Post-wash Sperm Research Articles

Semen Washing and Intrauterine Insemination for Reducing the Risk of Human Immunodeficiency Virus Transmission in Serodiscordant Couples: A Cross-sectional Study.

Antiretroviral therapy has helped human immunodeficiency virus (HIV)-infected people live an enhanced quality of life and attempt for a pregnancy, without placing their partner at risk. Although periconceptional pre-exposure prophylaxis for the uninfected partner and consistent antiretroviral therapy for the HIV-infected partner are important to prevent HIV transmission, semen washing could be a great option to further reduce the semen viral load. The aim of this study were as follows: to determine if semen washing with intrauterine insemination provides an added safety net to HIV-serodiscordant couples when the male partner is HIV-infected and virally suppressed and to determine if the U = U concept (undetectable = untransmittable) holds true in virally suppressed HIV-infected males. This was an observational study conducted in seropositive HIV men under treatment with highly active antiretroviral therapy (HAART) in collaboration with Metropolis Laboratory, a CAP recognised private Healthcare Laboratory in Mumbai, India. Blood and semen samples were collected from a total of 110 adult HIV-1-infected males virally suppressed on HAART. These samples were processed to assess the viral load in plasma as well as raw and processed semen fractions. Descriptive statistics were used to analyse the data. Only men with plasma viral loads < 1000 copies were selected in our study. Out of the 110 HIV-infected individuals, 102 (92.73%) patients had undetectable (<20 copies/ml) plasma viral load while 8 (7.27%) patients had a detectable (>20 copies/ml) viral load, who were excluded from the study. In the virally suppressed 102 men, the raw semen samples of 100 men showed an undetectable viral load, while 2 samples showed detectable contamination, even though their plasma samples from the blood showed a viral load of <20 copies/ml. The semen was then separated into the sperm and the seminal plasma samples. The seminal plasma had <20 copies/ml in 95 samples (93.14%) but a detectable viral load in 7 (6.86%) samples. After subjecting all the 102 processed (post-wash) sperm samples to quantitative analysis, an undetectable viral load of <20 copies/ml was found in all the samples. Thus, the raw sample (prewashed),seminal plasma and processed (postwash) samples were evaluated. The post-wash sperm sample showing zero contamination was frozen for intrauterine insemination (IUI) in the uninfected female partner. Semen washing with IUI should be advocated as a safe, efficacious way to increase the safety net and to further reduce the minimal risk of HIV transmission in serodiscordant couples in addition to the U = U concept.

Impact of current and previous sperm findings on outcomes of intrauterine insemination.

To examine the association between semen characteristics and outcomes of intrauterine insemination (IUI). This retrospective analysis examined 1380 IUI procedures involving 421 couples. The association of clinical pregnancy with pre- and post-wash sperm characteristics was assessed. Pre- and post-wash sperm characteristics did not differ between IUI cycles that resulted in pregnancy and those that did not. When the motility of pre-wash sperm was below the normal range (<42%) established by the World Health Organization (WHO), the pregnancy rate was significantly lower. In the IUI cycles when post-wash sperm motility was below the WHO standard, pregnancy was not achieved. The frequency of improvement in post-wash sperm motility in repeated IUI cycles appeared to correlate with the success of future IUI cycles. At the fourth IUI cycle, pregnancy was not achieved unless the post-wash sperm motility was normal in at least two of three attempts. When post-wash sperm concentration was below the normal range, the woman's age did not affect the IUI outcomes. Sperm motility above the lower limit of the WHO criteria in post-wash semen samples is an important factor in IUI outcomes.

Is There Any Effect of Change in Pre-Wash and Post-Wash Semen Parameters on the Success of Intrauterine Insemination?

