Geraldo Orrego Jorge, Mackenna Iñiguez Antonio, Schwarze Meza Juan Enrique, Ortega Parraguez Victoria, Carrasco Rojas Johanna, Palma Ceppi Cristián
Unidad de Medicina Reproductiva, Clínica Las Condes, Santiago de Chile, Chile.
Unidad de Medicina Reproductiva, Clínica Las Condes, Santiago de Chile, Chile.
Rev Int Androl. 2023 Jan-Mar;21(1):100326. doi: 10.1016/j.androl.2021.04.007. Epub 2022 Oct 15.
Sperm morphology has been used as a prognostic factor in in vitro fertilization, however, in intrauterine insemination (IUI) its predictive role is controversial. The aim of this study was to determine the impact of sperm morphology as isolated parameter of the spermiogram has on the probability of pregnancy in couples that are treated with IUI.
Retrospective study of IUI cycles performed in the Reproductive Medicine Unit of Clínica Las Condes between January 2016 and December 2018. Logistic regression of the following variables: sperm morphology grouped in 0-1%, 2-3% and≥4%, total progressively motile sperm count inseminated, age of the woman and the man.
A total of 385 cases were included and clinical pregnancy was diagnosed in 85 of them. When separating into groups of sperm morphology<4% and≥4%, the pregnancy rate was 22% in both groups. The age of the woman was the only statistically significant factor in the logistic regression. The area under the ROC curve of sperm morphology as a predictor of pregnancy was 0.53.
Our study concludes that sperm morphology should not be considered as a single parameter when deciding whether or not a couple can be treated with IUI, eliminating isolated teratozoospermia as a direct indication for in vitro fertilization. It was not possible to determine a cut-off point for sperm morphology that serves as a predictor of pregnancy.
精子形态已被用作体外受精的一个预后因素，然而，在宫内人工授精（IUI）中，其预测作用存在争议。本研究的目的是确定作为精液分析孤立参数的精子形态对接受IUI治疗的夫妇怀孕概率的影响。
对2016年1月至2018年12月在拉斯孔德斯诊所生殖医学科进行的IUI周期进行回顾性研究。对以下变量进行逻辑回归分析：精子形态分为0-1%、2-3%和≥4%，授精时总的进行性运动精子计数，女性和男性的年龄。
共纳入385例病例，其中85例诊断为临床妊娠。当将精子形态分为<4%和≥4%两组时，两组的妊娠率均为22%。女性年龄是逻辑回归中唯一具有统计学意义的因素。精子形态作为妊娠预测指标的ROC曲线下面积为0.53。
我们的研究得出结论，在决定一对夫妇是否可以接受IUI治疗时，不应将精子形态视为单一参数，不应将孤立的畸形精子症作为体外受精的直接指征。无法确定作为妊娠预测指标的精子形态的切点。
