RESEARCHOpenAccessEfficacyofspermmotilityafterprocessingandincubationtopredictpregnancyafterintrauterineinseminationinnormospermicindividualsLígiaFPdeAraújo1,2*,EdilbertodeAraújoFilho1,CássioLFácio1,MárciaCOBossoni1,LigianeAMachado-Paula1,JoséECorrente3,MárioCavagna4,5,PauloCSMatheus6andAnaglóriaPontes2AbstractBackground:Intrauterineinsemination(IUI)iswidelyusedtotreatinfertility,anditsadequateindicationisimportanttoobtaingoodpregnancyrates.
ToassesswhichcouplescouldbenefitfromIUI,thisstudyaimedtoevaluatewhetherspermmotilityusingadiscontinuousgradientofdifferentdensitiesandincubationinCO2innormospermicindividualsisabletopredictpregnancy.
Methods:Atotalof175couplesunderwent175IUIcycles.
Theinclusioncriteriaforwomenwereasfollows:35yearsoldoryounger(agerange:from27to35years)withnormalfallopiantubes;endometriosisgradesI-II;unexplainedinfertility;nonhyperandrogenicovulatorydysfunction.
Menwithnormalseminalparameterswerealsoincluded.
AllpatientsunderwentovarianstimulationwithclomiphenecitrateandhumanhMGorr-FSH.
Whenoneor(atmost)threefolliclesmeasuring18to20mmwereobserved,hCG(5000UI)orr-hCG(250mcg)wasadministeredandIUIperformed36–40hafterhCG.
Spermprocessingwasperformedusingadiscontinuousconcentrationgradient.
A20microlitersaliquotwasincubatedfor24hat37degreesCin5%CO2followingatotalprogressivemotilityanalysis.
TheMann–WhitneyandChi-squaretests,aswellasaROCcurvewereusedtodeterminethecutoffvalueformotility.
Results:Ofthe175couples,52(in52IUIcycles)achievedclinicalpregnancies(CPratepercycle:29.
7%).
Theanalysisofage,durationandcausesofinfertilitydidnotindicateanystatisticalsignificancebetweenpregnancyandnopregnancygroups,similartotheresultsfortotalspermcountandmorphologyanalyses,excludingprogressivemotility(p10millionandmorphologywas>4%.
MaleagewasalsoadeterminingfactorforIUIsuccess,evenwithanormalspermiogram.
Inourstudy,therewasnosig-nificantdifferenceinage(bothmenandwomen)inbothgroups(pregnancyandnopregnancy),andourdatareinforcethatspermmotility,whichwasverifiedinthepresentstudy,mayhelppatientsdeterminetheirchancesofIUIsuccess.
Currently,manystudiesinvestigateseminalparametersanditsimportanceinachievinggoodpregnancyoutcomesincouplesundergoingIUI.
Howevermanycontroversiesmakeitimpossibletoknowwhichcouplescouldbenefitfromthisformoftreatmentbecausethebasicsemenana-lysisisnotagoodparameterforIUIsuccess.
Moreover,wedonothaveanswersregardingthefeasibilityofselect-ivelyinsistingontheIUItechnique.
Thereisonlyonestudyintheliterature,whichwasperformedbyBraniganetal.
[20],thatanalyzedspermmotilityat24hafterpro-cessingandincubationasthepredictivetestofIUIsuc-cess.
Accordingtothestudyoutcome,thismotilitytestispredictiveofIUIsuccess.
Theauthorsassessed414cou-plesundergoingIUIbecauseofamalefactorandunex-plainedinfertility.
Theirresultsshowedthatnoneofthebasicsemenanalysisparametersofconcentration,motilityormorphologywaspredictiveofIUIsuccess.
Withthead-vancedanalysis,whentheprocessedtotalmotilespermthatwereavailableforIUIwas≥10*106andthespermsurvivalat24hafterincubationwas≥70%,89%ofthecouplesachievedpregnancy,witha21.