(1) Background: We aimed to investigate the effect of change in pre-wash and post-wash semen parameters on intrauterine insemination (IUI) success in a homogenous study group. (2) Methods: IUI cycles conducted at an infertility clinic were included in this study. Patient records were examined retrospectively. Δ sperm count (per mL) was calculated as [pre-wash sperm count (per mL)-post-wash sperm count (per mL)]. Δ Total progressive motile sperm count (TPMSC) was also calculated as (post-wash TPMSC-pre-wash TPMSC). (3) Results: No statistically significant difference was detected in terms of Δ sperm count (p = 0.38), and Δ TPMSC (p = 0.76) regarding the clinical pregnancy rate (CPR). There was no statistically significant difference between CPR (+) and CPR (-) groups in terms of post-wash sperm count, TPMSC, TPMSC ≥ 10 × 10⁶, TPMSC ≥ 5 × 10⁶ (p = 0.65, p = 0.79, p = 0.49, p = 0.49, respectively). The live birth rate (LBR) showed no statistically significant differences except for a pre-wash TPMSC ≥ 10 × 10⁶ (p = 0.02). Through the performed ROC analysis, no statistically significant cutoff value could be set for the pre-wash TPMSC. (4) Conclusions: There is only a pre-wash TPMSC ≥ 10 × 10⁶ that showed a significant role in the success of IUI, even when considering all other pre-wash and post-wash semen parameters. Δ sperm count and Δ are not useful markers for IUI success.

#336 : Improving Success of Intrauterine Insemination

Background and Aims: IUI is one of the most used methods to treat various forms of infertility. The aims were to compare the success rate of IUI with that of timed intercourse, review the methods used to time the IUI with ovulation, identify the factors to determine IUI outcome, compare the success rate of double IUI vs single IUI. Method: This is a cross-sectional prospective study conducted at a Private Fertility Centre, Chattogram, Bangladesh over a period of 40 months from 996 patients who underwent IUI. Variables such as age of women, cause of infertility, drugs used for COH, number of mature follicles, endometrial thickness post wash sperm count, type of IUI (single IUI and double IUI) were recorded and statistically analyzed. Results: The age for females and males were 18-41 and 23-52 respectively. The mean endometrial thickness was 8.9 mm ± 0.2 mm. Pregnancy rate for total motile sperm count less than 10 million was 7.2%. The successful conception rate for females were the age 28 was 9.6% compared to the whole group at 12%. Among 996 patients, 109 patients (10.94%) had successful conception. 209 patients (20.98%) underwent double IUI out of which 40 patients (19.14%) had a successful conception while 787 patients (79.01%) underwent single IUI out of which 69 patients (8.76%) had successful conception. Conclusion: IUI is currently a successful treatment modality for infertility especially as invasive treatment for couples with unexplained infertility, male factor infertility, anovulation, female less than 30 years of age. The numbers of motile sperms, appropriate endometrial thickness, have a remarkable impact on the outcome of IUI. Double IUI increases the success rate significantly. Acknowledgment: The authors are grateful to all who participated in the preparation of this manuscript.

First 15 Years of Assisted Reproductive Technology Using Washed Sperm in HIV-Positive Individuals Under Antiretroviral Therapy: Sweden's Nationwide Outcomes.

