Homologous Intrauterine Insemination Research Articles

Determinant Factors for Ongoing Pregnancy in Homologous Intrauterine Insemination Cycles - A Prospective Study.

Intrauterine insemination (IUI) is the most common assisted-reproduction treatment. However, it has lower success rate in comparison to other treatments. Therefore, determining factors that contribute to IUI success is of particular interest and this was the purpose of this prospective study. In this study, only homologous inseminations with fresh semen samples were included. All women received mild ovarian stimulation with clomiphene citrate and gonadotropins. Before IUI, basic semen analysis, evaluation of DNA fragmentation index (DFI), as well as measurement of sperm redox potential, were performed on each semen sample. Semen was processed with density-gradient centrifugation and 500 μl of processed sperm was used for insemination. In 200 cycles, there were 36 pregnancies, six of them ectopic. Cycles with ongoing pregnancies were characterized by younger male and female age and higher number of follicles. Multivariate logistic regression analysis showed that only female age was significantly associated with ongoing pregnancy. DFI was positively correlated with male age and negatively correlated with sperm concentration and progressive motility. Semen redox potential showed a strong negative correlation with sperm concentration and positive correlation with DFI. Female age seems to be the most important determinant factor for the achievement of an ongoing pregnancy in homologous IUI cycles with fresh semen.

Predicting success of intrauterine insemination using a clinically based scoring system

PurposeTo develop a predictive score for the success of intrauterine insemination (IUI) based on clinical parameters.MethodsWe performed a retrospective cohort study evaluating the homologous IUI cycles performed at a single university-based reproductive medical center between 2009 and 2017. The primary outcome measure was pregnancy, defined as positive serum human chorionic gonadotropin (hCG) 12–14 days after IUI. Predictive factors for pregnancy after IUI were identified, and a predictive score was developed using a multivariable continuation ratio model.ResultsOverall, 1437 IUI cycles in 758 couples were evaluated. We found a per cycle pregnancy rate of 10.9% and a cumulative pregnancy rate of 19.4%. In a multivariable analysis, the probability of pregnancy was negatively associated with female age ≥ 35 years (OR 0.63, 95% CI 0.41–0.97, p = 0.034), endometriosis, unilateral tubal factor, or anatomical alteration (OR 0.54, 95% CI 0.33–0.89, p = 0.016), anti-Mullerian hormone (AMH) < 1 ng/ml (OR 0.50, 95% CI 0.29–0.87, p = 0.014), and total progressive motile sperm count (TPMSC) < 5 mil (OR 0.47, 95% CI 0.19–0.72, p = 0.004). We developed a predictive clinical score ranging from 0 to 5. Following 3 cycles, couples in our cohort with a score of 5 had a cumulative probability of achieving pregnancy of nearly 45%. In contrast, couples with a score of 0 had a cumulative probability of only 5%.ConclusionIUI success rates vary widely depending on couples’ characteristics. A simple to use score could be used to estimate a couple’s chance of achieving pregnancy via IUI, facilitating individualized counseling and decision-making.

Twenty-one year experience with intrauterine inseminations after controlled ovarian stimulation with gonadotropins: maternal age is the only prognostic factor for success.

To report our experience on homologous intrauterine insemination (IUI) with gonadotropin controlled ovarian stimulation (COS) cycles and to examine different variables which could predict IUI success. This is a retrospective analysis of IUIs performed between January 1997 and December 2017. A total of 7359 COS IUI's procedures (2901 couples) were reviewed. Clinical pregnancy, live birth rate and age, body mass index (BMI), smoking habit, duration of infertility, sperm characteristics before and after treatment (total motile count, morphology, and vitality), day 3 FSH, total gonadotropin dose, and number of follicles were assessed by multivariate logistic regression analysis, and data were expressed as odds ratio (OR). The mean female age at the time of COS was 35.10 ± 3.93years. The most common single infertility diagnoses were unexplained infertility (53.55%), mild male factor (19.69%), and anovulation (10.95%). The total progressive motile sperm count (TPMC) was > 1 × 106/ml (mean 1.34 ± 1.08 × 106/ml). The clinical pregnancy rate was 9.38%, and the live birth rate was 7.19% per cycle. Twin pregnancies were 12.17%. Cumulative pregnancy was 21.89% and cumulative live birth rate was 17.58% per couple. Clinical pregnancy and live birth rates were significantly associated with female age [OR 0.97 (95% CI 0.95-0.99) and 0.95 (95% CI 0.93-0.97), respectively] and day 3 FSH [OR 0.91 (95% CI 0.87-0.94) e 0.90 (95% CI 0.87-0.94), respectively]. Clinical pregnancy rate and live birth rates after COS-IUIs were significantly influenced by female age and FSH levels. Clinical trial registration number: NCT03836118.

