Predictive value of sperm motility characteristics assessed by computer-assisted sperm analysis in intrauterine insemination with superovulation in couples with unexplained infertility원문보기
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 Univers)
,
Kang, Inn-Soo
,
Song, In-Ok
,
Han, Sang-Chul
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 su...
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.
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.
* AI 자동 식별 결과로 적합하지 않은 문장이 있을 수 있으니, 이용에 유의하시기 바랍니다.
제안 방법
Most of the studies on CASA parameters and fertility outcome in IUI have been conducted in couples with male infertility, whereas few studies were conducted in couples with unexplained infertility. In this study, we assessed the sperm motility parameters by CASA in 383 IUI cycles with superovulation indicated in couples with unexplained infertility. Specific CASA parameters such as VAP, RAPID, VSL, VCL, as well as sperm concentration and motility were significantly different between the pregnant group and the non-pregnant group.
Superovulation was conducted with either 150 IU of intramuscularly injected uhMG (IVF-M; LG Life Science, Seoul, Korea) or 100 mg of oral clomiphene citrate (Clomifene; Young Poong Pharmaceutical, Incheon, Korea) for five days starting on day 3 of the menstrual cycle, followed by daily injection of 150 IU of hMG. When more than two dominant follicles reached a diameter of 17 mm or the urinary specimen showed positive results for LH surge, 5,000 IU of hCG (Pregnyl; Organon, Oss, the Netherlands) was injected intramuscularly, and after 24 to 36 hours, IUI was performed only once.
대상 데이터
This is a retrospective case-control study that was performed in our infertility clinic between October 2006 and September 2008. Three hundred and eighty-three patients with unexplained infertility that underwent IUI with superovulation were included in this study. Patients were divided into two groups, the pregnant group and nonpregnant group.
데이터처리
Calculations of statistical differences between the groups were carried out by a Student’s t-test or a chi-square test.
성능/효과
According to the ROC curve, RAPID, motility, and concentration parameters in the unprocessed semen were predictive of pregnancy and the cut-off values were 30.1% for RAPID, 51.4% for motility, and 111 × 106 /mL for concentration.
In conclusion, concentration and motility assessment of semen by CASA is a fairly useful method for predicting pregnancy outcome after IUI with superovulation, which could be helpful in planning strategies for the further treatment of unexplained infertile couples by proceeding with IVF/ICSI-ET.
In this study, we assessed the sperm motility parameters by CASA in 383 IUI cycles with superovulation indicated in couples with unexplained infertility. Specific CASA parameters such as VAP, RAPID, VSL, VCL, as well as sperm concentration and motility were significantly different between the pregnant group and the non-pregnant group. We also found that the combination of parameters such as RAPID ≥ 30.
Statistically significant differences were found in some variables associated with semen analysis before swim-up: sperm concentration (152.9 ± 13.7 × 106 /mL vs. 118.8 ± 4.3 × 106 /mL in the pregnant and non-pregnant group, respectively; p= 0.021); motility (56.8 ± 1.8% vs. 51.2 ± 0.9%; p= 0.007); VAP (40.8 ± 1.05 µm/sec vs. 38.4 ± 0.4 µm/ sec; p= 0.033); and RAPID (28.1 ± 2.16% vs. 24.5 ± 0.87%; p= 0.022).
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 1534 10368500
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 15 359 364 9673879
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 61 303 307 8299787
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 17054143
7 Steures P van der Steeg JW Mol BW Eijkemans MJ van der Veen F Habbema JD Prediction of an ongoing pregnancy after intrauterine insemination Fertil Steril 2004 82 45 51 15236988
8 Shulman A Hauser R Lipitz S Frenkel Y Dor J Bider D Sperm motility is a major determinant of pregnancy outcome following intrauterine insemination J Assist Reprod Genet 1998 15 381 385 9673883
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 17 11167514
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 75 661 668 11287015
11 World Health Organization WHO laboratory manual for the examination of human semen and sperm-cervical mucus interaction 1999 4th ed Cambridge Cambridge University Press
12 Jørgensen N Auger J Giwercman A Irvine DS Jensen TK Jouannet P Semen analysis performed by different laboratory teams: an intervariation study Int J Androl 1997 20 201 208 9401822
13 Brazil C Swan SH Drobnis EZ Liu F Wang C Redmon JB Standardized methods for semen evaluation in a multicenter research study J Androl 2004 25 635 644 15223853
14 Larsen L Scheike T Jensen TK Bonde JP Ernst E Hjollund NH The Danish First Pregnancy Planner Study Team Computer-assisted semen analysis parameters as predictors for fertility of men from the general population Hum Reprod 2000 15 1562 1567 10875866
15 Shibahara H Obara H Ayustawati Hirano Y Suzuki T Ohno A Prediction of pregnancy by intrauterine insemination using CASA estimates and strict criteria in patients with male factor infertility Int J Androl 2004 27 63 68 15149462
16 Macleod IC Irvine DS The predictive value of computer-assisted semen analysis in the context of a donor insemination programme Hum Reprod 1995 10 580 586 7782436
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 58 179 186 1624002
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 14 531 537 9401872
19 Hirano Y Shibahara H Obara H Suzuki T Takamizawa S Yamaguchi C Relationships between sperm motility characteristics assessed by the computer-aided sperm analysis (CASA) and fertilization rates in vitro J Assist Reprod Genet 2001 18 213 218 11432113
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 18399982
21 Fréour T Jean M Mirallié S Dubourdieu S Barrière 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 149 186 189 20074847
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 1106 2245836
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 8293843
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 6540770
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 3235208
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 1932 9740451
29 Barratt CL Tomlinson MJ Cooke ID Prognostic significance of computerized motility analysis for in vivo fertility Fertil Steril 1993 60 520 525 8375537
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 2937 8747047
32 Suarez SS Control of hyperactivation in sperm Hum Reprod Update 2008 14 647 657 18653675
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 1339849
※ AI-Helper는 부적절한 답변을 할 수 있습니다.