Login to Access Video or Poster Abstract: MP07-05
Sources of Funding: None.

Introduction

A significant number of couples initiate fertility treatment with unmedicated and medicated intrauterine insemination (IUI) cycles. Previous published studies have suggested that low strict morphology scores are correlated with cycle failure. In an extremely large cohort, we sought to analyze whether strict morphology was correlated with results, and further analyzed the confounding variable of female age in correlation with cycle outcome.

Methods

In this retrospective study, couples undergoing an IUI cycle from December 2000 to October 2016 were reviewed. Sperm morphology scores were determined via Kruger&[prime]s strict criteria. Male partners were segregated by percent normal sperm morphology. Females were segregated by age (A: <35, B: 35-37, C: 38-40). Females greater than age 40 were excluded from the analysis. Pregnancy rates (PR) were determined by the presence of bHCG circulation in the blood stream (positive bHCG). Student&[prime]s t-test and chi-square analysis were performed with significance set at p<0.05.

Results

IUI cycles (n=23,035) that met the study&[prime]s inclusion criteria were evaluated. Overall, 4,019 IUI protocols resulted in achieving a positive pregnancy outcome (PR: 17.45%). In females <35, pregnancy rates rose steadily (PR: 13.4-24.3%) as percent of normal sperm morphology increased (% Normal Sperm: 1-11%). A similar trend was observed in older female cohorts (Age: 35-37; 38-40), albeit to a lesser degree (PR: 11.4-19.1%; 9.6-19.5% respectively) than the youngest cohort. Overall, a significant decline in pregnancy rate was between all patient age cohorts (<35-40) when the percent normal sperm morphology was ≤ 4% versus > 4% (PR: 14.4% versus 19.3%)(p<0.05).

Conclusions

Female age and sperm morphology have an influence on IUI pregnancy potential. This study demonstrated that females <35 to 40 can successfully utilize an IUI approach, albeit their cycle’s chances of success appear to diminish in the presence of low percentages of normal sperm morphology. This study confirms the utility of strict Kruger morphology criteria in counseling couples regarding their expected success with IUI intervention.

Funding

None.