Clinical and Experimental Reproductive Medicine

The Korean Society for Reproductive Medicine (대한생식의학회)
권호 표지
DOI QR코드

DOI QR Code

Predictive value of sperm motility characteristics assessed by computer-assisted sperm analysis in intrauterine insemination with superovulation in couples with unexplained infertility

  • Youn, Joung-Sub (Department of Obstetrics and Gynecology, Clinic of Dr. Min) ;
  • Cha, Sun-Hwa (Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Park, Chan-Woo (Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Yang, Kwang-Moon (Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Kim, Jin-Yeong (Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Koong, Mi-Kyoung (Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Kang, Inn-Soo (Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Song, In-Ok (Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Han, Sang-Chul (Laboratory of Reproductive Biology and Infertility, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine)
  • Received : 2010.12.23
  • Accepted : 2011.02.18
  • Published : 2011.03.02
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: To determine whether characteristics of sperm motility obtained by computer-assisted sperm analysis (CASA) could predict pregnancy after intrauterine insemination (IUI) in couples with unexplained infertility. Methods: Three hundred eighty-three cycles of intrauterine insemination with superovulation were retrospectively analyzed. Semen analysis was performed with CASA before and after swim-up and the parameters were compared between pregnant and non-pregnant women. Results: The pregnancy rate per cycle was 14.1%. Pregnant and non-pregnant women were comparable in terms of age, infertility duration, the number of dominant follicles. While sperm concentration, motility, and parameters such as average path velocity (VAP) and percentage rapid (RAPID) before semen preparation were significantly different between the pregnancy and non-pregnancy groups, there were no differences in sperm parameters when comparing the two groups after preparation. Using a receiver operating characteristic curve to measure sensitivity and specificity, the optimal threshold value for the predictors of pregnancy was revealed to be a concentration of ${\geq}111{\times}10^6/mL$, a motility of ${\geq}$ 51.4%, and RAPID ${\geq}$ 30.1% before preparation for IUI. Conclusion: Sperm parameters including concentration, motility, and RAPID before sperm preparation could have predictive value for pregnancy outcome after intrauterine insemination with superovulation in couples with unexplained infertility, and would be helpful when counseling patients before they make the decision to proceed with IVF/ICSI-ET.