Antiretroviral therapy has made HIV a chronic infectious disease. In Sweden, assisted reproductive technologies using sperm washing were implemented in 2004 for treatment of all HIV-positive males in serodiscordant couples at Karolinska Hospital in Stockholm. This study aimed to assess efficacy and safety of this approach and to investigate the effect of antiretroviral regimens on sperm quality of men treated for HIV. The study included all HIV-positive men (n = 53) adherent to antiretroviral treatment, including nucleoside/nucleotide analog reverse-transcriptase inhibitors (NRTIs) combined with non-nucleoside reverse-transcriptase inhibitors (NNRTIs) in 22 cases, or with other medication in 31 cases wishing fertility treatment. Sperm was washed using gradient centrifugation with a double tube system, frozen and thawed. Thereafter, single spermatozoa were injected in oocytes by intracytoplasmic sperm injection (ICSI). Treatment outcomes were compared to those of hepatitis B virus (HBV)-seropositive men in serodiscordant couples (n = 56), undergoing similar sperm washing protocols and ICSI at the center. In total, 82 fresh and 39 frozen/thawed embryo transfer (FET) cycles were performed in discordant HIV couples and 92 fresh and 36 FET cycles in HBV. Fertilization rates (69.2% vs. 64.6%, p = 0.310), clinical pregnancy rates (39.2% vs. 32.6%, p = 0.378), and live birth rates (35.8% vs. 31.5%, p = 0.565) were similar between the groups and the cumulative results yielded similar outcomes with a live birth rate of 52.8% and 51.8% (p = 0.913), respectively. No post-wash sperm sample was found positive for HIV viral particles. No partner seroconversion or offspring infection was reported. NNRTI-treated men had significantly lower motile sperm concentration than non-NNRTI-treated patients (54.48% vs. 36.41%, p < 0001). This study showed that in vitro fertilization/ICSI treatment with sperm washing was safe in individuals compliant to antiretroviral treatment and the reproductive outcome was similar to that of HBV-positive men. The observed moderate negative impact on sperm motility of NNRTI regimens may be overcome by using ICSI.

Is there a correlation between Body Mass Index, Hemoglobin A1c, Thyroid Stimulating Hormone, serum Vitamin D and B12 levels or Covid 19 infection history with pre- or post-wash sperm parameters in normospermic men?

Is there a correlation between Body Mass Index, Hemoglobin A1c, Thyroid Stimulating Hormone, serum Vitamin D and B12 levels or Covid 19 infection history with pre- or post-wash sperm parameters in normospermic men?

Differential sperm histone retention in normozoospermic ejaculates of infertile men negatively affects sperm functional competence and embryo quality.

The unique epigenetic architecture that sperm cells acquire during spermiogenesis by retaining <15% of either canonical or variant histone proteins in their genome is essential for normal embryogenesis. Whilst heterogeneous levels of retained histones are found in morphologically normal spermatozoa, their effect on reproductive outcomes is not fully understood. Processed spermatozoa (n=62) were tested for DNA integrity by sperm chromatin dispersion assay, and retained histones were extracted and subjected to dot-blot analysis. The impact of retained histone modifications in normozoospermic patients on sperm functional characteristics, embryo quality, metabolic signature in embryo spent culture medium and pregnancy outcome was studied. Dot-blot analysis showed heterogeneous levels of retained histones in the genome of normozoospermic ejaculates. Post-wash sperm yield was affected by an increase in H3K27Me3 and H4K20Me3 levels in the sperm chromatin (p<0.05). Also, spermatozoa with higher histone H3 retention had increased DNA damage (p<0.05). Spermatozoa from these cohorts, when injected into donor oocytes, correlated to a significant decrease in the fertilisation rate with an increase in sperm histone H3 (p<0.05) and H3K27Me3 (p<0.01). An increase in histone H3 negatively affected embryo quality (p<0.01) and clinical pregnancy outcome post-embryo transfer (p<0.05). On the other hand, spent culture medium metabolites assessed by high-resolution (800MHz) nuclear magnetic resonance showed an increased intensity of the amino acid methionine in the non-pregnant group than in the pregnant group (p<0.05) and a negative correlation with sperm histone H3 in the pregnant group (p<0.05). Histone retention in spermatozoa can be one of the factors behind the development of idiopathic male infertility. Such spermatozoa may influence embryonic behaviour and thereby affect the success rate of assisted reproductive technology procedures. These results, although descriptive in nature, warrant further research to address the underlying mechanisms behind these clinically important observations.

Improving Fertility Treatment Documentation - A Survey.

