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CC BY-NC-ND 4.0 · Revista Urología Colombiana / Colombian Urology Journal 2018; 27(03): 266-271
DOI: 10.1055/s-0038-1656517
Original Article | Artículo Original
Sociedad Colombiana de Urología. Publicado por Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Calidad seminal e inseminación intrauterina: estudio retrospectivo

Semen Quality and Intrauterine Insemination: A Retrospective Study
Luisa F. Calderón-Mendoza
1   Centro de Medicina Reproductiva, Concevidas, Medellín, Colombia
2   Estudiante de Maestría, Universidad CES, Medellín, Colombia
,
Lucero Castrillón López
1   Centro de Medicina Reproductiva, Concevidas, Medellín, Colombia
,
Carlos Felipe Vélez Giraldo
1   Centro de Medicina Reproductiva, Concevidas, Medellín, Colombia
,
Walter D. Cardona-Maya
3   Grupo de Reproducción, Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
,
Verónica Isaza Álvarez
1   Centro de Medicina Reproductiva, Concevidas, Medellín, Colombia
› Author Affiliations
Further Information

Publication History

21 April 2017

19 July 2017

Publication Date:
25 May 2018 (online)

Also available at
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Resumen

Objetivo El objetivo de este estudio fue evaluar los parámetros seminales en muestras seminales frescas y seleccionadas y determinar los factores que predicen el éxito de la inseminación intrauterina (IIU).

Materiales y Métodos Todas las parejas que se sometieron a IIU se registraron retrospectivamente y se incluyeron un total de 419 ciclos. Las muestras de semen fueron seleccionadas usando el método swim-up.

Resultados No se encontró un parámetro seminal que pueda ser considerado como predictor de embarazo. Después de la preparación de la muestra, hubo una mejoría en la movilidad espermática y una disminución en la concentración. Adicionalmente, una diferencia significativa en el volumen entre los individuos menores de 40 años y mayores de 40 años fue observada.

Conclusión No existen parámetros seminales que puedan predecir el éxito de la inseminación, básicamente debido a que lograr un embarazo depende de muchos factores. Sin embargo, el procesamiento en el laboratorio mejora considerablemente la movilidad espermática de las muestras y la IIU tiene tasas de embarazo aceptables; por lo tanto, debe ser considerada como primera elección de tratamiento.

Abstract

Objective The aim of the study was to evaluate the sperm parameters in fresh and washed samples and define the factors for predicting success after intrauterine insemination (IUI).

Materials and Methods All couples undergoing IUI were retrospectively enrolled, a total of 419 IUI cycles were included. Sperm samples were prepared using the swim-up.

Results There were no seminal parameters that could be considered as being predictors of pregnancy. After sperm washed, there was an improvement in sperm motility and a decrese in sperm concentration. There was also a significant difference in volume between individuals under 40 and those over 40.

Conclusion There are no seminal parameters that can predict the success of the insemination, basically because achieving a pregnancy is due to many factors. However, laboratory processing considerably improves the sperm motility of samples and IUI has acceptable pregnancy rates; therefore it should be considered a first choice treatment.

Palabras Claves

espermatozoide - inseminación intrauterina - embarazo - fertilidad - factor masculino

Keywords

sperm - intrauterine insemination - pregnancy - fertility - male factor

Responsabilidades éticas

Protección de personas y animales. Los autores declaran que para esta investigación no se han realizado experimentos en seres humanos ni en animales.


Confidencialidad de los datos. Los autores declaran que han seguido los protocolos de su centro de trabajo sobre la publicación de datos de pacientes.


Derecho a la privacidad y consentimiento informado. Los autores han obtenido el consentimiento informado de los pacientes y/o sujetos referidos en el artículo. Este documento obra en poder del autor de correspondencia.


 

