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How low is too low? Postwash total motile sperm count effect on pregnancy outcomes in intrauterine insemination
Abstract
Intrauterine insemination (IUI) is a frequently used method to treat couples with infertility. There is evidence of decreased pregnancy rates with a total motile sperm count (TMSC) of less than 10 million, yet there remains to be a consensus on semen parameters for which to recommend IUI in the infertile population. The aim of this study was to determine a minimum threshold of TMSC on semen analysis to offer IUI cycles. This is a retrospective cohort study of all IUI cycles at a private practice infertility centre over four years. Our primary outcome of interest was the presence of clinical pregnancy after each cycle. A total of 999 women underwent 2,169 IUI cycles. The overall clinical pregnancy rate was 19.8% per cycle. During the first IUI each woman underwent, there was an increase in clinical pregnancy with increasing TMSC (OR 0.44) for TMSC ≤1 M to (OR 0.99) for TMSC 6-10 M, compared to TMSC >10 M. Among all IUI with a TMSC between 6 and 10 M, pregnancy outcomes improved with morphology >4% (OR 0.84), compared to morphology <4% (OR 0.25), relative to TMSC >10 M. Using receiver operating characteristic curves, we did not identify a TMSC threshold to offer IUI, although there was a positive correlation between TMSC and IUI success.
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Metadata
- Authors
- Mathes, M., Kastrick, E., Sayles, H., & Gustin, S.
- Affiliations
- University of Nebraska Medical Center (US)
- Corresponding author
- Mathes, Melissa
- Venue
- Human Fertility
- Publisher
- Informa UK Limited
- Published
- 2022-11-10
- Volume
- 26
- Issue
- 5
- Pages
- 1108-1113
- ISSN
- 1464-7273 (ISSN-L)
- 1742-8149
- OpenAlex
- W4308774693
- Cited by
- 7
- References
- 11
- Citations by year
- 2026: 3 · 2024: 2 · 2023: 2
- FWCI
- 0.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Human Fertility (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 › Reproductive Medicine › Reproductive Biology and Fertility
- Keywords
- intrauterine insemination, total motile sperm count, semen analysis, clinical pregnancy rate, sperm morphology, infertility treatment
- MeSH terms
- Female, Humans, Infertility, Insemination, Artificial, Homologous, Male, Pregnancy, Pregnancy Outcome, Retrospective Studies, Semen, Sperm Count, Sperm Motility, Pregnancy Rate
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- The paper
- Mathes, M., Kastrick, E., Sayles, H., & Gustin, S. (2023). How low is too low? Postwash total motile sperm count effect on pregnancy outcomes in intrauterine insemination. Human Fertility. https://doi.org/10.1080/14647273.2022.2137858
