Abnormal sperm morphology

 The procedure of IUI has no therapeutic role in improving preg rate or miscarriage rate by IUI.

The procedure of IUI has no therapeutic role in improving preg rate or miscarriage rate by IUI :  It is well known that Intrauterine Insemination (IUI) cycles combined

with ovarian stimulation along with induction of ovulation has become

the first line of treatment for infertility. The question which still remains unanswered whether IUI procedure in cases where morphological disorders are predominant cause of subfertility,

The effect of morphology as a seminal parameter in order to evaluate reproductive

success in patients undergoing IUI

. All patients were stimulated with rFSH

(Puregon; Organon) starting cycle day 3, (once ovarian quiescence was confirmed

by transvaginal ultrasound scan,)- and estradiol and progesterone blood

tests when needed. Starting dose ranged between 75 and 150 IU, depending on

patients’ age and BMI. Final maturation was triggered with 250 mg of rhCG

when at least one follicle reached 17 mm in mean diameter. Two IUI were

scheduled at 16 and 28 hours since rhCG injection. Sperm samples were collected

into a sterile container 2 h prior insemination, by masturbation after a

minimum of two days of abstinence. Kruger´s strict criteria were applied to

evaluate sperm morphology. According to percentage of normal forms, samples

were classified into Group A (1-6% normal sperms) and Group B (7-14%).

Pregnancy Rate (PR) and Miscarriage Rate (MR) were compared in both

groups. t-test was applied.Most studies reveled that there is a trend towards better outcomes with increasing number of normal sperm, there were no statistically significant differences between

both groups in terms of PR [A: 21.03% (82/390); B: 29.17% (14/48)] and

MR [A: 2.31% (9/390); B: 2.08%, (1/48)].To conclude the efficacy of IUIin isolated sperm morphological defect is questionable.

 

: Sperm morphology is a widely used parameter to consider IUI. However,. The narrow range of sperm morphology classification may be responsible of these results, although WHO criteria to classify

morphology seems to show similar results. In the view of these results, there

is no clinical usefulness of morphological classification at least to predict PR

and MR.