Effect of sperm parameters on intrauterine insemination pregnancy rate.

OBJECTIVE To assess the effect of sperm parameters on pregnancy rate following Intrauterine Insemination (IUI) in primary and secondary infertile patients. STUDY DESIGN An observational study. PLACE AND DURATION OF STUDY The Assisted Conception Unit, Department of Obstetrics and Gynaecology, Services Institute of Medical Sciences, Lahore, Pakistan, from January 2004 to January 2006. PATIENTS AND METHODS One hundred and thirty-six couples, comprising 110 couples with primary and 26 with secondary infertility, of at least one year of infertility, were studied. All underwent a total of 231 intrauterine insemination cycles. A detailed history for infertility evaluation was taken. Hormonal profiles were done on day two of the menstrual cycle. Ovarian stimulation of all patients with Clomiphene citrate was done from day two of the menstrual cycle for 5 days and subsequent transvaginal scans on day twelve, for follicular tracking were done. Semen analysis was done, after 2-3 days abstinence and sperms for intrauterine insemination were prepared according to Density Gradient Sperm Wash Method. IUI was done 36 hours after tracking of the dominant follicles and injection hCG was given for follicular maturation and rupture. The main outcome measures were determining the effect of normal and abnormal sperm parameters on pregnancy outcome, in ovulation induced infertile couples, undergoing intrauterine insemination cycles. RESULTS Of the 136 couples, who underwent IUI cycles, 18 had male factor infertility and the rest were with normal semen parameters. An IUI pregnancy rate of 13.7% was seen with a total of 4 conceptions. CONCLUSION This study confirms that IUI, because of its cost effectiveness and minimum complications, can be applied as a first line treatment in infertile couples after considering the sperm parameters.