4%pregnancyratepercycle.
Withthecutoffvalues>70%fortheadvancedsemenanalysis,thetesthadasensitivityof94%andspeci-ficityof86%.
Interestinglytheauthorscomparedmenwithnormalsemenanalysis(groupofunexplainedinfertility)withthosemenpresentingamalefactor.
Theresultsshowedthat83%ofcoupleshadmalefactorproblems(basicsemenanalysisparameters),presentingapercyclepregnancyrateof17.
8%anda48%cumulativepregnancyrate.
Twenty-threeper-centofmenwithnormalsemenparameterspresentedapercyclepregnancyrateof1.
8%andtheydidnotmeettheadvancedsemenanalysiscutoffvaluesfor24hmotilityorprocessedtotalmotilesperm.
Therefore,theadvancedtestwaspredictive,independentofnormalorabnormalthebasicanalysisseminalparameters,becausethisadvancedanalysisaccuratelypredictedthese"occult"malefactors.
Thissametypeoftestwasperformedinthiswork,butonlyinnormospermicindividuals,whichallowedagoodsuccessrateinourIUIresults.
Somestudiesconfirmedthatpregnancyratesarehigherinnormospermicindivid-ualsasshownbyAllenetal.
[30],whichindicateda25%pregnancyratepercyclein104coupleswhenthemalefac-torwaspredominantanda60%pregnancyratepercyclein58coupleswhentherewasacervicalfactor.
ForGrigoriouetal.
[31],theratesofCPandlivebirthspercycleweresignificantlylowerintheteratozoospermiaTable3Sensitivity,specificity,positiveandnegativepredictivevaluesasdeterminedbycutoffvaluesoftheROCcurveAfterspermprocessing(cutoffvalue:69%)24hincubation(cutoffvalue:56.
5%)Sensitivity63.
5(50.
4–76.
5)96.
1(90.
9–100.
0)Specificity73.
1(65.
0–81.
0)92.
7(88.
1–97.
3)Positivepredictivevalue50(37.
9–62.
1)84.
7(75.
5–93.
9)Negativepredictivevalue82.
6(75.
5–89.
7)98.
3(95.
9–100.
0)Valuesareexpressedaspercentageand95%CI.
deAraújoetal.
ReproductiveBiologyandEndocrinology2013,11:101Page5of7http://www.
rbej.
com/content/11/1/101groupwhencomparedwiththenormozoospermiagroup,whereasthecumulativelivebirthrateafter4IUIcycleswassignificantlylowerinthegroupwithmalefactorsofinfertility.
Thesedatacorroboratetheresultspresentedhere,indicat-ingthathighpregnancyratesareobtainedinnormospermicpatientsinwhichspermmotilityafterincubationremainsunchanged.
Therefore,thetestwith24hincubationat37°Cin5%CO2afterspermprocessingallowedustoconcludethatmotilityisrelatedtothesuccessrateofIUI.
Thus,cou-plesseekingtreatmentforinfertilitycouldbesubjectedtothistest,andfromthetestresults,wewouldbeabletose-lectthosecoupleswhomightbenefitfromIUI.
Thus,cou-plesavoidsubjectiontoseveralunnecessarycyclesofIUI.
SuccessivefailedattemptsoftheIUIcanbeafrustratingex-perienceforthecouple,notonlybythedistressbetweenonecycleandanotherbutalsobythefearofnotachievingsuccess[10].
WealsobelievethatifthispredictivetestofIUIsuc-cesswasappliedtopatientsbeforetreatment,thenaconsensuscouldbedeterminedregardingtheexistingvariationinthelimitforthenumberofcyclestobeperformed.
Thepresentstudyaimsatthisgoalthroughacutoffvalueusingmotility,whichistheparameterthatappearstobethemostrelevant.
Thisobservationiscon-sistentwiththestudiesbyShulmanetal.
