Severity of oligo-asteno-teratozoospermia no longer determines overall success rate in male subfertility

Abstract

In this longitudinal multicentre cohort study, the overall ongoing pregnancy rate after current evidence-based management in male subfertility was studied. All subfertile couples who visited the fertility clinic for the first time between 2002 and 2006, and had male subfertility as a single diagnosis (n = 762 of 2476 couples), were included in this study. Couples were grouped by the severity of male factor. Group I (n = 541) had a total motile sperm count (TMSC) 1-20 × 10(6). Group II (n = 161) had a TMSC <1 × 10(6). Group III (n = 60) had azoospermia. The overall ongoing pregnancy rate was 65.5% (500/762). The overall ongoing pregnancy rates in group I (69.3%) and group II (61.5%) were comparable (p = 0.06). However, group I and group II conceived significantly more frequently than group III (43.3%) (group I vs. group III p < 0.001 and group II vs. group III p = 0.02, respectively). Moreover, the spontaneous ongoing pregnancy rate in group I was 35.3%, in group II 22.4% and in group III, 1.7% (group I vs. group II p = 0.002; group I vs. group III p < 0.001; group II vs. group III p < 0.001). Thus, despite a significant difference in spontaneous ongoing pregnancy rates, except for azoospermia, the overall ongoing pregnancy rates, regardless of the severity of the male factor, were comparable. Couples with poorer sperm parameters, however, have to undergo more invasive treatment to reach the same goal.

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

“…The study group was randomized to: group (A) with TMSC> 3x10 6 / ejaculate and a spontaneous conception; group (B) with TMSC <3 x 10 6 / ejaculate and conception after IUI, plus couples who did not achieve SP with TMSC> 3 x 10 6 / ejaculate and couples who did not achieve pregnancy. Both groups were classified in five subgroups based on TMSC subgroup ( 1 ) with TMSC 1-5 × 10 6 / ejaculate; subgroup ( 2 ) with TMSCl 5-10 × 10 6 / ejaculate; subgroup ( 3 ) with TMSCl 10-20 × 10 6 / ejaculate; subgroup( 4 ) with TMSCl> 20 × 10 6 / ejaculate and subgroup ( 5 ) with unexplained infertility…”

“…Infertility is defined as the inability to conceive after 1 year of unprotected relations of couples in the reproductive age ( 1 ). Male infertility factor is the most common cause of not having children ( 2 , 3 ). The diagnosis is based on the results of the analysis of semen.…”