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Advanced semen analysis: a simple screening test to predict intrauterine insemination success

1999; Elsevier BV; Volume: 71; Issue: 3 Linguagem: Inglês

10.1016/s0015-0282(98)00503-2

1556-5653

Emmett F Branigan, Mark Estes, Charles Müller,

Reproductive Health and Technologies

To determine if a simple screening test of sperm recovery through a density gradient preparation and sperm survival after a 24-hour incubation is predictive of IUI success.Prospective nonrandomized descriptive study.Tertiary assisted reproductive technology center.Four hundred fourteen couples undergoing IUI for male factor and unexplained infertility.An advanced semen analysis, which consisted of a basic semen analysis, sperm processing through a density gradient preparation, and a 24-hour sperm incubation, was performed on all couples before beginning IUIs.Cumulative and per cycle pregnancy rates (PRs) were calculated for routine semen parameters, number of sperm processed through density gradient, and percent motile sperm after a 24-hour incubation.None of the basic semen analysis parameters accurately predicted IUI success. When the processed total motile sperm available for insemination was > or = 10 x 10(6) and their 24-hour survival was > or = 70%, 89% (162 of 182) of couples achieved a pregnancy with a 21.4% (162 of 757) per cycle PR compared to a 2.8% (11 of 403) per cycle PR and 4.7% total PR when survival was <70%. With use of these cutoff values for the advanced semen analysis, the test had a sensitivity of 94% and specificity of 86%.The number of motile sperm available for insemination and especially their 24-hour survival are highly predictive of IUI success. This advanced semen analysis is an excellent screening test to evaluate couples considering IUI.