Keywords

References

  1. ESHRE Capri Workshop Group. Intrauterine insemination. Hum Reprod Update 2009;15:265-77. https://doi.org/10.1093/humupd/dmp003
  2. Stone BA, Vargyas JM, Ringler GE, Stein AL, Marrs RP. Determinants of the outcome of intrauterine insemination: analysis of outcomes of 9963 consecutive cycles. Am J Obstet Gynecol 1999;180:1522-34. https://doi.org/10.1016/S0002-9378(99)70048-7
  3. van der Westerlaken LA, Naaktgeboren N, Helmerhorst FM. Evaluation of pregnancy rates after intrauterine insemination according to indication, age, and sperm parameters. J Assist Reprod Genet 1998;15:359-64. https://doi.org/10.1023/A:1022576831691
  4. Ransom MX, Blotner MB, Bohrer M, Corsan G, Kemmann E. Does increasing frequency of intrauterine insemination improve pregnancy rates significantly during superovulation cycles? Fertil Steril 1994;61:303-7. https://doi.org/10.1016/S0015-0282(16)56522-4
  5. Dodson WC, Haney AF. Controlled ovarian hyperstimulation and intrauterine insemination for treatment of infertility. Fertil Steril 1991;55:457-67. https://doi.org/10.1016/S0015-0282(16)54168-5
  6. Verhulst SM, Cohlen BJ, Hughes E, Te Velde E, Heineman MJ. Intra- uterine insemination for unexplained subfertility. Cochrane Database Syst Rev 2006;(4):CD001838.
  7. Steures P, van der Steeg JW, Mol BW, Eijkemans MJ, van der Veen F, Habbema JD, et al. Prediction of an ongoing pregnancy after intrauterine insemination. Fertil Steril 2004;82:45-51. https://doi.org/10.1016/j.fertnstert.2003.12.028
  8. Shulman A, Hauser R, Lipitz S, Frenkel Y, Dor J, Bider D, et al. Sperm motility is a major determinant of pregnancy outcome following intrauterine insemination. J Assist Reprod Genet 1998; 15:381-5. https://doi.org/10.1023/A:1022585000740
  9. Hauser R, Yogev L, Botchan A, Lessing JB, Paz G, Yavetz H. Intrauterine insemination in male factor subfertility: significance of sperm motility and morphology assessed by strict criteria. Andrologia 2001;33:13-7. https://doi.org/10.1046/j.1439-0272.2001.00404.x
  10. van Voorhis BJ, Barnett M, Sparks AE, Syrop CH, Rosenthal G, Dawson J. Effect of the total motile sperm count on the efficacy and cost-effectiveness of intrauterine insemination and in vitro fertilization. Fertil Steril 2001;75:661-8. https://doi.org/10.1016/S0015-0282(00)01783-0
  11. World Health Organization. WHO laboratory manual for the examination of human semen and sperm-cervical mucus interaction. 4th ed. Cambridge: Cambridge University Press; 1999.
  12. Jorgensen N, Auger J, Giwercman A, Irvine DS, Jensen TK, Jouannet P, et al. Semen analysis performed by different laboratory teams: an intervariation study. Int J Androl 1997;20:201-8. https://doi.org/10.1046/j.1365-2605.1997.00052.x
  13. Brazil C, Swan SH, Drobnis EZ, Liu F, Wang C, Redmon JB, et al. Standardized methods for semen evaluation in a multicenter research study. J Androl 2004;25:635-44. https://doi.org/10.1002/j.1939-4640.2004.tb02835.x
  14. Larsen L, Scheike T, Jensen TK, Bonde JP, Ernst E, Hjollund NH, et al. Computer-assisted semen analysis parameters as predictors for fertility of men from the general population. The Danish First Pregnancy Planner Study Team. Hum Reprod 2000;15:1562-7. https://doi.org/10.1093/humrep/15.7.1562
  15. Shibahara H, Obara H, Ayustawati, Hirano Y, Suzuki T, Ohno A, et al. Prediction of pregnancy by intrauterine insemination using CASA estimates and strict criteria in patients with male factor infertility. Int J Androl 2004;27:63-8. https://doi.org/10.1111/j.0105-6263.2004.00437.x
  16. Macleod IC, Irvine DS. The predictive value of computer-assisted semen analysis in the context of a donor insemination programme. Hum Reprod 1995;10:580-6. https://doi.org/10.1093/oxfordjournals.humrep.a135993
  17. Marshburn PB, McIntire D, Carr BR, Byrd W. Spermatozoal characteristics from fresh and frozen donor semen and their correlation with fertility outcome after intrauterine insemination. Fertil Steril 1992;58:179-86. https://doi.org/10.1016/S0015-0282(16)55157-7
  18. Sidhu RS, Sharma RK, Agarwal A. Effects of cryopreserved semen quality and timed intrauterine insemination on pregnancy rate and gender of offspring in a donor insemination program. J Assist Reprod Genet 1997;14:531-7. https://doi.org/10.1023/A:1021131511209
  19. Hirano Y, Shibahara H, Obara H, Suzuki T, Takamizawa S, Yamaguchi C, et al. Relationships between sperm motility characteristics assessed by the computer-aided sperm analysis (CASA) and fertilization rates in vitro. J Assist Reprod Genet 2001;18:213-8.
  20. Freour T, Jean M, Mirallie S, Langlois ML, Dubourdieu S, Barriere P. Predictive value of CASA parameters in IUI with frozen donor sperm. Int J Androl 2009;32:498-504. https://doi.org/10.1111/j.1365-2605.2008.00886.x
  21. Freour T, Jean M, Mirallie S, Dubourdieu S, Barriere P. Computer- Assisted Sperm Analysis (CASA) parameters and their evolution during preparation as predictors of pregnancy in intrauterine insemination with frozen-thawed donor semen cycles. Eur J Obstet Gynecol Reprod Biol 2010;149:186-9. https://doi.org/10.1016/j.ejogrb.2009.12.029
  22. Bostofte E, Bagger P, Michael A, Stakemann G. Fertility prognosis for infertile men: results of follow-up study of semen analysis in infertile men from two different populations evaluated by the Cox regression model. Fertil Steril 1990;54:1100-6. https://doi.org/10.1016/S0015-0282(16)54012-6
  23. Eimers JM, te Velde ER, Gerritse R, Vogelzang ET, Looman CW, Habbema JD. The prediction of the chance to conceive in subfertile couples. Fertil Steril 1994;61:44-52. https://doi.org/10.1016/S0015-0282(16)56451-6
  24. Aitken RJ, Best FS, Warner P, Templeton A. A prospective study of the relationship between semen quality and fertility in cases of unexplained infertility. J Androl 1984;5:297-303. https://doi.org/10.1002/j.1939-4640.1984.tb00792.x
  25. Irvine DS, Aitken RJ. Predictive value of in-vitro sperm function tests in the context of an AID service. Hum Reprod 1986;1:539- 45. https://doi.org/10.1093/oxfordjournals.humrep.a136470
  26. Ducot B, Spira A, Feneux D, Jouannet P. Male factors and the likelihood of pregnancy in infertile couples. II. Study of clinical characteristics-- practical consequences. Int J Androl 1988;11:395-404. https://doi.org/10.1111/j.1365-2605.1988.tb01012.x
  27. Shibahara H, Mitsuo M, Inoue M, Hasegawa A, Shigeta M, Koyama K. Relationship between human in-vitro fertilization and intracytoplasmic sperm injection and the zona-free hamster egg penetration test. Hum Reprod 1998;13:1928-32. https://doi.org/10.1093/humrep/13.7.1928
  28. Aitken RJ. Sperm function tests and fertility. Int J Androl 2006;29: 69-75. https://doi.org/10.1111/j.1365-2605.2005.00630.x
  29. Barratt CL, Tomlinson MJ, Cooke ID. Prognostic significance of computerized motility analysis for in vivo fertility. Fertil Steril 1993;60:520-5. https://doi.org/10.1016/S0015-0282(16)56171-8
  30. Paston MJ, Sarkar S, Oates RP, Badawy SZ. Computer-aided semen analysis variables as predictors of male fertility potential. Arch Androl 1994;33:93-9. https://doi.org/10.3109/01485019408987809
  31. Sukcharoen N, Keith J, Irvine DS, Aitken RJ. Definition of the optimal criteria for identifying hyperactivated human spermatozoa at 25 Hz using in-vitro fertilization as a functional end-point. Hum Reprod 1995;10:2928-37. https://doi.org/10.1093/oxfordjournals.humrep.a135822
  32. Suarez SS. Control of hyperactivation in sperm. Hum Reprod Update 2008;14:647-57. https://doi.org/10.1093/humupd/dmn029
  33. Nichol R, Hunter RH, Gardner DK, Leese HJ, Cooke GM. Concentrations of energy substrates in oviductal fluid and blood plasma of pigs during the peri-ovulatory period. J Reprod Fertil 1992;96: 699-707. https://doi.org/10.1530/jrf.0.0960699
  34. Yao Y, Ho P, Yeung WS. Effects of human follicular fluid on the capacitation and motility of human spermatozoa. Fertil Steril 2000; 73:680-6. https://doi.org/10.1016/S0015-0282(99)00637-8

