Retrospective analysis of efficacy of washed husband semen IUI for oligoasthenoteratospermia in an urban centre
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20190266Keywords:
Intrauterine insemination, Oligoasthenoteratospermia, Sperm washAbstract
Background: The true incidence of male subfertility is unknown due to great variability in the prevalence of subfertility. Artificial insemination with husband’s semen is the most widely used treatment for male infertility, usually presumed because of oligospermia, and for what is called ‘mucus hostility’ when there is failure of sperm penetration of cervical mucus despite normal seminal analysis.
Methods: The study was conducted in 438 couples with male factor infertility at the ARTC (artificial reproductive technique centre) of Sri Ramakrishna Hospital, Coimbatore. Results of at least two seminograms (based on WHO norms) were used to primarily classify males into three categories-oligozoospermic, asthenozoo spermic and oligoasthenoteratospermic. The media used were the Earle’s Balanced Salt Solution (EBSS), Ham’s F10 and Medicult. EBSS and Ham’s F10 were obtained as “readymade” solutions from Sigma, USA. Medicult was imported from Denmark. EBSS and Ham’s F10 were supplemented with protein using FCS (Fetal cord Serum) or HEPES (4(2-hydroxyethyil)-1-piperazineethanesulfonic acid). Benzyl pencillin, 60mg per litre and Streptomycin, 50mg per litre were also to the media.
Results: By the DMRT analysis of post wash count, the influence of the count below 5 million or above 20 million on the pregnancy rate was significant at all the levels of male factor.
Conclusions: Considering the male factor, in cases of oligoasthenoteratospermia, IUI has a positive significant effect on the success rate of pregnancy at all three levels of the post wash sperm count.
References
Kumar N, Singh AK. Trends of male factor infertility, an important cause of infertility: A review of literature. J Hum Reprod Sci. 2015;8(4):191-6.
Olsen J, Ramlau-Hansen CH. Epidemiologic methods for investigating male fecundity. Asian J Androl. 2014;16:17-22
Vasan SS. Semen analysis and sperm function tests: How much to test?. IJU. 2011;27(1):41-8.
Zadehmodarres S, Oladi B, Saeedi S, Jahed F, Ashraf H. Intrauterine insemination with husband semen: an evaluation of pregnancy rate and factors affecting outcome. J Assist Reprod Genet. 2009;26(1):7-11.
World Health Organization, Department of Reproductive Health and Research. WHO laboratory manual for the examination and processing of human semen, Switzerland, WHO Press, 2010.
Van Weert JM, Repping S, Von Voorhis BJ, Bossuyt PMM, Mol BWJ. Performance of the post-wash total motile sperm count as a predictor of pregnancy at the time of intrauterine insemination: a meta-analysis. Fertil Steril. 2004;82:612-20.
Koyun OK. Post-wash semen and pregnancy outcomes. J Turkish-German Gynecol Assoc. 2013;14:142-5.
Branigan E, Estes A, Walker K. The effect of processed total motile sperm counts and twenty four hour sperm survival on the efficacy of intrauterine insemination in male infertility. Andrology. 2017;6:191.
Zhang E, Tao X, Xing W, Cai L, Zhang B. Effect of sperm count on success of intrauterine insemination in couples diagnosed with male factor infertility. Mater Sociomed. 2014;26(5):321-3.
Tan O, Ha T, Carr BR, Nakonezny P, Doody KM, Doody KJ. Predictive value of postwashed total progressively motile sperm count using CASA estimates in 6871 non-donor intrauterine insemination cycles. J Assist Reprod Genet. 2014;31(9):1147-53.
Lemmens L, Kos S, Beijer C, Brinkman JW, van der Horst FA, van den Hoven L, et al. Predictive value of sperm morphology and progressively motile sperm count for pregnancy outcomes in intrauterine insemination. Fertil Steril. 2016;105(6):1462-8.
Badawy A, Elnashar A, Eltotongy M. Effect of sperm morphology and number on success of intrauterine insemination. Fertil Steril. 2009;91(3):777-81.
Koyun E, Okyay RE, Doğan OE, Kovalı M, Doğan SS, Gülekli B. The effect of intrauterine insemination time on semen parameters. J Turk Ger Gynecol Assoc. 2014;15(2):82-5.