Many couples do not have adequate documentation following fertility treatments. To conduct a survey to understand the information needs of assisted reproductive technology physicians when assessing the reasons affecting treatment outcomes after intrauterine insemination (IUI) and in vitro fertilisation (IVF). Online survey. Anonymous online survey of 14 parameters related to IUI treatment and 21 parameters related to IVF treatment, followed by recommendation of selected parameters for routine documentation. Frequency distribution calculation of responses. For IUI, total motile sperm count and post-wash sperm count and motility and for IVF, the quality and number of gametes, embryo number and morphology were the most important parameters. The study creates recommendations for the minimum information desirable in the fertility treatment documentation given to the couple undergoing treatment.

Estimation of follicular growth—widely used, seldom studied

We assessed whether estimation of follicular growth, rather than actual measurement of follicular size on the day of hCG trigger, affected pregnancy rates in intrauterine insemination (IUI) cycles. Patient and cycle characteristics were extracted from an existing database. Comparisons were made between the pregnant (defined as a positive beta hCG) and non-pregnant groups for the following variables: patient’s age, number of previous IUI cycles, type of ovarian stimulation, endometrial thickness, number of follicles measuring 14 mm and above, pre and post wash sperm parameters, cycle day when IUI was done and number of days between last ultrasound scan and ovulation trigger. A total of 7302 cycles were included in the final analysis. In 4055 cycles (55.5%) the hCG trigger was on the day of the last ultrasound, in 2285 cycles (31.3%) the hCG trigger was 1 day after the last ultrasound, in 850 (11.6%) it was 2 days after the last ultrasound and in 112 (1.5%) it was 3 or more days after the last ultrasound. Sperm parameters, younger maternal age, and the number of follicles above 14 mm were all associated with pregnancy. No association was found between positive pregnancy test rates and the time from last ultrasound to hCG trigger. Planning IUI based on the estimation of follicular growth 1–4 days before trigger, does not affect pregnancy rates.

Evaluating the efficacy of ovulation stimulation with intrauterine insemination in women with diminished ovarian reserve compared to women with normal ovarian reserve.

To assess the efficacy of ovulation induction and intrauterine insemination (IUI) in couples with diminished ovarian reserve (DOR). Women aged 20-39 years and men younger than 50 years were included. Four "ovarian reserve groups" were created according to anti-Müllerian hormone (AMH) and the partner's age. Gestational sac finding on ultrasound examination was the primary outcome measure. The study was carried out on a total of 770 cycles of 362 women in an infertility cohort that consisted of 75 women with DOR treated by 153 cycles and 287 women without DOR treated by 617 cycles. The pregnancy rate was similar in the four ovarian reserve groups in terms of first, second, third plus fourth, and total attempts of IUI cycles. Moreover, the pregnancy rate, miscarriage rate, and multiple pregnancy rate were similar. We found no difference in the cumulative pregnancy rate among the groups after four IUI cycles. Multivariate logistic regression analysis of the entire cohort revealed that infertility duration, post-wash sperm count, and follicle number greater than 11 mm on the day of human chorionic gonadotropin trigger were independent predictors of pregnancy (P< 0.001). Neither age nor AMH predicted pregnancy after ovulation stimulation and IUI. Ovulation stimulation and IUI are equally effective in women with DOR and in women with normal ovarian reserve in terms of pregnancy rate, multiple pregnancy rate, and miscarriage rate per IUI cycle or cumulative pregnancy rate after four cycles of IUI.

Sperm characteristics in normal and abnormal ejaculates are differently influenced by the length of ejaculatory abstinence.