Factores asociados a embarazo en pacientes sometidas a inseminación intrauterina en el Hospital de las Mujeres Dr. Adolfo Carit Eva, Costa Rica, enero 2009 a diciembre 2015.

Introducción: La inseminación intrauterina es un procedimiento de baja complejidad en reproducción asistida que se ha utilizado por más de un siglo como tratamiento en infertilidad y consiste en el depósito de espermatozoides en el útero, previa capacitación, con la finalidad de lograr el embarazo. El objetivo general fue identificar los factores asociados a embarazo en pacientes sometidas a inseminación intrauterina homóloga en el Hospital de las Mujeres Dr. Adolfo Carit Eva. &#x0D; Metodología: Se realizó un estudio de casos y controles definiendo como caso aquella paciente con diagnóstico de embarazo clínico luego de ser sometida a inseminación intrauterina y como control a toda paciente que ha sido sometida a tres ciclos de inseminación intrauterina sin lograr un embarazo. Los factores pronósticos evaluados fueron: la edad materna, el índice de masa corporal, el periodo de infertilidad transcurrido, el recuento de espermatozoides móviles y el número de folículos mayor a 16mm previo a la aplicación de hormona gonadotropina coriónica. &#x0D; Resultados: No hubo diferencias significativas entre los casos y controles en la edad media (p=0,22), la evaluación del índice de masa corporal (p=0,18) y los otros factores evaluados; solo el periodo medio de infertilidad evidenció diferencias estadísticamente significativas, con un tiempo medio de 36,7 meses para el grupo de caso y de 49,7 meses dentro del grupo control (p= 0,01). &#x0D; Conclusiones: Dentro de las variables evaluadas, únicamente el periodo transcurrido de infertilidad resultó ser un factor pronóstico para el éxito de la inseminación intrauterina en la población estudiada.

Magnetic activated sorting selection (MACS) of non-apoptotic sperm (NAS) improves ongoing pregnancy rates in homologous intrauterine insemination (IUI)

Magnetic activated sorting selection (MACS) of non-apoptotic sperm (NAS) improves ongoing pregnancy rates in homologous intrauterine insemination (IUI)

Effect of Gonadotropin Types and Indications on Homologous Intrauterine Insemination Success: A Study from 1251 Cycles and a Review of the Literature.

Objective To evaluate the IUI success factors relative to controlled ovarian stimulation (COS) and infertility type, this retrospective cohort study included 1251 couples undergoing homologous IUI. Results We achieved 13% clinical pregnancies and 11% live births. COS and infertility type do not have significant effect on IUI clinical outcomes with unstable intervention of various couples' parameters, including the female age, the IUI attempt rank, and the sperm quality. Conclusion Further, the COS used seemed a weak predictor for IUI success; therefore, the indications need more discussion, especially in unexplained infertility cases involving various factors. Indeed, the fourth IUI attempt, the female age over 40 years, and the total motile sperm count <5 × 106 were critical in decreasing the positive clinical outcomes of IUI. Those parameter cut-offs necessitate a larger analysis to give infertile couples more chances through IUI before carrying out other ART techniques.