[22],whocon-cludedthatthedegreeofspermmotilityistheonlyparameterthatcanbecorrelatedwiththeIUIoutcomefornormalwomenwithapartnerwithgoodspermmo-tility,afterappropriatespermpreparation.
TheIUIisalesscomplextreatmentandthetestofspermmotilityat24hafterincubationat37°Cin5%CO2canbeusedtopredictCPpriortotheIUItreatmentorasanindicatortoverifywhetheranewIUIattemptmustbeperformedormorecomplexARTsarerequired.
ConclusionsInconclusion,thepresentstudysuggeststhatdeterminingthespermmotilityofnormospermicindividualsafterpro-cessingandincubationfor24hat37°Cin5%CO2,withacutoffvalueof56.
5%isabletopredictIUIsuccess.
AbbreviationsART:Assistedreproductiontechniques;CI:Confidenceinterval;COH:Controlledovarianhyperstimulation;CP:Clinicalpregnancy;hCG:Humanchorionicgonadotropin;hMG:Humanmenopausalgonadotropin;IUI:Intrauterineinsemination;IVF:invitrofertilization;mHTF:Modifiedhumantubalfluid;npv:Negativepredictivevalue;ppv:Positivepredictivevalue;r-FSH:Recombinantfolliclestimulatinghormone;r-hCG:Recombinanthumanchorionicgonadotropin;ROC:Receiveroperatingcharacteristiccurve;SSS:Syntheticserumsubstitute;TMC:Totalmotilespermcount.
CompetinginterestsTheauthorsdeclarethattheyhavenocompetinginterests.
Authors'contributionsLFPAwasresponsiblefordesigningandcoordinatingthestudy,thecollection,analysisandinterpretationofthedata,andforwritingthemanuscript.
EAFwasresponsibleforthecollection,analysisandinterpretationofthedata.
CLFandMCOBwereresponsiblefordatacollection.
LAM-Pwasresponsiblefortheanalysisandinterpretationofthedataandrevisingthemanuscript.
JECwasresponsibleforthestatisticalanalyses.
MCandPCSMwereresponsibleforrevisingthemanuscript.
APwasresponsiblefordesigningandcoordinatingthestudy.
Allauthorsreadandapprovedthefinalmanuscript.
AcknowledgementsTheauthorswishtothanktheElsevierLanguageEditinghttp://webshop.
elsevier.
com/languageediting/forrevisingtheEnglishtext.
Authordetails1CenterofHumanReproductionofSoJosédoRioPreto,SoJosédoRioPreto,SP,Brazil.
2DepartmentofGynaecologyandObstetrics,BotucatuMedicalSchool,SoPauloStateUniversity-UNESP,Botucatu,SP,Brazil.
3DepartmentofBioestatistics,InstituteofBiosciencesBotucatu,SoPauloStateUniversity-UNESP,Botucatu,SP,Brazil.
4CenterforHumanReproductionProf.
FrancoJr,RibeiroPreto,SP,Brazil.
5PaulistaCenterforDiagnosis,ResearchandTraining,RibeiroPreto,SP,Brazil.
6GERAR-FertilityClinic,Recife,PE,Brazil.
Received:22May2013Accepted:18October2013Published:22October2013References1.
DodsonWC,HaneyAF:Controlledovarianhyperstimulationandintrauterineinseminationfortreatmentofinfertility.
FertilSteril1991,55:457–467.
2.
MarchettiC,DewaillyD:Intrauterineinsemination:indicationsandmethods.
RevPrat2006,56:500–506.
3.
MervielP,HeraudMH,GrenierN,LourdelE,SanguinetP,CopinH:Predictivefactorsforpregnancyafterintrauterineinsemination(IUI):ananalysisof1038cyclesandareviewoftheliterature.
FertilSteril2010,93:79–88.
4.
