Efficacy of the motile sperm organelle morphology examination (MSOME) in predicting pregnancy after intrauterine insemination

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dc.contributor.authorAkl, Livia D. [UNESP]
dc.contributor.authorOliveira, Joao Batista A. [UNESP]
dc.contributor.authorPetersen, Claudia G. [UNESP]
dc.contributor.authorMauri, Ana L.
dc.contributor.authorSilva, Liliane F. I. [UNESP]
dc.contributor.authorMassaro, Fabiana C.
dc.contributor.authorBaruffi, Ricardo L. R.
dc.contributor.authorCavagna, Mario
dc.contributor.authorFranco, Jose G. [UNESP]
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.contributor.institutionCtr Human Reprod Prof Franco Jr
dc.contributor.institutionPaulista Ctr Diag Res & Training
dc.date.accessioned2014-05-20T13:35:37Z
dc.date.available2014-05-20T13:35:37Z
dc.date.issued2011-08-23
dc.description.abstractBackground: Although the motile sperm organelle morphology examination (MSOME) was developed merely as a selection criterion, its application as a method for classifying sperm morphology may represent an improvement in the evaluation of semen quality. The aim of this study was to determine the prognostic value of normal sperm morphology using MSOME with regard to clinical pregnancy (CP) after intrauterine insemination (IUI).Methods: A total of 156 IUI cycles that were performed in 111 couples were prospectively analysed. Each subject received 75 IU of recombinant FSH every second day from the third day of the cycle. Beginning on the 10th day of the cycle, follicular development was monitored by vaginal ultrasound. When one or two follicles measuring at least 17 mm were observed, recombinant hCG was administered, and IUI was performed 12-14 h and 36-40 h after hCG treatment. Prior to the IUI procedure, sperm samples were analysed by MSOME at 8400x magnification using an inverted microscope that was equipped with DIC/Nomarski differential interference contrast optics. A minimum of 200 motile spermatozoa per semen sample were evaluated, and the percentage of normal spermatozoa in each sample was determined.Results: Pregnancy occurred in 34 IUI cycles (CP rate per cycle: 21.8%, per patient: 30.6%). Based on the MSOME criteria, a significantly higher percentage of normal spermatozoa was found in the group of men in which the IUI cycles resulted in pregnancy (2.6+/-3.1%) compared to the group that did not achieve pregnancy (1.2+/-1.7%; P = 0.019). Logistic regression showed that the percentage of normal cells in the MSOME was a determining factor for the likelihood of clinical pregnancy (OR: 1.28; 95% CI: 1.08 to 1.51; P = 0.003). The ROC curve revealed an area under the curve of 0.63 and an optimum cut-off point of 2% of normal sperm morphology. At this cut-off threshold, using the percentage of normal sperm morphology by MSOME to predict pregnancy was 50% sensitive with a 40% positive predictive value and 79% specificity with an 85% negative predictive value. The efficacy of using the percentage of normal sperm morphology by MSOME in predicting pregnancy was 65%.Conclusions: The present findings support the use of high-magnification microscopy both for selecting spermatozoa and as a routine method for analysing semen before performing IUI.en
dc.description.affiliationSão Paulo State Univ UNESP, Botucatu Med Sch, Dept Obstet & Gynaecol, Botucatu, SP, Brazil
dc.description.affiliationCtr Human Reprod Prof Franco Jr, Ribeirao Preto, Brazil
dc.description.affiliationPaulista Ctr Diag Res & Training, Ribeirao Preto, Brazil
dc.description.affiliationUnespSão Paulo State Univ UNESP, Botucatu Med Sch, Dept Obstet & Gynaecol, Botucatu, SP, Brazil
dc.format.extent9
dc.identifierhttp://dx.doi.org/10.1186/1477-7827-9-120
dc.identifier.citationReproductive Biology and Endocrinology. London: Biomed Central Ltd., v. 9, p. 9, 2011.
dc.identifier.doi10.1186/1477-7827-9-120
dc.identifier.fileWOS000294868500001.pdf
dc.identifier.issn1477-7827
dc.identifier.urihttp://hdl.handle.net/11449/12264
dc.identifier.wosWOS:000294868500001
dc.language.isoeng
dc.publisherBiomed Central Ltd.
dc.relation.ispartofReproductive Biology and Endocrinology
dc.relation.ispartofjcr2.852
dc.relation.ispartofsjr1,203
dc.rights.accessRightsAcesso aberto
dc.sourceWeb of Science
dc.titleEfficacy of the motile sperm organelle morphology examination (MSOME) in predicting pregnancy after intrauterine inseminationen
dc.typeArtigo
dcterms.licensehttp://www.biomedcentral.com/about/license
dcterms.rightsHolderBiomed Central Ltd.
unesp.campusUniversidade Estadual Paulista (Unesp), Faculdade de Medicina, Botucatupt

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Artigos - Ginecologia e Obstetrícia - FMB