Use of the total motile sperm count to predict total fertilization failure in in vitro fertilization.
OBJECTIVE
To evaluate the capacity of baseline characteristics and total motile sperm count (TMC) to predict total fertilization failure (TFF) in patients undergoing IVF.


METHODS
Retrospective cohort study.


METHODS
University hospital.


METHODS
Eight hundred ninety-two couples with a total of 1,569 consecutive IVF cycles.


METHODS
Prewash and postwash TMC during fertility workup and at the time of ovum pickup (OPU).


METHODS
Analysis of logistic regression and the receiver operating characteristic curve were used to determine which variables could be used to predict TFF.


RESULTS
The area under the curve (AUC) for prewash TMC during fertility workup was 0.72, similar to a combination of pre- and postwash TMC. At the time of OPU, both pre- and postwash TMC had an AUC of 0.73. A model based on selected baseline characteristics (male age, number of IVF cycles, indication for IVF, and prewash TMC during fertility workup) had an AUC of 0.75. A model at the time of OPU, including the number of oocytes, had an AUC of 0.80.


CONCLUSIONS
The use of both models, one before start of the IVF cycle and one at the time of OPU, allows an accurate prediction of the chance of TFF and is useful in counseling patients on whether to opt for IVF or ICSI.
Repping
Sjoerd
S
Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands. s.repping@amc.uva.nl
van Weert
Janne-Meije
JM
Mol
Ben W J
BW
de Vries
Jan W A
JW
van der Veen
Fulco
F
D000328:Adult; D015331:Cohort Studies; D005260:Female; D005307:Fertilization in Vitro; D005544:Forecasting; D006801:Humans; D008297:Male; D008954:Models, Biological; D012372:ROC Curve; D012044:Regression Analysis; D012189:Retrospective Studies; D013076:Sperm Count; D013081:Sperm Motility; D017211:Treatment Failure