Sperm motility is a major determinant of pregnancy outcome following intrauterine insemination.
OBJECTIVE
Our purpose was to assess whether one or more sperm parameters have predictive value for the outcome of intrauterine insemination treatment.


METHODS
Infertile couples whose normoovulatory and normomechanical female partners underwent superovulation and intrauterine insemination were investigated. The semen profile of the male partner was discounted. In 160 couples, 544 cycles were obtained, resulting in 59 ongoing pregnancies (10.84%/cycle, 36.87%/patient).


RESULTS
The only parameter found to be significantly correlated with a positive outcome was the degree of sperm motility following preparation for intrauterine insemination. Close to half (47.5%) of the couples with a very good or an excellent degree of sperm motility conceived, whereas only 8.3% of those patients who had poor or fair sperm motility conceived. None of the semen characteristics, such as volume, count, percentage motility, or percentage normal morphology, were found to correlate with cycle outcome. Although there was a progressive increase in the pregnancy rate with an increase in the total number of motile sperm inseminated, it did not reach significance. Seventy percent of the pregnancies were achieved within a maximum of three treatment cycles. The spermatogram is not accurate enough as a prognostic factor for treatment outcome.


CONCLUSIONS
The degree of sperm motility, after appropriate preparation for intrauterine insemination, is the only parameter to be correlated with treatment outcome. For couples with a normal female partner, we suggest a maximum of three treatment cycles of induction of ovulation and intrauterine insemination, whenever good progressive motile sperm is obtained after suitable preparation. For cases with poor sperm progression, we suggest appropriate couple counseling and that an alternative assisted reproduction procedure be taken into consideration.
Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
A
A
Shulman
R
R
Hauser
S
S
Lipitz
Y
Y
Frenkel
J
J
Dor
D
D
Bider
S
S
Mashiach
L
L
Yogev
H
H
Yavetz
D000328:Adult; D006063:Chorionic Gonadotropin / Q000494:pharmacology / Q000627:therapeutic use; D002996:Clomiphene / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D005300:Fertility Agents, Female / Q000494:pharmacology / Q000627:therapeutic use; D005640:Follicle Stimulating Hormone / Q000032:analysis; D006801:Humans; D007248:Infertility, Male / Q000628:therapy*; D007317:Insemination, Artificial, Homologous; D007986:Luteinizing Hormone / Q000032:analysis; D008297:Male; D015999:Multivariate Analysis; D010062:Ovulation Induction / Q000379:methods; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D012189:Retrospective Studies; D012661:Semen / Q000166:cytology / Q000502:physiology; D013076:Sperm Count; D013081:Sperm Motility / Q000502:physiology*; D018709:Statistics, Nonparametric
D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D002996:Clomiphene; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone