scholarly journals The Effects of Total Motile Sperm Count on Spontaneous Pregnancy Rate and Pregnancy After IUI Treatment in Couples with Male Factor and Unexplained Infertility

2016 ◽  
Vol 70 (1) ◽  
pp. 39 ◽  
Author(s):  
Mithad Hajder ◽  
Elmira Hajder ◽  
Amela Husic
Keyword(s):  
Pregnancy Rate ◽  
Sperm Count ◽  
Unexplained Infertility ◽  
Motile Sperm ◽  
Male Factor ◽  
Spontaneous Pregnancy ◽  
Total Motile Sperm Count

scholarly journals Post-wash total motile sperm count a useful predictor in the decision to perform IVF/ICSI in patients with non-male factor infertility

2020 ◽  
Vol 3 (2) ◽  
pp. 99-106
Author(s):  
Sara Mahmood Qureshi ◽  
Salma Kafeel ◽  
Riffat Bibi ◽  
Jawad Mohmand
Keyword(s):  
Sperm Quality ◽  
Sperm Count ◽  
Adverse Outcomes ◽  
Male Factor Infertility ◽  
Motile Sperm ◽  
Operating Characteristics ◽  
Male Factor ◽  
Vitro Fertilization ◽  
Total Motile Sperm Count

Introduction: The unrestricted use of intracytoplasmic sperm injection (ICSI) for non-male factor infertility is associated with adverse outcomes. Post-wash total motile sperm count (PW-TMSC) offers prognostic value to assess sperm quality and aid in the decision to perform in vitro fertilization (IVF) or ICSI. Objectives: The aim of this study was to identify the effect of PW-TMSC on fertilization rates in patients undergoing IVF cycles exclusively with non-male factor infertility. It also aimed to identify whether unnecessary ICSI could be avoided in such cases, thus maximizing optimal outcomes. Materials & Methods: We retrospectively analyzed age, semen volume, prewash TMSC, and PW-TMSC in 68 conventional IVF cycles of infertile couples with non-male factor infertility. Clinical characteristics including female age, number of follicles, level of estradiol on trigger day, mature cumulus-oocyte complexes (COCs) collected, were also included. Results: Incidence of <30% fertilization was significantly higher in the 4-<10 Million group compared with the ≥20 Million post-wash TMSC group (P<0.001). Furthermore, Receiver operating characteristics (ROC) analysis revealed post-wash TMSC as a significant predictor (P<0.05) of total failed fertilization (TFF) and of ≥30% fertilization (P<0.05) with area under curve (AUC) of 0. 79 and 0.77, respectively, with a deemed cutoff of 10.89 Million. Conclusion: Post-wash TMSC is a good predictor of fertilization; it can help in avoiding potentially low or even total fertilization failure (TFF). A cut-off point of 10.89 Million or less should warrant the use of ICSI.

scholarly journals Total motile sperm count: a better indicator for the severity of male factor infertility than the WHO sperm classification system

2015 ◽  
Vol 30 (5) ◽  
pp. 1110-1121 ◽  
Author(s):  
J. A. M. Hamilton ◽  
M. Cissen ◽  
M. Brandes ◽  
J. M. J. Smeenk ◽  
J. P. de Bruin ◽  
...  
Keyword(s):  
Classification System ◽  
Sperm Count ◽  
Male Factor Infertility ◽  
Motile Sperm ◽  
Male Factor ◽  
Total Motile Sperm Count

scholarly journals Role of the total progressive motile sperm count (TPMSC) in different infertility factors in IUI: a retrospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e040563
Author(s):  
Haiyan Lin ◽  
Yu Li ◽  
Songbang Ou ◽  
Xuedan Jiao ◽  
Wenjun Wang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Live Birth ◽  
Retrospective Cohort ◽  
Outcome Measure ◽  
Sperm Count ◽  
Unexplained Infertility ◽  
Clinical Pregnancy ◽  
Male Factor Infertility ◽  
Motile Sperm ◽  
Male Factor

ObjectiveThe objective of this retrospective cohort study was to explore the optimal range of the total progressive motile sperm count (TPMSC) for live birth in couples with varying infertility diagnosis undergoing intrauterine insemination (IUI) in a university-affiliated teaching hospital.MethodsA total of 2647 couples and 5171 IUI cycles were included between January 2015 and December 2018. Of those, 1542 cycles were performed due to unexplained infertility, 1228 cycles due to anovulation, 1120 cycles due to mild male factor infertility and 122 cycles due to mild endometriosis. The primary outcome measure was live birth rate (LBR). The secondary outcome measure was clinical pregnancy rate (CPR).ResultsThe CPR and LBR were highest in patients with a diagnosis of anovulation compared with the other three groups of patients. The CPR and LBR in patients with unexplained, mild male factor and mild endometriosis were comparable. For the patients with mild male factor infertility, the CPR with prewash TPMSC of >75.0 M and postwash TPMSC of 65.10 M was above 10%, statistically significantly higher than other quartiles of TPMSC (p<0.05). The LBR with postwash TPMSC of >65.10 M was statistically significantly higher than other groups (p<0.05). However, in patients with unexplained infertility, the CPR and LBR were not statistically different in quartiles of TPMSC, being less than 10%. Overall, there was only one clinical pregnancy and no live birth in patients >40 years of age.ConclusionsIn conclusion, the infertility diagnosis plays a significant role for the patient undergoing IUI. Thus, the anovulatory patients benefitted most from IUI, irrespective of TPMSC. For patients with unexplained infertility, TPMSC does not affect the success rate of IUI. Overall,female patients more than 40 years old should not be referred to IUI.

P–077 Performance of the postwash total motile sperm count as a predictor of pregnancy at the time of intrauterine insemination

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
A Kasturiraj ◽  
S Reddy ◽  
M Daniel ◽  
S Namboor. Srinivasan ◽  
N Raja ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Intrauterine Insemination ◽  
Sperm Count ◽  
Semen Analysis ◽  
Sperm Parameters ◽  
Semen Parameters ◽  
Motile Sperm ◽  
Predictor Of Success ◽  
Infertile Couples ◽  
Total Motile Sperm Count

Abstract Study question Is the performance of the postwash total motile sperm count a predictor of pregnancy at the time of intrauterine insemination? Summary answer The number of motile spermatozoa inseminated (NMSI) in IUI can be used to define clear range of pre /postwash sperm parameters. What is known already There is no consensus about the optimal number of motile spermatozoa inseminated (NMSI) required for a reasonable chance of pregnancy after IUI. A meta-analysis of 16 studies assessing NMSI and IUI outcomes, concluded that at cut-off levels between 0.8 and 5 million, defined as the ability to predict failure to become pregnant. The purpose of this study is to determine the range of NMSI as a predictor of success in IUI. Study design, size, duration This prospective study includes 60 patients who underwent semen analysis at an academic infertility centre (SRIHER) during the month of December 2020 and January 2021. Participants/materials, setting, methods A total of 60 infertile couples who underwent IUI at our academic centre were enrolled in our study. A detailed history and infertility work up was done before proceeding for IUI, as per the department protocol. The semen was prepared by discontinuous 2 layered density gradient method. The results were analyzed by patient factors including age, BMI, semen parameters, NMSI. The NMSI were divided into 4 groups: A (&lt;1), B (1–4), C (5–9), D (&gt;10). Main results and the role of chance The mean age of the infertile couples who underwent IUI was (28.2 ± 3.8) in females and (31.8 ± 3.8) in males respectively. The sperm parameters such as concentration (21.8 ± 14.8), motility (53.15 ± 13.22), morphology (2.43 ± 1.33) respectively. When the NMSI was group C (5–9 x 10 6) the pregnancy rate was 38.5% whereas the pregnancy rate was 37.5% in group D ( &gt;10 x 10 6). In the other sub groups such as group A(&lt;1 x 10 6) and group C (1–4 x 10 6) the pregnancy rate was 14.2% and 12.5% respectively. Limitations, reasons for caution Infertile men with Azoospermia, Men with Retrograde ejaculation, Testicular samples, Epididymal samples, Infected samples. All of the above samples were avoided. It cannot be used for counselling during the initial infertility workup, but only during/after the IUI procedure. Wider implications of the findings: The results suggest that NMSI can be a predictor of success in IUI in patients who are &lt; 30 years of age & ≥35 years, NMSI does not appear to be a useful. The effect of NMSI on pregnancy rate needs to evaluated on a larger scale . Trial registration number Not applicable

O-024 Endoscopic management of the unexplained infertility, what does it add?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
S Gordts
Keyword(s):  
Pregnancy Rate ◽  
Cellular Proliferation ◽  
Unexplained Infertility ◽  
Endoscopic Management ◽  
Control Group ◽  
Consecutive Series ◽  
Infertile Patient ◽  
Tubal Patency ◽  
Spontaneous Pregnancy ◽  
Visualization Techniques

Abstract text Endoscopic management of the unexplained infertility, what does it add? Stephan Gordts [email protected] Unexplained infertility “strictu sensu” is not a diagnosis, but a description of a status where no causal factor is identified in a couple trying to conceive for at least one year. The more parameters are assessed, the more likely to identify an etiology, the less likely becomes “unexplained” infertility. Limiting the fertility exploration to indirect visualization techniques like ultrasound, HSG or HycoSy involves the risk of missing existing pathologies. Uterus Uterine volumetric abnormalities can be detected by indirect techniques, but information is lacking on the visualization of the endometrium in case of chronic endometritis and the presence of endometrial defects and hypervascularization areas as seen in patients with adenomyosis. Tubo-ovarian Even with the increased accuracy of indirect visualization techniques, lesions of minimal endometriosis and tubo-ovarian adhesions are not detected (Table). Tubal normality constitutes not only normal tubal patency but also normal tubal function. The importance of subtle tubal lesions is underestimated. Hydatid of Morgagni are detected in 38.1% in patients with infertility versus only in 16,7% in fertile women (Gupta et al. JMIG 2017).Removal of these lesions resulted in a spontaneous pregnancy rate of 58.7% versus 20.6 in the non-treated group (Rasheed et al. EJOG Repr. 2011). Endometriosis In a series of 107 patients with unexplained infertility and 3 failed IVF cycles (Agni Pantou et al. J. Clin. Med. 2019)laparoscopy revealed the presence of endometriosis in 57.97%, peri-adnexal adhesions in 23.3% and was normal in 18.69%. Also, in a group of patients with 3 failed IVF cycles and unexplained infertility (Xiaoming Yu et al.Medicine 2019) laparoscopy showed endometriosis in 57.7%, tubal abnormalities in 31.1% and adhesions in 33.3%. Laparoscopic correction of these pathologies did not only result in a spontaneous pregnancy rate of 35% but resulted also in a higher pregnancy rate after IVF compared to the non-treated control group. Unexplained infertility hides frequently undiagnosed endometriosis. Endometrial BCL6 levels, a proto-oncogene where overexpression is associated with increased cellular proliferation and progesterone resistance, are increased in patients with endometriosis. In case of elevated BCL6 in patients with unexplained infertility, laparoscopy confirmed the presence of endometriosis in 93.8% (Evans-Hoeker et al. 2016). Abnormal BCL6 expression in a population with unexplained infertility reduced the chance of having a successful IVF treatment in 74% of the population (Almquist et al. Fertil Steril 2017). Transvaginal Hydro Laparoscopy Direct endoscopic visualization remains important but due to the invasiveness, diagnostic standard laparoscopy is frequently postponed or omitted in the exploration of the infertile patient. The technique of transvaginal hydro-laparoscopy allows in a minimal invasive way the inspection of the pelvis. In a consecutive series of 2288 patients without obvious pelvic pathology, findings were normal in 49.3%, endometriosis was diagnosed in 15.9% and tubal pathology in 14.5% of the patients (Gordts et al. FVV 2021). The rate of failed access was 1% and the complication rate 0.74%. Causing a minimal ovarian trauma, treatment of these early endometriotic lesions resulted in a spontaneous pregnancy rate of 73.2%. Conclusion The inappropriate use of “unexplained infertility” by omitting the diagnostic endoscopy in the exploration of the infertile patient, can hide undiagnosed and treatable pathology, jeopardizing possibilities for patients for a spontaneous conception and can be responsible for reduced pregnancy rates after IVF.

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