Department of Obstetrics and Gynecology, University of Nebraska Medical Center, Omaha, NE, USA.
Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA.
Hum Fertil (Camb). 2023 Dec;26(5):1108-1113. doi: 10.1080/14647273.2022.2137858. Epub 2022 Nov 10.
Intrauterine insemination (IUI) is a frequently used method to treat couples with infertility. There is evidence of decreased pregnancy rates with a total motile sperm count (TMSC) of less than 10 million, yet there remains to be a consensus on semen parameters for which to recommend IUI in the infertile population. The aim of this study was to determine a minimum threshold of TMSC on semen analysis to offer IUI cycles. This is a retrospective cohort study of all IUI cycles at a private practice infertility centre over four years. Our primary outcome of interest was the presence of clinical pregnancy after each cycle. A total of 999 women underwent 2,169 IUI cycles. The overall clinical pregnancy rate was 19.8% per cycle. During the first IUI each woman underwent, there was an increase in clinical pregnancy with increasing TMSC (OR 0.44) for TMSC ≤1 M to (OR 0.99) for TMSC 6-10 M, compared to TMSC >10 M. Among all IUI with a TMSC between 6 and 10 M, pregnancy outcomes improved with morphology >4% (OR 0.84), compared to morphology <4% (OR 0.25), relative to TMSC >10 M. Using receiver operating characteristic curves, we did not identify a TMSC threshold to offer IUI, although there was a positive correlation between TMSC and IUI success.
宫腔内人工授精（IUI）是治疗不孕夫妇的常用方法。有证据表明，总活动精子计数（TMSC）小于 1000 万时妊娠率降低，但对于不孕人群中推荐 IUI 的精液参数仍存在共识。本研究旨在确定 TMSC 在精液分析中提供 IUI 周期的最低阈值。这是一项对四年内在一家私人执业不孕中心进行的所有 IUI 周期的回顾性队列研究。我们感兴趣的主要结果是每个周期后的临床妊娠情况。共有 999 名女性接受了 2169 次 IUI 周期。总体临床妊娠率为每周期 19.8%。在每个女性进行的第一次 IUI 中，随着 TMSC 的增加，临床妊娠率增加（OR 0.44，TMSC ≤1M 至 OR 0.99，TMSC 6-10M，与 TMSC >10M 相比）。在所有 TMSC 在 6 到 10M 之间的 IUI 中，与 TMSC >10M 相比，形态学 >4%（OR 0.84）的妊娠结局优于形态学 <4%（OR 0.25）。使用受试者工作特征曲线，我们没有确定 TMSC 阈值来提供 IUI，尽管 TMSC 与 IUI 成功之间存在正相关。
