Comparison of the sperm quality necessary for successful intrauterine insemination with World Health Organization threshold values for normal sperm

Dickey, Richard P; Pyrzak, Roman; Lu, Peter Y; Taylor, Steven N; Rye, Philip H

« PreviousFertility and Sterility
Volume 71, Issue 4 , Pages 684-689, April 1999

Comparison of the sperm quality necessary for successful intrauterine insemination with World Health Organization threshold values for normal sperm

Richard P Dickey, M.D., Ph.D.
- The Fertility Institute of New Orleans.
- Section of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Louisiana State University School of Medicine.
- The Fertility Institute of New Orleans, New Orleans, Louisiana, USA
- Louisiana State University School of Medicine, New Orleans, Louisiana, USA
Roman Pyrzak, Ph.D.
- The Fertility Institute of New Orleans.
- The Fertility Institute of New Orleans, New Orleans, Louisiana, USA
Peter Y Lu, M.D.
- The Fertility Institute of New Orleans.
- Section of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Louisiana State University School of Medicine.
- The Fertility Institute of New Orleans, New Orleans, Louisiana, USA
- Louisiana State University School of Medicine, New Orleans, Louisiana, USA
Steven N Taylor, M.D.
- The Fertility Institute of New Orleans.
- The Fertility Institute of New Orleans, New Orleans, Louisiana, USA
Philip H Rye, M.D.
- The Fertility Institute of New Orleans.
- The Fertility Institute of New Orleans, New Orleans, Louisiana, USA

Received 30 July 1998; received in revised form 2 November 1998; accepted 2 November 1998.

Abstract

Objective: To compare World Health Organization threshold values for normal sperm with the initial sperm quality necessary for successful IUI.

Design: Retrospective study.

Setting: Private fertility clinic.

Patient(s): One thousand eight hundred forty-one couples undergoing 4,056 cycles of IUI.

Intervention(s): Intrauterine insemination.

Main Outcome Measure(s): Relation of initial sperm quality to fecundity.

Result(s): Progressive motility and total motile sperm count were the initial sperm characteristics most closely related to pregnancy on discriminant analysis. The per-cycle pregnancy rate averaged 11.1% during the first three IUI cycles. Pregnancy rates were ≥8.2% per cycle when the initial sperm values were a concentration of ≥5 × 10⁶/mL, a total count of ≥10 × 10⁶, progressive motility of ≥30%, or a total motile sperm count of ≥5 × 10⁶. Minimal increases in fecundity occurred when initial values were greater than these threshold levels. The lowest initial values that resulted in pregnancy were a concentration of 2 × 10⁶/mL, a total count of 5 × 10⁶, motility of 17%, and a total motile sperm count of 1.6 × 10⁶. Pregnancy rates were <3.6% when initial values were between the threshold levels and the lowest levels.

Conclusion(s): The sperm quality that is necessary for successful IUI is lower than World Health Organization threshold values for normal sperm. Intrauterine insemination is effective therapy for male factor infertility when initial sperm motility is ≥30% and the total motile sperm count is ≥5 × 10⁶. When initial values are lower, IUI has little chance of success.

Keywords: Insemination technique, intrauterine insemination, semen analysis, sperm count, sperm motility, sperm preparation, World Health Organization