Lemmens Louise, Kos Snjezana, Beijer Cornelis, Brinkman Jacoline W, van der Horst Frans A L, van den Hoven Leonie, Kieslinger Dorit C, van Trooyen-van Vrouwerff Netty J, Wolthuis Albert, Hendriks Jan C M, Wetzels Alex M M
Fertility Laboratory, Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, the Netherlands.
Department of Clinical Chemistry, Maasstad Hospital, Rotterdam, the Netherlands.
Fertil Steril. 2016 Jun;105(6):1462-8. doi: 10.1016/j.fertnstert.2016.02.012. Epub 2016 Mar 2.
To investigate the value of sperm parameters to predict an ongoing pregnancy outcome in couples treated with intrauterine insemination (IUI), during a methodologically stable period of time.
Retrospective, observational study with logistic regression analyses.
University hospital.
PATIENT(S): A total of 1,166 couples visiting the fertility laboratory for their first IUI episode, including 4,251 IUI cycles.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): Sperm morphology, total progressively motile sperm count (TPMSC), and number of inseminated progressively motile spermatozoa (NIPMS); odds ratios (ORs) of the sperm parameters after the first IUI cycle and the first finished IUI episode; discriminatory accuracy of the multivariable model.
RESULT(S): None of the sperm parameters was of predictive value for pregnancy after the first IUI cycle. In the first finished IUI episode, a positive relationship was found for ≤4% of morphologically normal spermatozoa (OR 1.39) and a moderate NIPMS (5-10 million; OR 1.73). Low NIPMS showed a negative relation (≤1 million; OR 0.42). The TPMSC had no predictive value. The multivariable model (i.e., sperm morphology, NIPMS, female age, male age, and the number of cycles in the episode) had a moderate discriminatory accuracy (area under the curve 0.73).
CONCLUSION(S): Intrauterine insemination is especially relevant for couples with moderate male factor infertility (sperm morphology ≤4%, NIPMS 5-10 million). In the multivariable model, however, the predictive power of these sperm parameters is rather low.
在方法学稳定的时间段内，研究精子参数对接受宫腔内人工授精（IUI）治疗的夫妇持续妊娠结局的预测价值。
采用逻辑回归分析的回顾性观察性研究。
大学医院。
共有1166对夫妇首次到生育实验室接受IUI治疗，包括4251个IUI周期。
无。
精子形态、总渐进性运动精子计数（TPMSC）和授精的渐进性运动精子数量（NIPMS）；第一个IUI周期和第一个完成的IUI疗程后精子参数的优势比（OR）；多变量模型的判别准确性。
在第一个IUI周期后，没有精子参数对妊娠具有预测价值。在第一个完成的IUI疗程中，发现形态正常精子≤4%（OR 1.39）和中等NIPMS（500 - 1000万；OR 1.73）呈正相关。低NIPMS呈负相关（≤100万；OR 0.42）。TPMSC没有预测价值。多变量模型（即精子形态、NIPMS、女性年龄、男性年龄和疗程中的周期数）具有中等判别准确性（曲线下面积0.73）。
宫腔内人工授精对中度男性因素不育夫妇（精子形态≤4%，NIPMS 500 - 1000万）尤其重要。然而，在多变量模型中，这些精子参数的预测能力相当低。
