Author(s): Badawy A, Elnashar A, Eltotongy M
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Abstract OBJECTIVE: To assess the effects of the number of motile spermatozoa inseminated and percentage of morphologically normal spermatozoa on the success of IUI. DESIGN: A prospective observational study. SETTING: University teaching hospital and private practice setting. PATIENT(S): The study comprised 393 couples who underwent 714 IUI cycles. INTERVENTION(S): All IUI cycles were preceded by ovarian superovulation with clomiphene citrate 50 mg tablets orally twice daily for 5 days starting on the second day of menses and one hMG ampule 75 IU IM daily for 5 days starting day 5 of the cycle. Cycles were monitored by transvaginal ultrasound. The IUI was performed with a catheter 36 +/- 4 hours after hCG injection. MAIN OUTCOME MEASURE(S): Clinical pregnancy. RESULT(S): A total of 79 clinical pregnancies were obtained, for a pregnancy rate per cycle of 11.06\%. The pregnancy rate per cycle was 5.55\% when the number of motile spermatozoa was <5 x 10(6) and 24.28\% with normal motile sperm >5 x 10(6). For patients <25 years old, with number of motile spermatozoa >5 x 10(6), the pregnancy rate per cycle was 28.2\%, which is significantly higher than that of other age groups. Above the age of 35 years, no pregnancies were reported with number of motile spermatozoa <5 x 10(6), and the pregnancy rate was very low (0.84\%) with number of motile spermatozoa >5 x 10(6). When the normal sperm morphology was >30\% and number of motile spermatozoa inseminated >5 x 10(6), the pregnancy rate was 20.77\%. CONCLUSION(S): Intrauterine insemination used for treating male factor infertility has little chance of success when the woman is older than 35 years, the number of motile spermatozoa inseminated is <5 x 10(6), or normal sperm morphology is <30\%.
This article was published in Fertil Steril
and referenced in Andrology-Open Access