Sperm morphology from the actual inseminated sample does not predict clinical pregnancy following intrauterine insemination

Andrology

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VOLUME 2, ISSUE 1, P16-21, MARCH 01, 2021

Authors:

Jamie Stanhiser, M.D., M.S.C.R., Jennifer E. Mersereau, M.D., M.S.C.I., Daquan Dock, B.S., Caitlin Boylan, B.S., Hunter Caprell, B.S., R. Matthew Coward, M.D., Dara S. Berger, Ph.D., Marc Fritz, M.D.

Abstract:

Objective

To determine the effect of sperm morphology from the specific sample used for intrauterine insemination (IUI) on clinical pregnancy rates (CPR).


Design

Prospective cohort study.


Setting

Academic fertility clinic.


Patient(s)

Couples undergoing IUI July 2016–January 2017.


Intervention(s)

Morphology slides were prepared from the semen sample produced for IUI.


Main Outcome Measure(s)

CPR was measured by detection of cardiac activity. Multiple logistic regression modeling was performed to determine the association of sperm morphology with CPR, controlling for age, antimüllerian hormone level, and post-wash total motile sperm count.


Result(s)

Semen analyses, including Kruger strict criteria for morphology from the actual sample inseminated, were reviewed for 155 couples, comprising 234 total treatment cycles. The percent normal morphology significantly differed between the preliminary semen analysis and the IUI sample (−2.0% +3.7% (95% CI −2.55, −1.53). Of the total 234 treatment cycles, 8.6% resulted in clinical pregnancy. When categorized by strict morphology >4%, <4%, and <1%, the CPR was 6.6%, 9.8%, and 10.9%, respectively. In couples with otherwise normal semen parameters (isolated teratospermia), CPR by >4%, <4%, and <1% normal forms was 7.2%, 9.8%, and 11.1%, respectively. There was no significant association between the percent normal morphology and CPR in multivariate analysis.


Conclusion(s)

This study evaluating the morphology of the actual inseminated sample did not find differences in CPR following IUI among couples with normal and abnormal sperm morphology, including severe teratospermia. Abnormal sperm morphology should not exclude couples from attempting IUI.

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. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.