No association between the length of ejaculatory abstinence (LEA) and semen characteristics has been confirmed. A short LEA has been linked to improved sperm characteristics and a higher pregnancy rate, but its negative influence on sperm chromatin maturity and longevity may adversely affect reproductive outcomes. We sought to determine the influence of LEA on (i) semen parameters in normozoospermic and abnormal ejaculates; and (ii) the outcomes of sperm-preparation methods in a large number of subfertile men undergoing infertility workups. This retrospective registry-based cohort study analyzed the data of 10,674 ejaculates from 7972 subfertile men, who were then segregated into normozoospermic, oligozoospermic, asthenozoospermic, and oligo-asthenozoospermic cohorts. Variations in semen characteristics and post-wash outcomes were studied between four LEA intervals across 0-15 days. An age-adjusted analysis of covariance (ANCOVA) model linked significant increases in ejaculate volume, sperm concentration (except in the oligozoospermic cohort), and total sperm count to an increased LEA (p<0.05). LEA was negatively associated with motility (except in the asthenozoospermic cohort) and vitality (p<0.05). Large-headed spermatozoa were less common with an increased LEA only in the oligo-asthenozoospermic cohort (p<0.05). In the normozoospermic cohort, a longer LEA led to fewer spermatozoa with amorphous heads but more spermatozoa with tapered heads and cytoplasmic droplets (p<0.05). LEA extension resulted in greater sperm DNA fragmentation in the abnormal cohort (p<0.01). The post-wash sperm concentration and total motile sperm count were significantly improved with a longer LEA in the normozoospermic cohort (p<0.05). Considering the findings in this study and existing literature, a generalized recommendation for long LEA has no clinical value. The LEA should be individualized based on the ejaculate profile and the need for specific clinical intervention.

P–077 Performance of the postwash total motile sperm count as a predictor of pregnancy at the time of intrauterine insemination

Abstract Study question Is the performance of the postwash total motile sperm count a predictor of pregnancy at the time of intrauterine insemination? Summary answer The number of motile spermatozoa inseminated (NMSI) in IUI can be used to define clear range of pre /postwash sperm parameters. What is known already There is no consensus about the optimal number of motile spermatozoa inseminated (NMSI) required for a reasonable chance of pregnancy after IUI. A meta-analysis of 16 studies assessing NMSI and IUI outcomes, concluded that at cut-off levels between 0.8 and 5 million, defined as the ability to predict failure to become pregnant. The purpose of this study is to determine the range of NMSI as a predictor of success in IUI. Study design, size, duration This prospective study includes 60 patients who underwent semen analysis at an academic infertility centre (SRIHER) during the month of December 2020 and January 2021. Participants/materials, setting, methods A total of 60 infertile couples who underwent IUI at our academic centre were enrolled in our study. A detailed history and infertility work up was done before proceeding for IUI, as per the department protocol. The semen was prepared by discontinuous 2 layered density gradient method. The results were analyzed by patient factors including age, BMI, semen parameters, NMSI. The NMSI were divided into 4 groups: A (&amp;lt;1), B (1–4), C (5–9), D (&amp;gt;10). Main results and the role of chance The mean age of the infertile couples who underwent IUI was (28.2 ± 3.8) in females and (31.8 ± 3.8) in males respectively. The sperm parameters such as concentration (21.8 ± 14.8), motility (53.15 ± 13.22), morphology (2.43 ± 1.33) respectively. When the NMSI was group C (5–9 x 10 6) the pregnancy rate was 38.5% whereas the pregnancy rate was 37.5% in group D ( &amp;gt;10 x 10 6). In the other sub groups such as group A(&amp;lt;1 x 10 6) and group C (1–4 x 10 6) the pregnancy rate was 14.2% and 12.5% respectively. Limitations, reasons for caution Infertile men with Azoospermia, Men with Retrograde ejaculation, Testicular samples, Epididymal samples, Infected samples. All of the above samples were avoided. It cannot be used for counselling during the initial infertility workup, but only during/after the IUI procedure. Wider implications of the findings: The results suggest that NMSI can be a predictor of success in IUI in patients who are &amp;lt; 30 years of age &amp; ≥35 years, NMSI does not appear to be a useful. The effect of NMSI on pregnancy rate needs to evaluated on a larger scale . Trial registration number Not applicable

IMPACT OF SPERM DNA FRAGMENTATION ON PRE- AND POST-WASH SEMEN SAMPLES AND PREGNANCY OUTCOME WITH INTRACYTOPLASMIC SPERM INJECTION