Prognostic Factors of Pregnancy after Homologous Intrauterine Insemination

The objective was to identify the factors influencing the outcome of homologous intrauterine insemination (IUI-H). Nine hundred and sixty-eight couples underwent 2246 IUI-H cycles. The clinical pregnancy rate (PR) per IUI-H cycle and per couple, and the miscarriage and multiple pregnancy rates were 11.8%, 27.4%, 23.3%, and 12.0%, respectively. IUI-H for combined infertility (n = 118) was 3 times less efficient than IUI performed for unexplained infertility (n = 289), OR = 0.293 (95% CI, 0.098-0.872). PRs did not differ in CC, letrozole and gonadotropin cycles, but compared with CC, Gonal-F was twice as efficient, OR = 1.994 (95% CI, 1.137-3.495). The cycles with at least 3 follicles ≥17 mm were twice as successful as the cycles with 1 follicle only, OR = 1.836 (95% CI, 1.061-3.177). The success of IUI-H increases with higher inseminated motile sperm count (IMC), from 3.6×106 up to 12×106, where it reaches a plateau.

Experiencia con inseminación intrauterina

En el Servicio de Fertilidad del HNAL, la IIU homóloga logra resultados aceptables en los casos de factor cervical, Al parecer, la inducción de ovulación con CC contribuye a un incremento en la tasa de éxito. El facto masculino subnormal, astenozoospermia, no logra tener solución con esta técnica. La IUU heteróloga, utilizada en los casos de azoospermia, tiene una tasa eleva de éxito.

Inseminación intrauterina en mayores de 38 años, ¿vale la pena?

Objetivos: Realizar un análisis costo-eficiencia de los resultados obtenidos con inseminación intrauterina homóloga (IIU) en parejas infértiles cuyas mujeres fueran 38 años o mayores, en una unidad de reproducción humana, y comparar dicho rendimiento con lo publicado para el mismo grupo etario con técnicas de alta complejidad, en el Registro Latinoamericano de Reproducción Asistida (RedLARA). Diseño: Estudio retrospectivo, comparativo. Institución: Unidad de Reproducción Humana, Pontificia Universidad Católica de Chile, Santiago, Chile. Participantes: Mujeres mayores de 38 años tratadas con inseminación intrauterina homóloga. Intervenciones: Se revisó los resultados obtenidos en 5 421 ciclos de inseminación intrauterina homóloga (IIU) realizados entre enero 2000 y septiembre de 2011. Con el fin de analizar el impacto de la avanzada edad reproductiva, se comparó los resultados obtenidos en mujeres menores de 38 años (4 000 ciclos) y en aquellas de 38 años y más (1 421 ciclos). Se describe las tasas de embarazo clínico obtenidas con los distintos protocolos de estimulación ovárica. El análisis costo-eficiencia al intentar tres ciclos de IIU previo a optar por fertilización in vitro (FIV) en mujeres mayores de 38 años, en lugar de ir directamente a FIV, fue comparado con los datos publicados en la Red Latinoamericana de Reproducción Asistida 2009 para ciclos de FIV/ICSI en mujeres de edad reproductiva avanzada. Principales medidas de resultados: Análisis costo-eficiencia de intentar tres ciclos de IIU previo a optar por FIV, en mujeres mayores de 38 años. Resultados: Se incluyó 600 embarazos clínicos en toda la serie, lo que correspondió a una tasa de embarazo clínico de 11,1%, con multigestación de 5,3%. En mujeres de 38 años y más hubo significativo descenso de las mismas tasas (7,5% y 2,8%, respectivamente). Resultó evidente el aporte que implican los esquemas con gonadotropinas en las tasas de embarazo clínico obtenidas con los distintos protocolos de estimulación ovárica. El análisis costo-eficiencia demostró un beneficio en intentar 3 ciclos de IIU, cuando se reúne los criterios de inclusión, previo a optar por fertilización in vitro (FIV), en lugar de ir directamente a FIV. Conclusiones: En mujeres de 38 años y más disminuyeron las tasas de embarazo clínico y multigestación. El análisis costo-eficiencia demostró un beneficio en intentar tres ciclos de IIU, cuando se reúnelos criterios de inclusión, previo a optar por fertilización in vitro (FIV), en lugar de ir directamente a FIV.

