The Diagnostic and Therapeutic Values of the Huhner Test: A Retrospective Study of 718 Subfertile Couples

Abstract

Background: This retrospective study aims to investigate the value of Huhner test in the routine evaluation of infertile couples and to compare 4 different cut off levels to consider the positivity of the test. Methods: Pregnancy outcomes of 718 couples, who underwent a Huhner test from January 2004 to December 2012, were assessed. The follow up was stopped in 04/30/2013. Results: After exclusion of women’s FSH > 15 IU/ml and altered sperm, total pregnancy rate was higher in the positive HT group than in the negative one (70.5% vs. 57.8% p<0.05). A negative HT was significantly associated with half chance of natural conception (38.8% vs. 20% P<0.05). For simple stimulation, pregnancy rate was three times higher in the positive group than in the negative HT group (17.8% vs. 6.8% p<0.05). For IUI, there were twice as many pregnancies in the negative HT group compared with positive HT group (30.5% vs. 13.2% p<0.01) and three times more in ICSI (27.1%vs 9.3% p<0.01). For IVF, there was no significant difference. The best cut off level, for a positive Huhner test, appeared to be 1 motile spermatozoon seen in the entire cervix according to WHO 2010. Conclusion: This study showed that the Huhner test was still useful in predictive and therapeutic diagnostic: If a woman is young and the Huhner test is positive, we should merely give a chance to a natural conception and therefore give more time to the couple before moving on to simple stimulation. With a negative HT, no clear conclusions can be drawn, but it seems logical to proceed directly to IUI and shift more rapidly towards ICSI.