Integrity signals

Registry

Crossref · 10.1016/s0015-0282(98)00519-6

Cites

48 of 49 references verified0 citation errors · 1 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

28 Own result · 8 Own interpretation · 5 No full text of the sources · 2 No basis given · 1 Own method

Show all 29 claims

  • It may state two separate claims as one. 13
  • Probably not a substantial claim. 3
15 of 15
  • 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.”
1 of 1

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.

5 of 5

Citations

Cites

Research works printed but not linked: 1

  1. van Zyl JA, Menkveld R, Kotze TJ, Van Niekerk WA. The importance of spermiograms that meet the requirements of international standards and the most important factors that influence semen parameters. Proceedings of the 17th Congress of the International Urological Society, Vol. 20; Paris. 1976:263.

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Metadata

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
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
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 › Medicine › Urology › 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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