Louise Lemmens1, Snjezana Kos2, Cornelis Beijer3, Jacoline W Brinkman4, Frans A L van der Horst5, Leonie van den Hoven6, Dorit C Kieslinger7, Netty J van Trooyen-van Vrouwerff8, Albert Wolthuis9, Jan C M Hendriks10, Alex M M Wetzels6. 1. Fertility Laboratory, Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, the Netherlands. Electronic address: louise.lemmens@radboudumc.nl. 2. Department of Clinical Chemistry, Maasstad Hospital, Rotterdam, the Netherlands. 3. Department of Clinical Chemistry, Atalmedial, Medical Diagnostic Centre, Amsterdam, the Netherlands. 4. Department of Clinical Chemistry, Sint Jansdal Hospital, Harderwijk, the Netherlands. 5. Department of Clinical Chemistry, Reinier de Graaf Groep, Delft, the Netherlands. 6. Fertility Laboratory, Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, the Netherlands. 7. IVF Center, Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, the Netherlands. 8. Department of Clinical Chemistry, Sint Antonius Hospital, Nieuwegein, the Netherlands. 9. Department of Clinical Chemistry, Medical Centre Leeuwarden, Leeuwarden, the Netherlands. 10. Department for Health Evidence, Radboud University Medical Center, Nijmegen, the Netherlands.
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. DESIGN: Retrospective, observational study with logistic regression analyses. SETTING: University hospital. PATIENT(S): A total of 1,166 couples visiting the fertility laboratory for their first IUI episode, including 4,251 IUI cycles. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): 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. RESULT(S): 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). CONCLUSION(S): 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.
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. DESIGN: Retrospective, observational study with logistic regression analyses. SETTING: University hospital. PATIENT(S): A total of 1,166 couples visiting the fertility laboratory for their first IUI episode, including 4,251 IUI cycles. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): 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. RESULT(S): 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). CONCLUSION(S): 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: U Punjabi; H Van Mulders; L Van de Velde; I Goovaerts; K Peeters; W Cassauwers; T Lyubetska; K Clasen; P Janssens; O Zemtsova; E Roelant; D De Neubourg Journal: J Assist Reprod Genet Date: 2021-01-05 Impact factor: 3.412
Authors: Jamie Stanhiser; Jennifer E Mersereau; Daquan Dock; Caitlin Boylan; Hunter Caprell; R Matthew Coward; Dara S Berger; Marc Fritz Journal: F S Rep Date: 2020-12-09