ScemamaH,Salat-BarouxJ,AntoineJM,SaadaH:Valueofcontrolledhyperstimulationinintrauterineinseminations.
ContraceptFertilSex1995,23:37–44.
5.
vanWeertJM,ReppingS,VanVoorhisBJ,vanderVeenF,BossuytPM,MolBW:Performanceofthepostwashtotalmotilespermcountasapredictorofpregnancyatthetimeofintrauterineinsemination:ameta-analysis.
FertilSteril2004,82:612–620.
6.
ArnyM,QuagliarelloJ:Semenqualitybeforeandafterprocessingbyaswim-upmethod:relationshiptooutcomeofintrauterineinsemination.
FertilSteril1987,48:643–648.
7.
HorvathP,BohrerM,SheldenR,KemmannE:Therelationshipofspermparameterstocyclefecundityinsuperovulatedwomanundergoingintrauterineinsemination.
FertilSteril1989,52:288–294.
8.
FrancavillaF,RomanoR,SantucciR,PocciaG:Effectofspermmorphologyandmotilespermcountonoutcomeofintrauterineinseminationinoligozoospermiaand/orasthenozoospermia.
FertilSteril1990,53:892–897.
9.
BraschJG,RawlinsR,TarchalaS,RadwanskaE:Therelationsbetweentotalmotilespermcountandthesuccessofintrauterineinsemination.
FertilSteril1994,62:150–154.
10.
CampanaA,SakkasD,StalbergA,BianchiPG,ComteI,PacheT,WalkerD:Intrauterineinsemination:evaluationoftheresultsaccordingtothewoman'sage,spermquality,totalspermcountperinseminationandlifetableanalysis.
HumReprod1996,11:732–736.
11.
DickeyRP,PyrzakR,LuPY,TaylorSN,RyePH:ComparisonofthespermqualitynecessaryforsuccessfulintrauterineinseminationwithWHOthresholdvaluesfornormalsperm.
FertilSteril1999,71:684–689.
12.
KhalilMR,RasmussenPE,ErbK,LaursenSB,RexS,WestergaardLG:Homologousintrauterineinsemination.
Anevaluationofprognosticfactorsbasedonareviewof2473cycles.
ActaObstetGynecolScand2001,80:74–81.
deAraújoetal.
ReproductiveBiologyandEndocrinology2013,11:101Page6of7http://www.
rbej.
com/content/11/1/10113.
VanVoorhisBJ,BarnettM,SparksAE,SyropCH,RosenthalG,DawsonJ:Effectofthetotalmotilespermcountontheefficacyandcost-effectivenessofintrauterineinseminationandinvitrofertilization.
FertilSteril2001,75:661–668.
14.
MillerDC,HollenbeckBK,SmithGD,RandolphJF,ChristmanGM,SmithYR,LebovicDI,OhlDA:Processedtotalmotilespermcountcorrelateswithpregnancyoutcomeafterintrauterineinsemination.
Urology2002,60:497–501.
15.
WainerR,AlbertM,DorionA,BaillyM,BergèreM,LombrosoR,GombaultM,SelvaJ:Influenceofthenumberofmotilespermatozoainseminatedandoftheirmorphologyonthesuccessofintrauterineinsemination.
HumReprod2004,19:2060–2065.
16.
ZhaoY,VlahosN,WyncottD,PetrellaC,GarciaJ,ZacurH,WallachEE:Impactofsemencharacteristicsonthesuccessofintrauterineinsemination.
JAssistReprodGenet2004,21:143–148.
17.
BadawyA,ElnasharA,EltotongyM:Effectofspermmorphologyandnumberonsuccessofintrauterineinsemination.
FertilSteril2009,91:777–781.
18.
DorjpurevU,KuwaharaA,YanoY,TaniguchiT,YamamotoY,SutoA,TanakaY,MatsuzakiT,YasuiT,IraharaM:Effectofsemencharacteristicsonpregnancyratefollowingintrauterineinsemination.
