Madbouly Khaled, Isa Ahmed, Habous Mohamad, Almannie Raed, Abu-Rafea Basim, Binsaleh Saleh
Department of Urology, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia.
Can J Urol. 2017 Jun;24(3):8847-8852.
Pregnancy rates after intrauterine insemination (IUI) varies greatly. We aimed to identify pre and post processing semen analysis parameters that may be predictive of successful pregnancy in couples undergoing IUI.
A retrospective study of the records of all couples underwent IUI for a 2 year period at our infertility center. Different characteristics of female subjects, pre and post processing semen parameters and treatment parameters were compared statistically.
Thirty-two clinical pregnancies followed 526 IUI cycles in 294 couples, for a clinical pregnancy rate of 6.1% per cycle and a 10.9% per couple. The mean age of the women at IUI was 31.14 ± 6 years (range 19-45 years). Neither maternal age, body mass index, number of mature follicles, maximum day 3 follicle stimulating hormone level, presence or absence of previous children, number of previous miscarriages, nor prewash semen parameters had any impact on pregnancy rate post IUI. Postwash total motile sperm count (TMSC) (p = .027) and number of cycles (p = .042) were independent predictors of successful pregnancy after IUI.
A postwash TMSC of 5 million sperm or more is significantly associated with a high pregnancy rate. After ruling out medically or surgically correctable male factors that may contribute to infertility, we recommend including a pretreatment sperm processing during routine male fertility work up for proper patient counseling and direction to the suitable assisted reproduction technique.
宫腔内人工授精（IUI）后的妊娠率差异很大。我们旨在确定处理前和处理后的精液分析参数，这些参数可能预测接受IUI的夫妇成功妊娠。
对在我们不孕不育中心接受2年IUI治疗的所有夫妇的记录进行回顾性研究。对女性受试者的不同特征、处理前和处理后的精液参数以及治疗参数进行统计学比较。
294对夫妇进行了526个IUI周期，有32例临床妊娠，临床妊娠率为每个周期6.1%，每对夫妇为10.9%。接受IUI时女性的平均年龄为31.14±6岁（范围19 - 45岁）。产妇年龄、体重指数、成熟卵泡数量、第3天最大促卵泡激素水平、有无子女、既往流产次数以及洗涤前精液参数均对IUI后的妊娠率无任何影响。洗涤后总活动精子计数（TMSC）（p = 0.027）和周期数（p = 0.042）是IUI后成功妊娠的独立预测因素。
洗涤后TMSC达到500万或更多精子与高妊娠率显著相关。在排除可能导致不孕的医学或手术可纠正的男性因素后，我们建议在常规男性生育检查期间进行预处理精子处理，以便为患者提供适当的咨询并指导其选择合适的辅助生殖技术。
