The Prognostic Factors that Could be Effect Pregnancy Rates in Intra Uterine Insemination (IUI) Cycles

Background: Although intrauterine insemination (IUI) is a widely used method of reproductive technology in the world, the influence of various sperm characteristics on the pregnancy rate is controversial. The aim of our study was to assess the influence of number, motility and morphology of sperm on the IUI outcome. Methods: This was retrospective study of 183 couples who underwent 330 IUI cycles in Obstetrics and Gynecology Department of Baskent University Medical Faculty between March 2003 and March 2004. Results: Fortythree of 183 patients became pregnant in 330 IUI cycles, for a clinical pregnancy rate/couple and a clinical pregnancy rate/cycle, 23.5 % and 13.3% respectively. Pregnancy rates were higher in patients whose inseminated total motile sperm count was >= 10x106 than the patients with inseminated sperm count less than 10x106 (15.2% and 1.9%, respectively). Pregnancy rates were 10% in patients whose normal sperm morphology was less than 4% and 19.1% in patients with >= 4% normal sperm morphology. We did not achieve any pregnancy in patients who had < 200x103 total motile normal sperm at baseline spermiogram. In the Clomiphene stimulated cycles the pregnancy rate was 15.3% at the first cycle, 4.55% at second cycle and 5.26 % at the third cycle. In the FSH stimulated cycles pregnancy rate per four cycles was 11.25%, 14.28%, 20%, and 23.07%, respectively. Conclusion: The results of our study show that if a minimum 200x103 total motile normal sperm at baseline spermiogram and minimum >10x106 total motile sperm for insemination can be obtained IUI may be advised. If this threshold cannot be obtained, in vitro fertilization program may be recommended. In the IUI cycles, starting with CC to ovulation induction may be advantageous but to be continuing with this treatment more than two cycles may be reasonable for consuming the patient and the time.