Fertility Laboratory, Department of Obstetrics and Gynaecology, Radboud university medical center, Nijmegen, The Netherlands.
Department of Clinical Chemistry, Maasstad Hospital, Rotterdam, The Netherlands.
Andrology. 2018 Sep;6(5):707-713. doi: 10.1111/andr.12510. Epub 2018 Jun 29.
There is a wide practice variation of used methods and outcomes in IUI in fertility laboratories. Standardization of the IUI procedure is important for reducing inconsistency among laboratories in counseling infertile couples and in pregnancy results. The aim of the study was to evaluate the currently used laboratory procedures of IUI in Dutch fertility laboratories and their effect on IUI pregnancy results. Additionally, the methods for semen analysis (SA) were evaluated, as SA is related to IUI in terms of inseminated sperm number and IUI counseling.
This questionnaire survey study was sent to laboratories participating in the Dutch external quality control program for semen analysis (SKML) and consisted of 46 questions concerning laboratory management, methods for semen analysis and IUI, and clinical results. The results were analyzed using univariable and multivariable logistic regression models.
A total of 52 laboratories (out of 99) provided information on used methodologies for SA or laboratory procedures of IUI and the organization of the laboratory. A wide variability was confirmed in used methods for both SA and IUI. Evaluation of pregnancy results obtained during 3 years (2013-2015) showed that specific used laboratory methods have a significant effect on the probability of becoming pregnant.
Important to remark is that in this survey study cycle-specific data, including variables of the individual couples (age, stimulation protocol, etc), were not included and may have effects on the results. The reported results provide an overview of the current practice performance; however, the organization of fertility laboratories is changing rapidly. The use of standardized methods in IUI is important for optimizing the performance of care and improving pregnancy results. The knowledge on used procedures, however, is limited, and further research on factors involving SA and the IUI procedure is necessary.
在生育实验室中，IUI 的方法和结果存在广泛的实践差异。IUI 程序的标准化对于减少实验室之间在咨询不孕夫妇和妊娠结果方面的不一致性非常重要。本研究旨在评估荷兰生育实验室中目前使用的 IUI 实验室程序及其对 IUI 妊娠结果的影响。此外，还评估了精液分析 (SA) 的方法，因为在授精精子数量和 IUI 咨询方面，SA 与 IUI 相关。
这项问卷调查研究是向参与荷兰精液分析外部质量控制计划 (SKML) 的实验室发送的，共包含 46 个问题，涉及实验室管理、精液分析和 IUI 方法以及临床结果。使用单变量和多变量逻辑回归模型分析结果。
共有 52 家实验室（99 家中的 52 家）提供了有关 SA 或 IUI 实验室程序的使用方法和实验室组织的信息。确认了在 SA 和 IUI 中使用的方法都存在很大的差异。对 3 年（2013-2015 年）获得的妊娠结果进行评估表明，特定使用的实验室方法对怀孕的可能性有显著影响。
需要注意的是，在这项调查研究周期中，未包括特定夫妇的周期特异性数据（包括年龄、刺激方案等变量），这些数据可能会对结果产生影响。报告的结果提供了当前实践表现的概述；然而，生育实验室的组织正在迅速变化。在 IUI 中使用标准化方法对于优化护理性能和提高妊娠结果非常重要。然而，关于使用程序的知识有限，需要进一步研究涉及 SA 和 IUI 程序的因素。
