The impact of sperm morphology evaluated by strict criteria on intrauterine insemination success.
OBJECTIVE
To determine the relationship between IUI success and the level of morphologically normal sperm, evaluated using strict criteria, in the raw semen.


METHODS
Evaluation of semen quality characteristics and pregnancy results for 538 stimulated IUI cycles.


METHODS
University medical center infertility clinic.


METHODS
Women undergoing IUI with their partner's semen as treatment for infertility (n = 193).


METHODS
Ovulation induction using clomiphene citrate, hMG, or both; preparation of raw semen using wash and swim-up or Percoll; deposition of prepared semen at the uterine fundus.


METHODS
Pregnancy status after IUI. Percentage morphologically normal sperm in raw semen, evaluated using strict criteria. Sperm concentration and percentage motile sperm in raw and prepared semen.


RESULTS
Pregnancy rates (PRs) per cycle were not different when the percentage of morphologically normal sperm in raw semen was < 5%, 5% to 9%, 10% to 19%, 20% to 29%, and > or = 30% (6.5% +/- 3.9%, 13.6% +/- 3.2%, 8.8% +/- 2.4%, 7.1% +/- 2.5%, and 9.7% +/- 3.3%, respectively). Pregnancy rates did not differ among age groups, infertility diagnoses, ovarian stimulation protocols, or semen preparation methods.


CONCLUSIONS
The percentage of morphologically normal sperm in the raw semen, as judged by strict criteria, did not affect IUI PR. Intrauterine insemination appears to be a successful treatment modality for male factor infertility, even when the percentage of morphologically normal sperm in raw semen is very low.
Karabinus
D S
DS
University of Arizona Health Sciences Center College of Medicine, Department of Obstetrics and Gynecology, Tucson 85724, USA.
Gelety
T J
TJ
D000328:Adult; D002996:Clomiphene / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007317:Insemination, Artificial, Homologous / Q000379:methods*; D016018:Least-Squares Analysis; D008297:Male; D008596:Menotropins / Q000627:therapeutic use; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D012189:Retrospective Studies; D012661:Semen; D013076:Sperm Count; D013081:Sperm Motility; D013094:Spermatozoa / Q000002:abnormalities / Q000166:cytology* / Q000502:physiology; D016896:Treatment Outcome; D014599:Uterus
D002996:Clomiphene; D008596:Menotropins