Efficacy of sperm motility after processing and incubation to predict pregnancy after intrauterine insemination in normospermic individuals

dc.contributor.authorAraujo, Ligia F. P. de [UNESP]
dc.contributor.authorAraujo Filho, Edilberto de
dc.contributor.authorFacio, Cassio L.
dc.contributor.authorBossoni, Marcia C. O.
dc.contributor.authorMachado-Paula, Ligiane A.
dc.contributor.authorCorrente, José Eduardo [UNESP]
dc.contributor.authorCavagna, Mario
dc.contributor.authorMatheus, Paulo C. S.
dc.contributor.authorPontes, Anaglória [UNESP]
dc.contributor.institutionCtr Human Reprod Sao Jose do Rio Preto
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.contributor.institutionCtr Human Reprod Prof Franco Jr
dc.contributor.institutionPaulista Ctr Diag Res & Training
dc.contributor.institutionGERAR Fertil Clin
dc.date.accessioned2014-12-03T13:10:34Z
dc.date.available2014-12-03T13:10:34Z
dc.date.issued2013-10-22
dc.description.abstractBackground: Intrauterine insemination (IUI) is widely used to treat infertility, and its adequate indication is important to obtain good pregnancy rates. To assess which couples could benefit from IUI, this study aimed to evaluate whether sperm motility using a discontinuous gradient of different densities and incubation in CO2 in normospermic individuals is able to predict pregnancy.Methods: A total of 175 couples underwent 175 IUI cycles. The inclusion criteria for women were as follows: 35 years old or younger (age range: from 27 to 35 years) with normal fallopian tubes; endometriosis grades I-II; unexplained infertility; nonhyperandrogenic ovulatory dysfunction. Men with normal seminal parameters were also included. All patients underwent ovarian stimulation with clomiphene citrate and human hMG or r-FSH. When one or (at most) three follicles measuring 18 to 20 mm were observed, hCG (5000 UI) or r-hCG (250 mcg) was administered and IUI performed 36-40 h after hCG. Sperm processing was performed using a discontinuous concentration gradient. A 20 microliters aliquot was incubated for 24 h at 37 degrees C in 5% CO2 following a total progressive motility analysis. The Mann-Whitney and Chi-square tests, as well as a ROC curve were used to determine the cutoff value for motility.Results: Of the 175 couples, 52 (in 52 IUI cycles) achieved clinical pregnancies (CP rate per cycle: 29.7%). The analysis of age, duration and causes of infertility did not indicate any statistical significance between pregnancy and no pregnancy groups, similar to the results for total sperm count and morphology analyses, excluding progressive motility (p < 0.0001). The comparison of progressive motility after processing and 24 h after incubation between these two groups indicated that progressive motility 24 h after incubation was higher in the pregnancy group. The analysis of the progressive motility of the pregnancy group after processing and 24 h after incubation has not shown any motility difference at 24 h after incubation; additionally, in couples who did not obtain pregnancy, there was a statistically significant decrease in progressive motility 24 h after incubation (p < 0.0001). The ROC curve analysis generated a cutoff value of 56.5% for progressive motility at 24 h after incubation and this cutoff value produced 96.1% sensitivity, 92.7% specificity, 84.7% positive predictive value and 98.3% negative predictive value.Conclusions: We concluded that the sperm motility of normospermic individuals 24 h after incubation at 37 degrees C in 5% CO2, with a cutoff value of 56.5%, is predictive of IUI success.en
dc.description.affiliationCtr Human Reprod Sao Jose do Rio Preto, Sao Jose Do Rio Preto, SP, Brazil
dc.description.affiliationSao Paulo State Univ UNESP, Botucatu Med Sch, Dept Gynaecol & Obstet, Botucatu, SP, Brazil
dc.description.affiliationSao Paulo State Univ UNESP, Inst Biosci Botucatu, Dept Bioestat, Botucatu, SP, Brazil
dc.description.affiliationCtr Human Reprod Prof Franco Jr, Ribeirao Preto, SP, Brazil
dc.description.affiliationPaulista Ctr Diag Res & Training, Ribeirao Preto, SP, Brazil
dc.description.affiliationGERAR Fertil Clin, Recife, PE, Brazil
dc.description.affiliationUnespSao Paulo State Univ UNESP, Botucatu Med Sch, Dept Gynaecol & Obstet, Botucatu, SP, Brazil
dc.description.affiliationUnespSao Paulo State Univ UNESP, Inst Biosci Botucatu, Dept Bioestat, Botucatu, SP, Brazil
dc.format.extent7
dc.identifierhttp://dx.doi.org/10.1186/1477-7827-11-101
dc.identifier.citationReproductive Biology And Endocrinology. London: Biomed Central Ltd, v. 11, 7 p., 2013.
dc.identifier.doi10.1186/1477-7827-11-101
dc.identifier.fileWOS000326242800001.pdf
dc.identifier.issn1477-7827
dc.identifier.lattes0514178654667684
dc.identifier.orcid0000-0001-5478-4996
dc.identifier.urihttp://hdl.handle.net/11449/112271
dc.identifier.wosWOS:000326242800001
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.subjectSperm motilityen
dc.subjectSuccessful inseminationen
dc.subjectIntrauterine inseminationen
dc.subjectSperm survivalen
dc.subjectAdvanced semen analysisen
dc.titleEfficacy of sperm motility after processing and incubation to predict pregnancy after intrauterine insemination in normospermic individualsen
dc.typeArtigo
dcterms.rightsHolderBiomed Central Ltd
unesp.author.lattes0514178654667684
unesp.author.orcid0000-0001-5478-4996[6]
unesp.campusUniversidade Estadual Paulista (Unesp), Instituto de Biociências, Botucatupt
unesp.campusUniversidade Estadual Paulista (Unesp), Faculdade de Medicina, Botucatupt

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