Effect of sperm morphology and number on success of intrauterine insemination

Fertil Steril. 2009 Mar;91(3):777-81. doi: 10.1016/j.fertnstert.2007.12.010. Epub 2008 Mar 4.

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%.

Publication types

  • Retracted Publication

MeSH terms

  • Adult
  • Age Factors
  • Cell Shape
  • Chorionic Gonadotropin / administration & dosage
  • Clomiphene / administration & dosage
  • Female
  • Fertility Agents, Female / administration & dosage
  • Humans
  • Infertility, Male / pathology
  • Infertility, Male / therapy*
  • Insemination, Artificial*
  • Male
  • Ovulation Induction / methods
  • Pregnancy
  • Pregnancy Rate*
  • Prospective Studies
  • Sperm Count
  • Sperm Motility
  • Spermatozoa / pathology*
  • Treatment Outcome
  • Young Adult

Substances

  • Chorionic Gonadotropin
  • Fertility Agents, Female
  • Clomiphene