Double versus single homologous intrauterine insemination for male factor infertility: a systematic review and meta-analysis

Male factor infertility affects 30%-50% of infertile couples worldwide, and there is an increasing interest in the optimal management of these patients. In studies comparing double and single intrauterine insemination (IUI), a trend towards higher pregnancy rates in couples with male factor infertility was observed. Therefore, we set out to perform a meta-analysis to examine the superiority of double versus single IUI with the male partner's sperm in couples with male factor infertility. An odds ratio (OR) of 95% confidence intervals (CIs) was calculated for the pregnancy rate. Outcomes were analysed by using the Mantel-Haesel or DerSimonian-Laird model according to the heterogeneity of the results. Overall, five trials involving 1125 IUI cycles were included in the meta-analysis. There was a two-fold increase in pregnancies after a cycle with a double IUI compared with a cycle with a single IUI (OR: 2.0; 95% CI: 1.07-3.75; P<0.03). Nevertheless, this result was mainly attributed to the presence of a large trial that weighted as almost 50% in the overall analysis. Sensitivity analysis, excluding this large trial, revealed only a trend towards higher pregnancy rates among double IUI cycles (OR: 1.58; 95% CI: 0.59-4.21), but without statistical significance (P=0.20). Our systematic review highlights that the available evidence regarding the use of double IUI in couples with male factor infertility is fragmentary and weak. Although there may be a trend towards higher pregnancy rates when the number of IUIs per cycle is increased, further large and well-designed randomized trials are needed to provide solid evidence to guide current clinical practice.

Improvements in identification of the best sperm for ICSI?

Sperm fertility assessment remains a dubiously objective art. In this issue of Reproductive BioMedicine Online, the IVI group once again have exploited their ready access to donor oocytes to attempt to expand our knowledge of what is or is not a ‘good’ sperm for intracytoplasmic sperm injection (ICSI) and more importantly why. Using the donor oocyte model to reduce possible bias introduced on the female side, Garcia-Herrero et al., 2011Garcia-Herrero S. Garrido N. Martinez-Conjerro J.A. Remohi J. Pellicer A. Differential transcriptomic profile in spermatozoa achieving pregnancy or not via ICSI.Reprod. Biomed. Online. 2011; 22: 25-36Abstract Full Text Full Text PDF PubMed Scopus (66) Google Scholar have applied microarrays to derive differential transcriptome profiles from sperm that either did or did not achieve pregnancy following ICSI. Their preliminary study describes quite clear differences in the profiles obtained using fresh sperm, but not those that had been frozen and thawed. Their earlier work in women undergoing intrauterine insemination (Garcia-Herrero et al., 2010Garcia-Herrero S. Meseguer M. Martinez-Conjerro J.A. Remohi J. Pellicer A. Garrido N. The transcriptome of spermatozoa used in homologous intrauterine insemination varies considerably between samples that achieve pregnancy and those that do not.Fertil. Steril. 2010; 94: 1360-1373Abstract Full Text Full Text PDF PubMed Scopus (56) Google Scholar) formed the basis of this more detailed analysis, which confirms that in clinical practice more attention to detail when selecting sperm for ICSI should be beneficial. Benefits for infertile couples are provided by more thorough assessment of individual sperm morphology prior to ICSI – but regrettably this approach is not widely used, the reluctance being possibly cost-related or the lingering feeling that there is still too much subjectivity when assessing the microstructure of spermatozoa. The use of microarrays may bring an objectivity that is lacking in imaging techniques, and might therefore be more readily accepted in the clinical arena. Furthermore, subsequent analysis of the transcripts in relation to the man’s clinical details, as well as to treatment outcome, promises to introduce added value to the area of male fertility and infertility – hitherto too often neglected or sidelined. This study is not without its weaknesses, which are correctly acknowledged by the authors, but nevertheless the new findings should provide encouragement and impetus to more studies that will in turn lead to more insights into genetically determined aspects of male fertility.

Magnetic activated sorting selection (MACS) of non-apoptotic sperm (NAS) improves pregnancy rates in homologous intrauterine insemination (IUI). preliminary data

OBJECTIVE: Adequate selection of sperm could improve clinical outcomes in assisted reproduction. Apoptosis is more frequent in infertile men's sperm and externalization of the phosphatidylserine (PS) is a symptom, which can be used to remove apoptotic sperm (AS) by MACS based on Annexin V (AV) affinity to PS. The aim of this study was to determine the relevance of MACS removal of AS in the results of IUI.

