Pregnancy outcome after IUI for male and idiopathic infertility using a new simplified method for sperm preparation|
Siam, Emad M.
Introduction: Intrauterine insemination (IUI) is a valid treatment for infertility with a
cumulative pregnancy rate of 40–90% after 3–10 treatment cycles.
Design: We prospectively studied the efficacy of a new simplified method for motile sperm preparation
for IUI for both male causes of infertility, and for those diagnosed with idiopathic infertility.
Methods: A prospective clinical trial was performed with 200 couples, with a 2–8 years history of
primary infertility. One hundred couples had been diagnosed as idiopathic, while another 100 couples
with male factors of infertility. Motile sperm for IUI was prepared by: (A) the classic World
Health Organization self-migration (swim–up) method which includes centrifugation, or (B) the
proposed simplified swim-up procedure without centrifugation. Both anti–estrogens and HMG
had been used for ovarian stimulation. Depending on the cause of infertility, patients were matched
one-to-one at the time of IUI, so that when a total of 100 couples had been treated of both causes of
infertility, 50/100 women received sperm prepared by method A and 50/100 by method B.
Results: A statistically significant correlation was found between the percentage motile sperm of
the original semen sample and the percentage of motile sperm recovered by method A (r 0.333,
P < 0.01) and B (r = 0.400, P < 0.01). A highly significant correlation (r = 0.997, P < 0.001) was found between the two methods. The pregnancy outcome after the proposed IUI procedure was
not significantly different after the traditional swim-up sperm preparation.
Conclusions: The simple proposed swim-up method was as effective as the classic swim-up method,
regarding the sperm recovery and pregnancy outcome, but in an easier, and faster way.
IUI; Ovarian stimulation; Sperm preparation; Swim-up