The spermatozoa nuclear component especially it’s DNA integrity is essential for normal fertilization, pregnancy & embryo development. Currently sperm DNA fragmentation (SDF) testing is one advanced sperm function test used along other conventional tests to evaluate male infertility.We aim to assess the impact of SDF on pre- & post-wash semen parameters and to investigate effect of various SDF cut-off values on pregnancy outcome with Intracytoplasmic sperm injection (ICSI). Retrospective, Chart review. The charts of 2277 patients who underwent ICSI were reviewed. 481 infertile men who had SDF testing were included. Patients demographic & laboratory data along with ICSI cycle outcome were included. Semen samples & SDF were analyzed according to WHO 5thedition guidelines & sperm chromatin dispersion (Halosperm kit, Halotech, Madrid, Spain) respectively. Patients were divided according to SDF cut-offs; <20, 20-30 & >30%. Variables were reported as mean ± SE and compared using Kruskal Wallis Test. P value of <0.05 was considered statistically significant The mean patient age was 36.88 ± 0.362, while mean SDF was 25.41± 0.72. The pre & post wash semen parameters in patients with SDF cut-offs <20, 20-30 & >30% were compared (Table 1). Significantly worse results were obtained with increasing SDF cut-offs for pre- & post-wash sperm concentration, total motility & post-wash normal morphology. SDF was significantly inversely correlated with pre wash parameters (concentration: r -.140, p=o.oo3; total Motility: r -.282, p<0.001; normal morphology: r -.143, p=0.003) and post wash parameters (concentration: r -.156, p=o.oo1; total Motility: r -.218, p<0.00; normal morphology: r -.140, p=0.002) The clinical pregnancy rate decreased with increasing SDF cut-offs (44.4% with SDF <20%, 31.4% with SDF 20-30% and 24.3% with SDF >30), though the result was not statistically significant SDF negatively impacts pre-& post-processing semen parameters for patients undergoing ICSI. This may influence ICSI pregnancy rate, though the impact was not statistically significant in this cohort.Tabled 1ParametersTotalSDF <20SDF 20-30SDF >30P ValuePre wash Concentration (M/ml)38.94 ± 1.6945.24 ± 2.7935.82 ± 2.6130.57 ± 2.870.016Pre wash Total Motility %38.61 ± 0.944.18 ± 1.2837.82 ± 1.6229.26 ± 1.68<0.001Pre wash Normal Morphology %12.49 ± 0.6112.01 ± 0.7814.53 ± 1.3511.18 ± 1.270.121Post Wash Concentration (M/ml)13.93 ± 0.6315.96 ± 0.9513.854 ± 1.129.95 ± 1.16<0.001Post Wash Total Motility %4.21 ± 0.275.24 ± 0.453.99 ± 0.432.45 ± 0.47<0.001Post Wash normal Morphology %12.31 ± 0.6512.12 ± 0.8913.36 ± 1.3111.53 ± 1.370.010 Open table in a new tab

