The Influence of Sperm Morphology, Total Motile Sperm Count of Semen and the Number of Motile Sperm Inseminated in Sperm Samples on the Success of Intrauterine Insemination

Background: The present study aimed to analyze the prognostic value of sperm morphology, total motile sperm count (TMSC) and the number of motile sperm inseminated (NMSI) on the outcome of intrauterine insemination (IUI). Materials and Methods: This cross sectional study was carried out 445 women undergoing 820 IUI cycles. All of the patients underwent controlled ovarian hyper stimulation with clomiphen citrate and human menopausal gonadotropin (HMG) followed by intrauterine insemination with the husband's sperm. Pregnancy rate (PR) per cycle in correlation to sperm morphology, TMSC and NMSI was obtained. Statistical analysis of the data was done by the SPSS version 13 (Chicago,USA). Results: A total of 81 clinical pregnancies were obtained for a pregnancy rate per cycle of 9.9%. When the TMSC was 5x10(6) to <10x10(6), the PR per cycle was significantly higher than the subgroups <1x10(6), 1x10(6) to <5x10(6) and >= 10x10(6) (15%, 5.6%, 5.1%, 10.8%, respectively). Sperm morphology was in itself a significant factor that affected the likelihood of IUI success. Nonetheless, the most significant difference of the PR per cycle with sperm morphology was in the subgroup <5 % (2.1% vs. 97.9%). When the NMSI was >= 10x10(6), the PR per cycle was significantly higher than the subgroups<5x10(6) and 5x10(6) to< 10x 10(6) (11.2%, 4.1%, 5.2%, respectively). Conclusion: The study showed that TMSC 5x10(6) to < 10x 10(6) and normal sperm morphology >= 5% and NMSI >= 10x10(6) are useful prognostic factors of IUI cycles.