Different transcriptomic fingerprint profile between sperm samples (SS) from infertile patients (IP) achieving or not pregnancy among different assisted reproduction techniques (ARTs)

OBJECTIVE: Basic SS analysis is providing limited information to explain and predict male infertility and pregnancy failures from ARTs. New tools like microarrays (M) are interesting options to be employed in this sense. Our work's aim is to use M technology to characterize differential gene expression profiles (EP) between SS from IP achieving or not pregnancy in homologous intrauterine insemination (IUI-H), In vitro fertilization (IVF) and Intracytoplasmic sperm injection (ICSI) cycles with donated oocytes from young healthy women, in both IVF and ICSI procedures, in order to avoid any female factor bias and compare their specific differences pattern among them.

Heterotopic triplets: tubal ectopic and twin intrauterine pregnancy. A review of obstetric outcomes with a case report

Heterotopic triplets hardly take place, but nowadays the extended use of assisted reproductive technologies is increasing the ectopic pregnancies rate and subsequently the heterotopic pregnancies, leading to a potentially dangerous condition for the woman and the intrauterine pregnancy. Fourteen cases previously reported in the literature of patients presenting an intrauterine twin pregnancy which became complicated by a tubal ectopic pregnancy have been reviewed. The case of a patient following a homologous intrauterine insemination treatment, resulting in live birth of both twins, is also described. Although the diagnosis of heterotopic triplets with tubal ectopic is challenging, a timely surgical treatment will preserve intrauterine gestation with a great chance of a successful obstetric outcome for both twins.

The effect of nasal oxytocin on pregnancy rates following intrauterine insemination: double-blind, randomized, clinical pilot study

We tested the hypothesis that the application of intranasal oxytocin (8 IU) following intrauterine insemination (IUI) would increase pregnancy rates, without causing major side effects. Randomized, double-blind, placebo-controlled pilot study: eighty-six couples with idiopathic infertility, polycystic ovary syndrome and/or male sub-fertility treated with 132 homologous IUI cycles with nasal application of placebo or 8 IU oxytocin following IUI. In 132 IUI cycles of 86 women, 17 pregnancies were achieved, accounting for a pregnancy rate of 12.9% (17/132) per IUI cycle. The pregnancy rates were 13.4% (9/67) per IUI cycle in the placebo group, and 12.3% (8/65) per IUI cycle in the oxytocin group, the difference not being statistically significant. No relevant side effects were observed in both groups. Intranasal application of 8 IU oxytocin has no major side effects but at the same time did not affect pregnancy rates after IUI in our population. This study does not exclude that a larger patient group, a different time interval between oxytocin application and IUI, higher or multiple oxytocin applications or a different mode of application would have achieved different effects on pregnancy rates.

The transcriptome of spermatozoa used in homologous intrauterine insemination varies considerably between samples that achieve pregnancy and those that do not

To differentiate transcripts' expression in the sperm from patients who achieved pregnancy in their first IUI cycle from those who did not. Basic sperm analysis is limited to forecasting pregnancies by means of assisted reproduction. New assays, such as microarray analysis, are potential predictive tools for this purpose. Nested case-control study. University-affiliated private setting. Twenty sperm samples were obtained from infertile males undergoing their first IUI cycle with healthy partners. Sperm samples with which pregnancy was achieved (P; n=10) and those with which it was not achieved (NP; n=10) were identified and their respective messenger RNA expression profiles were compared. None. Using microarrays, global genome expression was compared in pooled samples from each group. Results were evaluated to detect differentially expressed transcripts (TDEs; FC>2; P<0.05) and to identify those transcripts that were expressed in only one of the groups (exclusive transcripts [ETs]). In group P, 756 TDEs presented increased expression, whereas 194 in group NP were found to be overexpressed. Furthermore, we found 741 ETs that were expressed only in group P and 976 that were expressed only in group NP. Results reveal profound differences between expression profiles of sperm samples that impregnate successfully and those that do not. These differences might improve the predictive power of sperm evaluation to estimate IUI success by complementing the basic sperm analysis.

