The role of semen parameters in pregnancy of women having intrauterine insemination

Abstract

Aim To research the role of semen parameters in the likelihood of pregnancy of the couples with unexplained infertility who underwent intrauterine insemination.Methods 545 cycles of IUI performed in our clinic due to unexplained infertility were included in the study. The IUI cycles were divided into two groups according to whether they achieved pregnancy: Group 1 pregnancy (77 cycles) and Group 2 non-pregnancy (468 cycles). Sperm parameters were statistically evaluated before and after the sperm washing. ROC (Receiver Operating Characteristic) analysis was performed to identify the effective cut-off values to predict pregnancy. P<0.05 was considered significant. Results Morphology was observed to be statistically higher in the pregnant group than in the non-pregnant group before and after sperm washing (p=0.033 and p=0.028, respectively). No statistically significant difference was observed in any other parameters ( p>0.05). As a result of the pre-wash ROC analysis of sperm parameters, only morphology was found to be significant for the pregnancy to be
predicted (p=0.029). When different cut-off values were analyzed in terms of morphology, the highest cut-off value in sensitivity and specificity was found to be 4.5. As a result of post-wash ROC analysis, it was detected that morphology, +4 and +3 values of sperm motility had statistically significant effects on the detection of pregnancy (p=0.029, p=0.020, and p=0.043, respectively). Other parameters were not observed to have any significant effects for the prediction of pregnancy (p>0.05). A cut-off value of 2.5 for post-wash morphology was found to have 92.9% sensitivity and 75.5% specificity.Conclusion Pre- and postwash morphology may affect the result of pregnancy by IUI in unexplained infertility. The cut-off values of morphology may predict the likelihood of pregnancy and this could allow advanced treatments to start sooner.

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