title: Impact of sperm morphology on the likelihood of pregnancy after intrauterine insemination.
abstract: OBJECTIVE
  To determine whether there is a difference in ongoing pregnancy rates (PRs) between patients undergoing IUI with strict sperm morphology ≤4% compared with >4% on initial semen analysis.
  
  
  METHODS
  Retrospective chart review with multivariate analysis.
  
  
  METHODS
  Academic outpatient reproductive center.
  
  
  METHODS
  A total of 408 couples with male and/or female factor infertility and known strict sperm morphology (SSM).
  
  
  METHODS
  A total of 856 IUIs with partner's sperm (IUI-P).
  
  
  METHODS
  Ongoing PRs based on ultrasound documentation of intrauterine pregnancy with fetal heart tones.
  
  
  RESULTS
  There is no statistically significant difference in per cycle PRs when comparing patients with a strict sperm morphology of ≤4% versus >4% who undergo IUI-P (17.3% vs. 16.7%; odds ratio 0.954, 95% confidence interval 0.66-1.37). Multiple potential confounding factors were assessed using multivariate analysis.
  
  
  CONCLUSIONS
  Strict sperm morphology ≤4% is not associated with lower PRs in couples undergoing IUI-P, and thus should not be the sole reason for advancing to IVF.
authors.affiliation: Department of Obstetrics and Gynecology, Froedtert Medical College Lab Building, Medical College of Wisconsin, Milwaukee, Wisconsin. Electronic address: ndeveneau@gmail.com.
authors.forename: Nicolette E
authors.initials: NE
authors.lastname: Deveneau
authors.affiliation: Department of Obstetrics and Gynecology, Froedtert Medical College Lab Building, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Omar
authors.initials: O
authors.lastname: Sinno
authors.affiliation: Department of Urology, Froedtert Medical College Lab Building, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Miriam
authors.initials: M
authors.lastname: Krause
authors.affiliation: Division of Biostatistics, Medical College of Wisconsin, Biostatistics Consulting Service, Milwaukee, Wisconsin.
authors.forename: Daniel
authors.initials: D
authors.lastname: Eastwood
authors.affiliation: Department of Obstetrics, Gynecology and Women's Health, University of Louisville, School of Medicine, Louisville, Kentucky.
authors.forename: Jay I
authors.initials: JI
authors.lastname: Sandlow
authors.affiliation: Department of Obstetrics and Gynecology, Froedtert Medical College Lab Building, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Paul
authors.initials: P
authors.lastname: Robb
authors.affiliation: Department of Obstetrics and Gynecology, Froedtert Medical College Lab Building, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Amy
authors.initials: A
authors.lastname: Granlund
authors.affiliation: Department of Obstetrics and Gynecology, Froedtert Medical College Lab Building, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Estil Y
authors.initials: EY
authors.lastname: Strawn
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007248:Infertility, Male / Q000209:etiology; D007314:Insemination; D007317:Insemination, Artificial, Homologous; D008297:Male; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D013094:Spermatozoa / Q000166:cytology*; D014646:Varicocele / Q000150:complications
keywords: Intrauterine insemination; pregnancy rate; strict sperm morphology