Genes differentially expressed (GDE) from infertile male's (IM) sperm samples (SS) undergoing intrauterine insemination (IUI) achieving or not pregnancy involve in reproductive processes (RP)

OBJECTIVE: Basic SS analysis has limited predictive power to forecast pregnancy achievement in homologous IUI. Our work' s aim is to use microarray technology to characterize differential expression profile (EP) between SS achieving (group P) or not pregnancy (group NP) in IUI cycles, and to compare our results with the current knowledge of genes already described to be implicated in RP.

Sperm samples (SS) from infertile patients (IP) undergoing intracytoplasmic sperm injection (ICSI) or intrauterine insemination (IUI) show profound different expression profiles (EP)

OBJECTIVE: Basic SS analysis presents limited predictive power on pregnancy achievement by assisted reproductive techniques (ARTs). Other molecular factors as mRNA present within spermatozoa have recently been described. Our group listed genes differentially expressed (GDE) from SS from pregnant (group P) vs. those non pregnant (group NP) by microarray technology in couples undergoing homologous IUI and ICSI. Our aim is to characterize differential gene EP between SS achieving or not pregnancy in ICSI and IUI cycles. DESIGN: Nested cases and controls study, where 10 SS (5 that achieved pregnancy and 5 failing to conceive) were obtained from IP undergoing IUI with healthy female partners and ICSI cycle with oocytes from young donors. After freezing aliquots of the SS employed for both treatments we compared their respective mRNA expression profiles. Finally 4 microarrays in duplicate were performed with sperm samples from group P vs. NP from both techniques. MATERIALS AND METHODS: SS mRNA was extracted using Trizol, suspended in DEPC-treated water and frozen at -80ºC until the microarray experiments were performed. RNAs were analyzed on Agilent Bioanalyzer 2100 and those genes differentially expressed (GDE) at least twice, with statistically significant differences between P and NP in IUI and ICSI SS were listed and compared. RESULTS: Total number of genes expressed (TNG) in IUI microarray was 19938 and 19229 in ICSI. About 70 % of TNG was common in both procedures. Around 50% of GDE in group P of ICSI group were GDE in group P from IUI group too. There are more GDE (950) in IUI group compared with ICSI group (49). CONCLUSIONS: These data reveals that sperm EP is consistent and molecular features required to pregnant are different in IUI and ICSI procedures. These differences could be potentially employed to detect ICSI and IUI success markers, although it needs to be further explored in order to figure out their biological roles.

Hypoosmotic swelling test in normo-, oligo-, astheno- and oligoasthenozoospermic men before and after swim-up separation of spermatozoa

Semen samples from a total 58 men were examined by routine semen analyses and the hypoosmotic swelling test. Samples were classified as normal, oligo-, astheno- or oligoasthenozoospermic on the basis of spermatogram findings. The latter three groups showed a significant decrease in the percentage of HOS positive forms in comparison to normal spermograms. All these samples were treated with the swim up technique to select motile spermatozoa, using a procedure similar to that routinely employed in clinical settings for homologous intrauterine insemination (IUI). Following swim-up, the ejaculate supernatant and residual precipitate were subjected to the hypoosmotic swelling test (HOS test), and the percentage of normal forms was determined in the three groups. The results showed greater percentages of HOS positive, normal and HOS positive-normal forms in the group of normal individuals than in any of the other three groups. The supernatant used in IUI showed a significant increase in percentage HOS positive spermatozoa, normal forms and spermatozoa which were both normal and HOS positive in comparison with the other two groups in normal and oligozoospermic samples, but not in samples which presented suboptimal motility (astheno- and oligozoospermia). In conclusion, the swim-up technique is effective in separating high-quality spermatozoa in normo- and oligozoospermic samples, although its effectiveness with astheno- and oligoasthenozoospermic samples should be questioned.

