title: Can hyaluronan binding assay predict the outcome of intrauterine insemination in couples with unexplained or mild male factor infertility?
abstract: BACKGROUND
  The purpose of this study was to evaluate the prognostic effect of Hyaluronan Binding Assay (HBA) which has been used as a method of sperm selection for intracytoplasmic sperm injection procedure, on the outcome of intrauterine insemination (IUI) in couples with unexplained or mild male factor infertility.
  
  
  METHODS
  77 infertile couples were enrolled in our study. On the day of IUI procedure, HBA test was performed by using fresh semen samples, and the rates of sperm binding to HBA were calculated. HBA values and semen parameters were compared. Fisher exact test was used to evaluate the relationship between HBA ratio and pregnancy status. Mann-Whitney U test was used to compare quantitative variables between pregnant and non-pregnant groups. The p < 0.05 was considered statistically significant.
  
  
  RESULTS
  In this study, HBA ratio was 69(29.25%) and pregnancy rate was 14.29%. A significant positive correlation between HBA and total motile sperm count, inseminating sperm count, progressive motility, morphology, and sperm concentration (p < 0.001, p < 0.001, p:0.007, p < 0.003, p:0.003 respectively) was observed. Although HBA values in pregnant group were higher than those in non-pregnant group, this result did not reach the statistically significant level (HBA: 67(20%) for non-pregnant group, 80.5(21.3%) for pregnant group). Also, no relationship between HBA values and pregnancy status was found. Moreover, there was no significant correlation between pregnancy status and HBA ratios based on the suggested cut-off value of 60 in literature (p = 0.425).
  
  
  CONCLUSIONS
  HBA does not predict the IUI outcome in couples with unexplained infertility or mild male factor infertility, but it can be used together with semen parameters to verify sperm quality.
authors.affiliation: Ankara Ataturk Training and Research Hospital, Department of Obstretrics and Gynecology, Bilkent, Ankara, Turkey.
authors.forename: Melahat
authors.initials: M
authors.lastname: Yildirim
authors.affiliation: Turgut Ozal University Hospital, Department of Obstretrics and Gynecology, Ankara, Turkey.
authors.forename: Candan Iltemir
authors.initials: CI
authors.lastname: Duvan
authors.affiliation: Turgut Ozal University Hospital, Department of Obstretrics and Gynecology, Ankara, Turkey.
authors.forename: Aslihan
authors.initials: A
authors.lastname: Pekel
authors.affiliation: Turgut Ozal University Hospital, Department of Obstretrics and Gynecology, Ankara, Turkey.
authors.forename: Aylin
authors.initials: A
authors.lastname: Ayrim
authors.affiliation: Gazi University School of Medicine, Department of Obstretrics and Gynecology, Ankara, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Kafali
keywords: Hyaluronan binding assay; Intrauterine insemination; Mild male factor infertility; Prediction; Unexplained infertility