Toner J P, Mossad H, Grow D R, Morshedi M, Swanson R J, Oehninger S
Jones Institute for Reproductive Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk 23507, USA.
Andrologia. 1995 May-Jun;27(3):143-8. doi: 10.1111/j.1439-0272.1995.tb01085.x.
The purpose of this study was to investigate the relationship between sperm parameters and the outcome of artificial (intrauterine) insemination (IUI). One hundred and twenty-six patients undergoing 395 consecutive IUI cycles in a 1-year period in our institution were studied. In all cases, controlled ovarian stimulation and hCG-timed IUI were performed, followed by progesterone supplementation of the luteal phase. In 86 patients, (243 cycles) the husband's sperm was utilized, whereas in 40 couples (152 cycles), donor sperm was used due to severe male factor infertility. Among the sperm parameters of the original ejaculate, % normal morphology (assessed by strict criteria) was the most significant predictor of pregnancy (stepwise regression analysis, P = 0.003). Using logistic regression, morphology was the best predictor of pregnancy (r = 0.12); linearity of movement significantly enhanced the predictive value of morphology alone (r = 0.17, P = 0.004). Overall, the pregnancy rates were significantly higher (P = 0.01) in cases with > or = 14% normal morphology (15% per cycle) compared to cases with < 14% normal morphology (7% per cycle). This threshold level for morphology is in agreement with previously published IVF results. These results underscore the significance of sperm morphology assessed by strict criteria as a predictor of pregnancy outcome in the IUI setting.
本研究的目的是调查精子参数与人工（宫腔内）授精（IUI）结果之间的关系。对在我们机构1年期间连续进行395个IUI周期的126例患者进行了研究。所有病例均进行了控制性卵巢刺激和hCG定时IUI，随后在黄体期补充孕酮。86例患者（243个周期）使用丈夫的精子，而40对夫妇（152个周期）因严重男性因素不育使用供体精子。在初始射精的精子参数中，正常形态百分比（根据严格标准评估）是妊娠的最显著预测指标（逐步回归分析，P = 0.003）。使用逻辑回归分析，形态是妊娠的最佳预测指标（r = 0.12）；运动的直线性显著提高了单独形态的预测价值（r = 0.17，P = 0.004）。总体而言，正常形态≥14%（每个周期15%）的病例与正常形态<14%（每个周期7%）的病例相比，妊娠率显著更高（P = 0.01）。这种形态的阈值水平与先前发表的体外受精结果一致。这些结果强调了根据严格标准评估的精子形态作为IUI环境中妊娠结局预测指标的重要性。
