Postwash total motile sperm count and intrauterine insemination pregnancy rate: how low can you go?

Reflections

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VOLUME 115, ISSUE 6, P1424-1425

Authors:

Phillip A. Romanski, M.D., Hey-Joo Kang, M.D.

Abstract:

Reflections on "Clarifying the relationship between total motile sperm counts and intrauterine insemination pregnancy rates. Fertil Steril 2021" by Muthigi et al.

Read the full text here. 

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. 

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Go to the profile of Pandiyan  Natarajan
5 months ago

Post wash spermatozoa concentration and pregnancy rates: 

Post wash spermatozoa parameters do play a role in the sucess of the Intra UterineInsemination program. Spermatozoa wash only improves the motility and not the morphology. But it is just one of the parameters. Woman's age, number of follicles and duration of infertility are other critical determinants.

It is most likely that good spermatozoa can be obtained post wash in almost all men with Normozoospermia. In other men, particularly those with severe Oligozoospermia, it may certainly be worthwhile doing a, 'Trial swim up,' before counseling and recruiting these patients for IUI. This has been our practice.

In our practice, the probability of a pregnancy is quite low when the motile spermatozoa injected is less than 1 million. However, on the day of insemination, if the prepared sample is poor and has only occasional motile spermatozoa, it would still be worthwhile injecting those  few spermatozoa than canceling the cycle. After all you need only one spermatozoa; but the couple need to be counseled to move onto ICSI. 

In patients with varying semen sample, it may be prudent to cryopreserve a good sample.

Professor Dr Pandiyan Natarajan,

Chettinad Academy of Research and Education,

Chettinad Super Speciality Hospital.

Chennai, Tamil Nadu, India-603103.