Journal of Assisted Reproduction and Genetics

, Volume 16, Issue 9, pp 476–482 | Cite as

Relationship of Total Motile Sperm Count and Percentage Motile Sperm to Successful Pregnancy Rates Following Intrauterine Insemination

  • Eleonora B. Pasqualotto
  • James A. Daitch
  • Benjamin N. Hendin
  • Tommaso Falcone
  • Anthony J. ThomasJr.
  • David R. Nelson
  • Ashok Agarwal
Article

Abstract

Purpose:This study sought (i) to investigate the relationship between postwash total motile sperm count and postwash percentage motile sperm in predicting successful intrauterine insemination and (ii) to determine the minimal postwash total motile sperm count required to achieve pregnancy with intrauterine insemination.

Methods:Five hundred four women, who underwent 1636 intrauterine insemination cycles with their partner's sperm for infertility treatment from 1993 through 1995, were included in this retrospective study. All patient charts were reviewed for age, infertility etiology, ovarian stimulation regimens, semen characteristics, and treatment outcome. To determine the relationship between total motile sperm count and intrauterine insemination outcome, patients were grouped as (1) less than 0.5 million, (2) 0.5 to 1 million, (3) 1 to 5 million, (4) greater than 5 million, and (5) greater than 20 million.

Results:Similar live birth rates (per cycle) were seen among the postwash total motile sperm count groups: group 1, 3.5%; group 2, 2.4%; group 3, 7.0%; group 4, 6.9%; and group 5, 7.0% (P = 0.37). However, regardless of the postwash total motile sperm count, the postwash motility predicted intrauterine insemination success at a cutoff value of 40%.

Conclusions:The percentage of postwash sperm motility, and not the postwash total motile sperm count, can predict successful intrauterine insemination outcome. Such information can be useful in counseling patients regarding their chance of success with intrauterine insemination and in determining when alternate methods of assisted reproduction may be a better approach.

male infertility intrauterine insemination sperm sperm motility total motile sperm count 