A significantly different transcriptome is found between sperm samples from patients undergoing homologous intrauterine insemination (IUI) achieving or not pregnancy

OBJECTIVE: Sperm analysis is deficient in predictive power on pregnancy achievement in IUI, mainly because the lack of information regarding the molecular causes of these failure attempts. New tools are being introduced to improve sperm analysis. Massive testing equipments such as microarrays are interesting options to be employed in assisted reproduction. Our aim with this work is to use microarray technology to characterize differential gene expression profiles between sperm samples achieving or not pregnancy in IUI cycles.DESIGN: Cases and controls study with 20 sperm samples obtained from infertile males undergoing their first IUI cycle presenting normal sperm count and motility (WHO criteria) parameters, having their partners normal infertility work-up investigation results. After freezing aliquots of the sperm samples employed for IUI from patients accomplishing the inclusion criteria, we identified samples from which pregnancy was achieved (P, n=10) or not (NP, n=10).MATERIALS AND METHODS: Sperm mRNA was extracted using Trizol protocol, suspended in DEPC-treated water and frozen at −80°C until the microarray experiments were performed. RNAs were analyzed on Agilent Bioanalyzer 2100. The results were evaluated with the Gene Ontology that describe gene products in terms of their associated biological processes in different steps (www.geneontology.org) and those genes differentially expressed (GDE) at least twice, with statistically significant differences between P and NP sperm samples.RESULTS: 872 GDE were found in group P, presenting increased expression, whereas 204 were found in group NP. In group P 3.4% of the GDE presented fold changes (FC) >10, 16.3% with FC between 5 and 10, and 80.3% have a FC <5. In group P, 222 genes (31.2% of GDE in group P) are involved in cell communication and 209 (29.4%) are signal transduction genes, among other functions. In NP group only 2 genes have FC ≥5, 99% of them presented FC <5. From them, 39 genes (25.5% of GDE in group NP) are involved in multicellular organic processes and 35 in developmental processes (22.9%). There are no complete biological processes statistically affected.CONCLUSIONS: To our knowledge, this is the first work describing profound differences in the expression profiles between samples which achieved pregnancy vs. those unable in assisted reproduction. These differences could be potentially employed to detect IUI success markers, although it needs to be further explored in order to figure out their biological roles. OBJECTIVE: Sperm analysis is deficient in predictive power on pregnancy achievement in IUI, mainly because the lack of information regarding the molecular causes of these failure attempts. New tools are being introduced to improve sperm analysis. Massive testing equipments such as microarrays are interesting options to be employed in assisted reproduction. Our aim with this work is to use microarray technology to characterize differential gene expression profiles between sperm samples achieving or not pregnancy in IUI cycles. DESIGN: Cases and controls study with 20 sperm samples obtained from infertile males undergoing their first IUI cycle presenting normal sperm count and motility (WHO criteria) parameters, having their partners normal infertility work-up investigation results. After freezing aliquots of the sperm samples employed for IUI from patients accomplishing the inclusion criteria, we identified samples from which pregnancy was achieved (P, n=10) or not (NP, n=10). MATERIALS AND METHODS: Sperm mRNA was extracted using Trizol protocol, suspended in DEPC-treated water and frozen at −80°C until the microarray experiments were performed. RNAs were analyzed on Agilent Bioanalyzer 2100. The results were evaluated with the Gene Ontology that describe gene products in terms of their associated biological processes in different steps (www.geneontology.org) and those genes differentially expressed (GDE) at least twice, with statistically significant differences between P and NP sperm samples. RESULTS: 872 GDE were found in group P, presenting increased expression, whereas 204 were found in group NP. In group P 3.4% of the GDE presented fold changes (FC) >10, 16.3% with FC between 5 and 10, and 80.3% have a FC <5. In group P, 222 genes (31.2% of GDE in group P) are involved in cell communication and 209 (29.4%) are signal transduction genes, among other functions. In NP group only 2 genes have FC ≥5, 99% of them presented FC <5. From them, 39 genes (25.5% of GDE in group NP) are involved in multicellular organic processes and 35 in developmental processes (22.9%). There are no complete biological processes statistically affected. CONCLUSIONS: To our knowledge, this is the first work describing profound differences in the expression profiles between samples which achieved pregnancy vs. those unable in assisted reproduction. These differences could be potentially employed to detect IUI success markers, although it needs to be further explored in order to figure out their biological roles.