A minimum number of motile spermatozoa are required for successful fertilisation through artificial intrauterine insemination with husband's spermatozoa

Abstract

Intrauterine insemination (IUI) is an effective, noninvasive, relatively simple and cheap method of infertility treatment. Many factors that affect IUI outcomes have been studied. However, there is no consensus about the optimal number of motile spermatozoa inseminated (NMSI) required for a reasonable chance of pregnancy after IUI. In this retrospective study, we aimed to assess the relationship between NMSI and the pregnancy rate after IUI with husband's spermatozoa. Couples who had either primary or secondary infertility for more than one year were recruited from the Department of Reproduction, Nanjing Maternity and Child Health Hospital, China, between January 2007 and December 2010. Overall, 1153 IUI cycles with husband's spermatozoa were performed in 645 women after ovarian stimulation. Factors that have previously been associated with a successful fertilisation after IUI were assessed. A total pregnancy rate of 13.88% was obtained. The pregnancy rate was only 4.05% if less than 2 × 10(6) motile spermatozoa were used, but this rose to 14.55% when more than 2 × 10(6) motile spermatozoa were inseminated. We therefore conclude that IUI can be performed when the NMSI exceeds 2 × 10(6) . With this recommendation, IUI with husband's spermatozoa can be used to treat many more infertile couples.

Prognostic factors in intrauterine insemination cycles

“…It has been shown that pregnancy rates may vary significantly depending on the number of motile sperm inseminated ( Badawy et al. , 2009 ; Merviel et al , 2010 ; Cao et al , 2014 ). Dinelli et al (2014) reported that the main problem related to male infertility was moderated asthenozoospermia, and that pregnancy rates were significantly higher when the number of motile sperm with progressive motility used in insemination was at least 1×10 6 .…”

Factors affecting clinical pregnancy rates after IUI for the treatment of unexplained infertility and mild male subfertility

“…It was shown that only a sperm presence with +4 motility increased clinical pregnancy rates, which might be explained due to this study only including an unexplained and mild male subfertile patient group. Cao et al (35) evaluated 1153 IUI cycles in 2014 and reported that a number of motile sperms lower than 2×10 6 in the insemination had low success rates in IUI, but the author also showed that sperm numbers higher than this is increased the observed pregnancy rates. They concluded that IUI can be performed when the NMSI (number of motile sperm inseminated) exceeds 2x10 6 .…”

Prognostic Factors of Pregnancy after Homologous Intrauterine Insemination

“…As regard to swim-up and density gradient centrifugation, the differences in the number of either technique used (128 swim-up vs. 725 DGC) can be explained by the fact that after the publication of Morshredi et al [31] in 2004 indicating that "although samples with an acceptable number of motile sperm can be processed efficiently by wash only, poor quality semen samples should be processed using DGC", we decided that sperm would be prepared exclusively by DGC. The fact that the threshold for IUI we determined is relatively higher than that proposed by Dinelli et al [11] and Cao et al [32] is probably due to the fact that we did not include the couples with extremely poor sperm in the study; those couples being treated by ICSI. The big limitation of our study is its retrospective nature.…”