Influence of semen quality on the success of intrauterineinsemination result in a university teaching hospital infertility center

Abstract

Introduction: Intrauterine insemination is effective for the treatment of male factor and unexplained infertility. The objective of the study was to understand whether one or more parameters of sperm quality i.e. morphology, motility and concentration have predictive value for the pregnancy outcome of the intrauterine insemination treatment for couple with primary infertility with male factor or unknown cause in the select defined population.

Methods: This is a hospital based prospective study of 776 IUI cycles. The study population was those couples between 19-35 years of age who had been trying unsuccessfully to conceive for a minimum of one year. They were randomly distributed into two groups; partner with sperm morphology, motility and concentration below 5^th percentile constituted group A and group B comprised of those with above 5^th percentile and their IUI outcome was evaluated.

Results: A total of 776 IUI cycles were studied out of which 94 clinical pregnancies were obtained, for a pregnancy rate cycle of 12.1%. The study shows that sperm morphology is positively associated with IUI results with statistically significant p value (p=0.034). Likewise, a higher total motility level is positively associated with IUI results. Moreover, incidence of positive IUI results were significantly more with post processing motility with excellent progression >90% with statistically significance p value (P=0.004).

Conclusion: Combination of superovulation and intrauterine insemination is an effective means of achieving pregnancy for unexplained and male factor infertility. The probability of pregnancy increases with higher normal morphology, total motile sperms with excellent progression and sperm concentration. If semen parameters are below the 5^th percentile value, IVF-ICSI would be preferred.