Cited by

  1. Sperm wars and the evolution of male fertility. vol.144, pp.5, 2011, https://doi.org/10.1530/rep-12-0285
  2. Cystic fibrosis transmembrane conductance regulator is correlated closely with sperm progressive motility and normal morphology in healthy and fertile men with normal sperm parameters vol.46, pp.8, 2011, https://doi.org/10.1111/and.12155
  3. Comparative Cytotoxicity and Sperm Motility Using a Computer-Aided Sperm Analysis System (CASA) for Isomers of Phthalic Acid, a Common Final Metabolite of Phthalates vol.78, pp.16, 2015, https://doi.org/10.1080/15287394.2015.1067503
  4. Maternal age and intracytoplasmic sperm injection outcome in infertile couples at Khartoum, Sudan vol.4, pp.None, 2015, https://doi.org/10.12688/f1000research.7386.1
  5. Incidence of Sperm Surface Autoantibodies and Relationship with Routine Semen Parameters and Sperm Kinematics vol.76, pp.1, 2011, https://doi.org/10.1111/aji.12519
  6. Update of the risk assessment on 3‐monochloropropane diol and its fatty acid esters vol.16, pp.1, 2018, https://doi.org/10.2903/j.efsa.2018.5083
  7. MicroRNA expression in infertile men: its alterations and effects vol.27, pp.5, 2011, https://doi.org/10.1017/s0967199419000340
  8. Evaluation of Prognostic Factors for Clinical Pregnancy Rate Following Artificial Insemination by Husband in the Chinese Population vol.8, pp.None, 2011, https://doi.org/10.3389/fmed.2021.638560
  9. Comparison of commercially available chamber slides for computer-aided analysis of human sperm vol.67, pp.2, 2021, https://doi.org/10.1080/19396368.2020.1850907
  10. Predictive value of sperm motility before and after preparation for the pregnancy outcomes of intrauterine insemination vol.48, pp.3, 2011, https://doi.org/10.5653/cerm.2021.04469
  11. The association between testicular toxicity induced by Li2Co3 and protective effect of Ganoderma lucidum: Alteration of Bax & c-Kit genes expression vol.72, pp.None, 2011, https://doi.org/10.1016/j.tice.2021.101552