title: Intrauterine insemination with frozen donor sperm: a prospective randomized trial comparing three different sperm preparation techniques.
abstract: OBJECTIVE
  To compare the pregnancy rates (PRs) after intrauterine insemination (IUI) with frozen-thawed donor sperm. Sperm were isolated after thawing using three different sperm preparation techniques: simple washing, Percoll density gradient, and Sephadex columns (SpermPrep Column; Fertility Technologies, Natick, MA).
  
  
  METHODS
  Women (n = 98) were randomized upon entry into the program into one of three different sperm preparation methods. The same sperm preparation technique was used for the woman during subsequent cycles, if pregnancy did not occur. The study was stopped when > or = 75 treatment cycles for each group were completed for analysis of PRs per treatment cycle.
  
  
  METHODS
  All patients were treated at our private care center at the University of Texas Southwestern Medical Center.
  
  
  METHODS
  Patients entering this study were spontaneously ovulating women undergoing IUI with frozen donor sperm.
  
  
  METHODS
  Pregnancy rate per cycle of timed IUI.
  
  
  RESULTS
  After 260 cycles of insemination, the PR per cycle was 19.1% with simple washing, 16.9% with Sephadex columns, and 11.4% with Percoll density gradient. Although these results were not statistically different, Percoll density gradient had a 40% lower PR per treatment cycle compared with simple washing. However, Percoll density gradient preparation of sperm resulted in a statistically significant increase in the motility, curvilinear velocity, straight line velocity, and the number of normal heads compared with the other two treatments.
  
  
  CONCLUSIONS
  Although Percoll density gradient separation of sperm results in a population of cells that is more motile and morphologically normal, this did not result in subsequent cycle fecundity. These data suggest that the reliance on the averaged values of motility, curvilinear velocity, straight line velocity and morphology may have little predictive value of the potential fertility of frozen-thawed sperm.
authors.affiliation: Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas 75205-9032.
authors.forename: W
authors.initials: W
authors.lastname: Byrd
authors.forename: E Z
authors.initials: EZ
authors.lastname: Drobnis
authors.forename: W H
authors.initials: WH
authors.lastname: Kutteh
authors.forename: P
authors.initials: P
authors.lastname: Marshburn
authors.forename: B R
authors.initials: BR
authors.lastname: Carr
mesh_terms: D000328:Adult; D015925:Cryopreservation; D005260:Female; D006801:Humans; D007316:Insemination, Artificial, Heterologous; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies; D013048:Specimen Handling / Q000379:methods*; D013094:Spermatozoa