Clinical Success of Intrauterine Insemination in A Private Fertility Centre

Background : IUI is one of the most frequently and widely used therapeutic modalities to treat various forms of infertility. Achieving pregnancy after IUI is presumably due to increase in the number of highly motile spermatozoa with a high proportion of morphologically normal spermatozoa near the site of fertilization. The objectives were to compare the success rates of IUI with that of timed intercourse, compare the success rate of IUI according to the protocols, review methods used to time the IUI with ovulation, identify the factors to determine IUI outcome.&#x0D; Materials and methods : This is a cross sectional prospective study conducted in Surgiscope Fertility Centre, Chattogram, Bangladesh over a period of 21 months from 596 patients who underwent IUI. Multiple variables were selected such patient parameters like age of woman and cause of infertility, parameters related to ovulation induction such as drugs used for COH, number of mature follicles and endometrial thickness and laboratory parameters such as post wash sperm count and type of IUI (Single or double IUI) which were recorded and statistically analysed.&#x0D; Results : The minimum age for females and males were 18 and 19 respectively and the maximum age for females and males were 40 and 66 respectively. The mean age for females was 27.3 +/- 0.4 years and the mean age for males was 35.9 +/- 0.5 years. Another variable was endometrial thickness where the mean was 8.9 mm ± 0.2 mm and median was 8.5 mm. Furthermore, successful pregnancies also depend on total motile sperm count taken post-wash. The total motile sperm count was 29.8 million ± 1.5 million and median was 30 million. Pregnancy rate for total motile sperm count less than 10 million was 8.6%. For women over 28 and total motile sperm count &lt;10 million, the success rate was only 2.7%.Most of the patients who underwent IUI were between the ages of 28-31, which was 175 (29.3%). The successful conception rate for females over the age 28 was 9.6% compared to the whole group at 12%. Among 596 patients, 71 patients (11.91%) had successful conceptions while 525 patients (88.09%) did not. There is a statistically significant relationship between number of IUI cycles completed and the rate of successful pregnancy. There is also a relationship between the number of inseminations and the success rate.&#x0D; Conclusion : IUI is a successful contemporary treatment especially as a good first line invasive treatment for couples with unexplained infertility, male factor infertility, anovulation, female less than 30 years of age. Percentage of actual number of motile sperms appear to have an important impact on outcome. Success rate of conception was also found to be statistically significant in patients with appropriate endometrial thickness. Careful and criteria-based selection of patients along with ovarian stimulation seem to be the ideal model for achieving clinical success in IUI.&#x0D; JCMCTA 2019 ; 30 (2) : 26-31

The sperm parameters and prediction of IUI success

Aim: We aimed to compare the different sperm motility parameters in pregnant and non-pregnant patients who underwent IUI in our tertiary center. Material and Methods: Total of 110 gonadotrophin plus IUI patients were evaluated between 2017 January and January 2020 in this retrospective study. Some demographic features and infertility time, post-wash sperm parameters and basal hormone levels were compared between pregnant and non-pregnant patients and the regression analysis method was used to evaluate IUI success between other parameters.Results: Endometrial thickness (9.1±1.4 vs.7.6±1.4 ) on hCG triggering day and , post-wash progressive sperm motility value together with the a ratio and infertility time were correlated well with IUI success (ie pregnacy result ) between 38 pregnant and 72 non pregnant patients.Conclusion: After wash progressive sperm ratio may predict IUI success with infertility time and endometrial thickness.

Prosaposin in seminal plasma on the day of oocyte retrieval is associated with normal fertilization and embryo development in in vitro fertilization cycles.

The prospective study including 166 participants aims to evaluate the association between seminal prosaposin and the outcomes of in vitro fertilization (IVF) cycles in humans. The generalized linear model (GLM) was used to analyze the associations between seminal prosaposin concentrations and normal fertilization rates and good embryos proportion. The generalized estimating equation (GEE) was used to evaluate the association between embryo parameters and the prosaposin concentrations. Each model was adjusted for age of the couples, female basal FSH, AFC and BMI, starting dose and oocyte yield of IVF cycles and smoker. GLM models suggested that prosaposin was significantly associated with fertilization rate (P = 0.005) and good embryo proportion (P = 0.038) while none of the semen parameters (sperm concentration, motility, progressive motility, normal morphology rate, postwash sperm concentration and motility) was significantly associated with the parameters in the cohort. Using GEE, it was also shown that prosaposin was positively associated with the occurrence of early cleavage and negatively associated with uneven cleavage pattern on day 3. In both the overall population and the normozoospermia patients, the prosaposin was significantly associated with pregnancy with adjustment with covariates. In conclusion, our data suggested that seminal prosaposin concentration could provide more information regarding normal fertilization and embryo development in IVF than traditional semen parameters.

Body Mass Index Effects Kruger's Criteria in Infertile Men.

