title: Predictive value of sperm morphology and progressively motile sperm count for pregnancy outcomes in intrauterine insemination.
abstract: OBJECTIVE
  To investigate the value of sperm parameters to predict an ongoing pregnancy outcome in couples treated with intrauterine insemination (IUI), during a methodologically stable period of time.
  
  
  METHODS
  Retrospective, observational study with logistic regression analyses.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  A total of 1,166 couples visiting the fertility laboratory for their first IUI episode, including 4,251 IUI cycles.
  
  
  METHODS
  None.
  
  
  METHODS
  Sperm morphology, total progressively motile sperm count (TPMSC), and number of inseminated progressively motile spermatozoa (NIPMS); odds ratios (ORs) of the sperm parameters after the first IUI cycle and the first finished IUI episode; discriminatory accuracy of the multivariable model.
  
  
  RESULTS
  None of the sperm parameters was of predictive value for pregnancy after the first IUI cycle. In the first finished IUI episode, a positive relationship was found for ≤4% of morphologically normal spermatozoa (OR 1.39) and a moderate NIPMS (5-10 million; OR 1.73). Low NIPMS showed a negative relation (≤1 million; OR 0.42). The TPMSC had no predictive value. The multivariable model (i.e., sperm morphology, NIPMS, female age, male age, and the number of cycles in the episode) had a moderate discriminatory accuracy (area under the curve 0.73).
  
  
  CONCLUSIONS
  Intrauterine insemination is especially relevant for couples with moderate male factor infertility (sperm morphology ≤4%, NIPMS 5-10 million). In the multivariable model, however, the predictive power of these sperm parameters is rather low.
authors.affiliation: Fertility Laboratory, Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, the Netherlands. Electronic address: louise.lemmens@radboudumc.nl.
authors.forename: Louise
authors.initials: L
authors.lastname: Lemmens
authors.affiliation: Department of Clinical Chemistry, Maasstad Hospital, Rotterdam, the Netherlands.
authors.forename: Snjezana
authors.initials: S
authors.lastname: Kos
authors.affiliation: Department of Clinical Chemistry, Atalmedial, Medical Diagnostic Centre, Amsterdam, the Netherlands.
authors.forename: Cornelis
authors.initials: C
authors.lastname: Beijer
authors.affiliation: Department of Clinical Chemistry, Sint Jansdal Hospital, Harderwijk, the Netherlands.
authors.forename: Jacoline W
authors.initials: JW
authors.lastname: Brinkman
authors.affiliation: Department of Clinical Chemistry, Reinier de Graaf Groep, Delft, the Netherlands.
authors.forename: Frans A L
authors.initials: FA
authors.lastname: van der Horst
authors.affiliation: Fertility Laboratory, Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Leonie
authors.initials: L
authors.lastname: van den Hoven
authors.affiliation: IVF Center, Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, the Netherlands.
authors.forename: Dorit C
authors.initials: DC
authors.lastname: Kieslinger
authors.affiliation: Department of Clinical Chemistry, Sint Antonius Hospital, Nieuwegein, the Netherlands.
authors.forename: Netty J
authors.initials: NJ
authors.lastname: van Trooyen-van Vrouwerff
authors.affiliation: Department of Clinical Chemistry, Medical Centre Leeuwarden, Leeuwarden, the Netherlands.
authors.forename: Albert
authors.initials: A
authors.lastname: Wolthuis
authors.affiliation: Department for Health Evidence, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Jan C M
authors.initials: JC
authors.lastname: Hendriks
authors.affiliation: Fertility Laboratory, Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Alex M M
authors.initials: AM
authors.lastname: Wetzels
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007248:Infertility, Male / Q000175:diagnosis / Q000628:therapy*; D007315:Insemination, Artificial / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D012189:Retrospective Studies; D013076:Sperm Count / Q000379:methods*; D013081:Sperm Motility / Q000502:physiology*; D013094:Spermatozoa / Q000473:pathology / Q000502:physiology*; D055815:Young Adult
keywords: IUI; Intrauterine insemination; prognostic value; semen analysis