JMedInvest2011,8:127–133.
19.
EddyEM,O'BrienDA:Thespermatozoon.
InThePhysiologyofReproduction.
EditedbyKnobilE,NeillJD.
NewYork:RavenPress;1994:29–77.
20.
BraniganEF,EstesMA,MullerCH:Advancedsemenanalysis:asimplescreeningtesttopredictintrauterineinseminationsuccess.
FertilSteril1999,71:547–551.
21.
HuangHY,LeeCL,LaiYM,ChangeMY,WangHS,ChangeSY,SoongYK:Theimpactofthetotalmotilespermcountonthesuccessofintrauterineinseminationwithhusband'sspermatozoa.
JAssistReprodGenet1996,13:56–63.
22.
ShulmanA,HauserR,LipitzS,FrenkelY,DorJ,BiderD,MashiachS,YogevL,YavetzH:Spermmotilityisamajordeterminantofpregnancyoutcomefollowingintrauterineinsemination.
JAssistReprodGenet1998,15:381–385.
23.
StanfordJB,MikolajczykRT,LynchCD,SimonsenSE:Cumulativepregnancyprobabilitiesamongcoupleswithsubfertility:effectsofvaryingtreatments.
FertilSteril2010,93:2175–2181.
24.
WorldHealthOrganization:WHOLaboratoryManualfortheExaminationandProcessingofHumanSemen.
5thedition.
Geneva:WHO;2010.
25.
ESHRE:GuidelinefortheDiagnosisandTreatmentofEndometriosis.
http://www.
guidelines.
endometriosis.
org.
26.
McGovernP,QuagliarelloJ,ArnyM:Relationshipofwithin-patientsemenvariabilitytooutcomeofintrauterineinsemination.
FertilSteril1989,51:1019–1023.
27.
BergU,BruckerC,BergFD:Effectofmotilespermcountafterswim-uponoutcomeofintrauterineinsemination.
FertilSteril1997,67:747–750.
28.
PasqualottoEB,DaitchJA,HendinBN,FalconeT,ThomasAJJr,NelsonDR,AgarwalA:Relationshipoftotalmotilespermcountandpercentagemotilespermtosuccessfulpregnancyratesfollowingintrauterineinsemination.
JAssistReprodGenet1999,16:476–482.
29.
DemirB,DilbazB,CinarO,KaradagB,TasciY,KocakM,DilbazS,GoktolgaU:Factorsaffectingpregnancyoutcomeofintrauterineinseminationcyclesincoupleswithfavourablefemalecharacteristics.
JObstetGynaecol2011,31:420–423.
30.
AllenNC,HerbertCM3rd,MaxsonWS,RogersBJ,DiamondMP,WentzAC:Intrauterineinsemination:acriticalreview.
FertilSteril1985,44:569–580.
31.
GrigoriouO,PantosK,MakrakisE,HassiakosD,KonidarisS,CreatsasG:Impactofisolatedteratozoospermiaontheoutcomeofintrauterineinsemination.
FertilSteril2005,83:773–775.
doi:10.
1186/1477-7827-11-101Citethisarticleas:deAraújoetal.
:Efficacyofspermmotilityafterprocessingandincubationtopredictpregnancyafterintrauterineinseminationinnormospermicindividuals.
ReproductiveBiologyandEndocrinology201311:101.
SubmityournextmanuscripttoBioMedCentralandtakefulladvantageof:ConvenientonlinesubmissionThoroughpeerreviewNospaceconstraintsorcolorgurechargesImmediatepublicationonacceptanceInclusioninPubMed,CAS,ScopusandGoogleScholarResearchwhichisfreelyavailableforredistributionSubmityourmanuscriptatwww.
biomedcentral.
com/submitdeAraújoetal.
ReproductiveBiologyandEndocrinology2013,11:101Page7of7http://www.
rbej.
com/content/11/1/101
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