BackgroundThe aim of this study is to evaluate the relationship between sperm parameters and body mass index (BMI) in the male spouses with infertility complaints, who had reffered to our clinic.Materials and Methods The male spouses from 159 couples reffering to our clinic because of infertility, during a six-month period, were included in the study. In this prospective case control study, the included men were catego- rized as non-obese (BMI<25 kg/m2), overweight (BMI 25-29 kg/m2) and obese (BMI ≥30 kg/m2) according to their BMIs. The assessed sperm parameters consisted of; sperm concentration, Kruger morphology, progressive motility level, and volume pH levels. The statistical significant level was set as less than 0.05 .ResultsThe assessed group consisted of 159 patients applying to our clinic with infertility symptoms. Fifty-three non-obese, 53 overweight and 53 obese men were eligible for the study. There was statistically significant differences in sperm volume (P<0.001), progressive motility (P<0.001), postwash sperm count (P<0.001) and Kruger (P<0.001) morphology among the patient groups grouping according to the BMI levels.ConclusionIn this study, increased BMI was associated with decreased semen quality, affecting volume, concentra- tion, and motility. further studies with a wider range of prospective cases need to be conducted in order to investigate the effects on male fertility in more detail.

Prognostic factors affecting outcome of intrauterine insemination procedures at a fertility center in Ondo, South West Nigeria

Background: There is a recent resurgence in the use of intrauterine insemination (IUI) in Nigeria. However, there is a need for a rational use of the procedure so that couples do not waste time and money on ineffective therapy if it is not indicated. Objective: The objective of this study was to identify the possible prognostic factors affecting outcome of IUI among patients undergoing the procedure. Patients and Methods: This is a retrospective review of the case files and treatment protocols of fifty consecutive couples who had IUI procedure following the established diagnosis of Infertility at the Paramount Fertility Center of Paramount Specialist Hospital Ondo, Nigeria, over a period of 1 year (February 2016 to January 2017). Results: There were ten (20.0%) pregnancies recorded, of which three (6%) clients had first-trimester miscarriages (between the 5th and 13th weeks), one (2%) had an ectopic pregnancy, whereas six (12%) were carried to the age of viability and delivered. Forty (80%) clients did not achieve pregnancy. The postwash concentration of sperm was noticed to be the only parameter significantly affecting the rate of pregnancy in our treatment cycles with P Conclusion: This study shows that the postwash sperm count and age of the female have the most predictive value for IUI clinical pregnancy outcome in our center.

Comparison of pre-wash and post-wash sperm morphological indices with pregnancy outcomes in intrauterine insemination and in vitro fertilization

Comparison of pre-wash and post-wash sperm morphological indices with pregnancy outcomes in intrauterine insemination and in vitro fertilization

The effect of intrauterine insemination time on semen parameters.

The purpose of this observational study was to determine whether semen parameters (concentration, motility) were affected by the interval between the onset of postwash sperm incubation and intrauterine insemination (IUI) time. Semen specimens of 100 normozoospermic men collected at the clinic were allowed 20 minutes for liquefaction at room temperature. Semen samples were subjected to both macroscopic and microscopic examinations. After centrifugation in a density gradient column and sperm-washing medium, the samples were kept in an incubator. After 30 minutes, 60 minutes, and 120 minutes, the concentration and motility were recorded. According the results of the Bonferroni post hoc test, there were significant differences in values of mean sperm count, percent progressive sperm motility, and total motile sperm count between 30 minutes and 120 minutes (p=0.000, p=0.000, and p=0.000) and between 60 minutes and 120 minutes (p=0.000, p=0.000, and p=0.001), but there was no significant difference between 30 minutes and 60 minutes (p=1, p=0.173, and p=1). This study demonstrated that sperm parameters are negatively affected from prolonged incubation time. A maximum 60-minute limit of the interval between the onset of postwash sperm incubation and IUI time may increase pregnancy rates.