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REFERENCES

  1. 1.
    Campana A, Sakkas D, Stalberg A, Bianchi PG, Comte I, Pache T, Walker D: Intrauterine insemination: Evaluation of the results according to the women's age, sperm quality, total sperm count insemination and life table analysis. Hum Reprod 1996;11:732-736Google Scholar
  2. 2.
    Burr RW, Sieberg R, Flaherty, SP, Wang X, Matthews CD: The influence of sperm morphology and the number of motile sperm inseminated on the outcome of intrauterine insemination combined with mild ovarian stimulation. Fertil Steril 1996;65:127-132Google Scholar
  3. 3.
    Berg U, Brucker C, Berg FD: Effect of motile sperm count after swing-up on outcome of intrauterine insemination. Fertil Steril 1997;67:747-750Google Scholar
  4. 4.
    Van der Westerlaken LA, Naaktgeboren N, Helmerhorst FM: Evaluation of pregnancy rates after intrauterine insemination according to indication, age, and sperm parameters. J Assist Reprod Genet 1998;15:359-364Google Scholar
  5. 5.
    Horvath PM, Bohrer M, Shelden RM, Kemmann E: The relationship of sperm parameters to cycle fecundity in superovulated women undergoing intrauterine insemination. Fertil Steril 1989;52:2880-294Google Scholar
  6. 6.
    Dodson WC, Haney AF: Controlled ovarian hyperstimulation and intrauterine insemination for treatment of infertility. Fertil Steril 1991;55:457-467Google Scholar
  7. 7.
    Ho P, So W, Chan Y, Yeung WS: Intrauterine insemination after ovarian stimulation as a treatment for subfertility because of subnormal semen: A prospective randomized trial. Fertil Steril 1992;58:995-999Google Scholar
  8. 8.
    Brasch JG, Rawlins R, Tarchala S, Radwanska E: The relationship between total motile sperm count and the success of intrauterine insemination. Fertil Steril 1994;62:150-154Google Scholar
  9. 9.
    Huang H, Lee C, Lai Y, Chang M, Wang H, Chang S, Soong Y: The impact of the total motile sperm count on the success of intrauterine insemination with husband's spermatozoa. J Assist Reprod Genet 1996;13:56-63Google Scholar
  10. 10.
    DiMarzo SJ, Kennedy JF, Young PE, Hebert SA, Rosenberg DC, Villanueva B: Effect of controlled ovarian hyperstimulation on pregnancy rates after intrauterine insemination. Am J Obstet Gynecol 1992;166:1607-1613Google Scholar
  11. 11.
    Ombelet W, Cox A, Janssen M, Vandeput H, Bosmans E: Artificial insemination 2: using the husband's sperm. Human spermatozoa in assisted reproduction. In Human Spermatozoa in Assisted Reproduction, A Acosta, TF Kruger (eds). New York, Parthenon, 1996, pp 399-412Google Scholar
  12. 12.
    Cressman BE, Pace-Owens S, Pliego JF, Wincek TJ, Kuehl TJ: Effect of sperm dose on pregnancy rate from intrauterine insemination: A retrospective analysis. Tex Med 1996;92:74-79Google Scholar
  13. 13.
    Tomlinson MJ, Amissah-Arthur JB, Thompson KA, Kasraie JL, Bentick B: Prognostic indications for intrauterine insemination (IUI): Statistical model for IUI success. Hum Reprod 1996;11:1892-1896Google Scholar
  14. 14.
    Comhaire F, Milingos S, Liapi A, Gordts S, Campo R, Depypere, Dhont M, Schoonjans F: The effective cumulative pregnancy rate of different modes of treatment of male infertility. Andrologia 1995;27:217-221Google Scholar
  15. 15.
    Dodson WC: Is superovulation and intrauterine insemination really an alternative to assisted reproductive technology? Semin Reprod Endocrinol 1995;13:85-89Google Scholar
  16. 16.
    Keck C, Gerber-Schafer C, Wilhelm C, Vogelgesang D, Breckwoldt M: Intrauterine insemination for treatment of male infertility. Int J Androl 1997;20:55-64Google Scholar
  17. 17.
    Shekarriz M, Sharma RK, Thomas AJ Jr, Agarwal A: Positive myeloperoxidase staining (Endtz test) as indicator of excessive reactive oxygen species formation in semen. J Assist Reprod Genet 1995;12:70-74Google Scholar
  18. 18.
    Mortimer D, Templeton AA: Sperm transport in the human female reproductive tract in relation to semen analysis characteristics and time of ovulation. J Reprod Fert 1982;64:401-408Google Scholar
  19. 19.
    Shulman A, Hauser R, Lipitz S, Frenkel Y, Dor J, Bider D, Mashiach S, Yogev L, Yavetz H: Sperm motility is a major determinant of pregnancy outcome following intrauterine insemination. J Assist Reprod Genet 1998;15:381-385Google Scholar
  20. 20.
    Kerin J, Byrd W: Supracervical placement of spermatozoa: utility of intrauterine and tubal insemination. In Controversies in Reproductive Endocrinology and Infertility, MR Soules (eds). New York, Elsevier, 1989, pp 183-204Google Scholar
  21. 21.
    Tucker MJ, Wong CJY, Chang YM, Leong KH, Leung CKM: Intrauterine insemination as frontline treatment for non-tubal infertility. Asia Oceania. J Obstet Gynecol 1990;16:137-143Google Scholar
  22. 22.
    Byrd W: Processing human semen for insemination: Comparison of methods. In Evaluation and Treatment of the Infertile Male, GM Centola, KA Ginsburg (eds). New York, Cambridge University Press, 1996, pp 39-107Google Scholar
  23. 23.
    Centola GM: Successful treatment of severe oligozoospermia with sperm washing and intrauterine insemination. J Androl 1997;18:448-453Google Scholar
  24. 24.
    Arny M, Quagliarello J: Semen quality before and after processing by a swim-up method: Relationship to outcome of intrauterine insemination. Fertil Steril 1987;48:643-648Google Scholar
  25. 25.
    Dickey RP, Olar TT, Taylor SN, Curole DN, Rye PH, Matulich EM: Relationship of follicle number, serum estradiol, and other factors bo birth rate and multiparity in human menopausal gonadotropin-induced intrauterine insemination cycles. Fertil Steril 1991;56:89-92Google Scholar
  26. 26.
    Ombelet W, Puttemans P, Bosmans E: Intrauterine insemination: A first-step procedure in the algorithm of male subfertility treatment. Hum Reprod 1995;10:1090-1102Google Scholar
  27. 27.
    Aitken RJ, Clarkson JS: Cellular basis of defective sperm function and its association with the genesis of reactive oxygen species by human spermatozoa. J Reprod Fert 1987;81:459-469Google Scholar
  28. 28.
    Sharma RK, Agarwal A: Role of reactive oxygen species in male infertility. Urology 1996;48:835-850Google Scholar
  29. 29.
    Yovich JM, Edirisinghie WR, Cummins JM, Yovich JL: Influence of pentoxifylline in severe male factor infertility. Fertil Steril 1990;53:715-732Google Scholar
  30. 30.
    Brennan AP, Holden CA: Pentoxifylline-supplemented cryoprotectant improves human sperm motility after cryopreservation. Hum Reprod 1995; 10:2308-2312Google Scholar
  31. 31.
    Sandro CE, Sharma RK, Thomas AJ, Agarwal A: Cryopreservation of human spermatozoa with pentoxifylline improves the post-thaw agonist-induced acrosome reaction rate. Hum Reprod 1998;13:3384-3389Google Scholar
  32. 32.
    Ombelet W, Vandeput H, Putte GV, Cox A, Janssen M, Jacobs P, Bosmans E, Steeno O, Kruger T: Intrauterine insemination after ovarian stimulation with clomiphene citrate: Predictive potential of inseminating motile count and sperm morphology. Hum Reprod 1997;12:1458-1463Google Scholar
  33. 33.
    Francavilla F, Romano R, Santucci R, Poccia G: Effect of sperm morphology and motile sperm count on outcome of intrauterine insemination in oligozoospemia and/or asthenozoospermia. Fertil Steril 1990;53:892-897Google Scholar

Copyright information

© Plenum Publishing Corporation 1999

Authors and Affiliations

  • Eleonora B. Pasqualotto
    • 1
  • James A. Daitch
    • 1
  • Benjamin N. Hendin
    • 2
  • Tommaso Falcone
    • 1
  • Anthony J. ThomasJr.
    • 1
  • David R. Nelson
    • 2
  • Ashok Agarwal
    • 1
  1. 1.Center for Advanced Research in Human Reproduction and Infertility, The Cleveland Clinic Foundation, Cleveland, Ohio. Department of Gynecology–Obstetrics, The Cleveland Clinic FoundationCleveland
  2. 2.Department of UrologyThe Cleveland Clinic FoundationCleveland

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