  • Referencias

  • 1 Meniru G. Intrauterine insemination. Cambridge Guide to Infertility Management and Assited Reproduction. 1rs ed. Cambridge: Cambridge University Press; 2004
    Search in Google Scholar
  • 2 Vargas-Hernández VM, Tovar-Rodríguez JM, Acosta-Altamirano G, Moreno-Eutimio MA. Papel de la inseminación intrauterina en la era de la fertilización in vitro. Clin Invest Ginecol Obstet 2014; 41 (01) 29-34
    PubMedSearch in Google Scholar
  • 3 Badawy A, Elnashar A, Eltotongy M. Effect of sperm morphology and number on success of intrauterine insemination. Fertil Steril 2009; 91 (03) 777-781
    CrossrefPubMedSearch in Google Scholar
  • 4 Zhao Y, Vlahos N, Wyncott D. , et al. Impact of semen characteristics on the success of intrauterine insemination. J Assist Reprod Genet 2004; 21 (05) 143-148
    CrossrefPubMedSearch in Google Scholar
  • 5 Duran HE, Morshedi M, Kruger T, Oehninger S. Intrauterine insemination: a systematic review on determinants of success. Hum Reprod Update 2002; 8 (04) 373-384
    CrossrefPubMedSearch in Google Scholar
  • 6 Devranoğlu B, Özdamar Ö, Köle E, Eken MK, Bozdağ H, Doğer E. Do younger women with elevated basal follicular stimulating hormone levels undergoing gonadotropin-stimulated intrauterine insemination cycles represent compromised reproductive outcomes?. Eur J Obstet Gynecol Reprod Biol 2016; 199: 141-145
    CrossrefPubMedSearch in Google Scholar
  • 7 Hansen KR, He ALW, Styer AK. , et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Reproductive Medicine Network. Predictors of pregnancy and live-birth in couples with unexplained infertility after ovarian stimulation-intrauterine insemination. Fertil Steril 2016; 105 (06) 1575-1583.e2
    CrossrefPubMedSearch in Google Scholar
  • 8 Moro F, Tropea A, Scarinci E. , et al. Anti-Müllerian hormone concentrations and antral follicle counts for the prediction of pregnancy outcomes after intrauterine insemination. Int J Gynaecol Obstet 2016; 133 (01) 64-68
    CrossrefPubMedSearch in Google Scholar
  • 9 WHO. WHO laboratory manual for the Examination and processing of human semen. fifth edit. WHO Library; 2010
    Search in Google Scholar
  • 10 Erdem M, Abay S, Erdem A. , et al. Recombinant FSH increases live birth rates as compared to clomiphene citrate in intrauterine insemination cycles in couples with subfertility: a prospective randomized study. Eur J Obstet Gynecol Reprod Biol 2015; 189: 33-37
    CrossrefPubMedSearch in Google Scholar
  • 11 Yumusak OH, Kahyaoglu S, Pekcan MK, Isci E, Cinar M, Tasci Y. Does intrauterine insemination timing matter for achieving pregnancy during ovulation induction using gonadotropins? A retrospective cohort study. J Chin Med Assoc 2017; 80: 366-370
    CrossrefPubMedSearch in Google Scholar
  • 12 Luco SM, Agbo C, Behr B, Dahan MH. The evaluation of pre and post processing semen analysis parameters at the time of intrauterine insemination in couples diagnosed with male factor infertility and pregnancy rates based on stimulation agent. A retrospective cohort study. Eur J Obstet Gynecol Reprod Biol 2014; 179: 159-162
    CrossrefPubMedSearch in Google Scholar
  • 13 Atasever M, Kalem MN, Hatırnaz Ş, Hatırnaz E, Kalem Z, Kalaylıoğlu Z. Factors affecting clinical pregnancy rates after IUI for the treatment of unexplained infertility and mild male subfertility. J Turk Ger Gynecol Assoc 2016; 17 (03) 134-138
    PubMedSearch in Google Scholar
  • 14 Merviel P, Heraud MH, Grenier N, Lourdel E, Sanguinet P, Copin H. Predictive factors for pregnancy after intrauterine insemination (IUI): an analysis of 1038 cycles and a review of the literature. Fertil Steril 2010; 93 (01) 79-88
    CrossrefPubMedSearch in Google Scholar
  • 15 Ombelet W, Dhont N, Thijssen A, Bosmans E, Kruger T. Semen quality and prediction of IUI success in male subfertility: a systematic review. Reprod Biomed Online 2014; 28 (03) 300-309
    CrossrefPubMedSearch in Google Scholar
  • 16 Miller DC, Hollenbeck BK, Smith GD. , et al. Processed total motile sperm count correlates with pregnancy outcome after intrauterine insemination. Urology 2002; 60 (03) 497-501
    CrossrefPubMedSearch in Google Scholar
  • 17 Dorjpurev U, Kuwahara A, Yano Y. , et al. Effect of semen characteristics on pregnancy rate following intrauterine insemination. J Med Invest 2011; 58 (1-2): 127-133
    CrossrefPubMedSearch in Google Scholar
  • 18 Papillon-Smith J, Baker SE, Agbo C, Dahan MH. Pregnancy rates with intrauterine insemination: comparing 1999 and 2010 World Health Organization semen analysis norms. Reprod Biomed Online 2015; 30 (04) 392-400
    CrossrefPubMedSearch in Google Scholar
  • 19 Tjon-Kon-Fat RI, Tajik P, Custers IM. , et al. Can we identify subfertile couples that benefit from immediate in vitro fertilisation over intrauterine insemination?. Eur J Obstet Gynecol Reprod Biol 2016; 202: 36-40
    CrossrefPubMedSearch in Google Scholar
  • 20 Wang L, Sun N, Lu X. , et al. Effect of Timing and Number of Intrauterine Insemination (IUI) on the Cycle Clinical Outcome. J Reprod Contracept 2014; 25 (04) 219-226
    PubMedSearch in Google Scholar
  • 21 van Weert JM, Repping S, Van Voorhis BJ, van der Veen F, Bossuyt PMM, Mol BWJ. Performance of the postwash total motile sperm count as a predictor of pregnancy at the time of intrauterine insemination: a meta-analysis. Fertil Steril 2004; 82 (03) 612-620
    CrossrefPubMedSearch in Google Scholar
  • 22 Dinelli L, Courbière B, Achard V. , et al. Prognosis factors of pregnancy after intrauterine insemination with the husband's sperm: conclusions of an analysis of 2,019 cycles. Fertil Steril 2014; 101 (04) 994-1000
    CrossrefPubMedSearch in Google Scholar
  • 23 Shabtaie SA, Gerkowicz SA, Kohn TP, Ramasamy R. Role of Abnormal Sperm Morphology in Predicting Pregnancy Outcomes. Curr Urol Rep 2016; 17 (09) 67
    CrossrefPubMedSearch in Google Scholar
  • 24 Lemmens L, Kos S, Beijer C. , et al; Semen Section of the Dutch Foundation for Quality Assessment in Medical Laboratories. Predictive value of sperm morphology and progressively motile sperm count for pregnancy outcomes in intrauterine insemination. Fertil Steril 2016; 105 (06) 1462-1468
    CrossrefPubMedSearch in Google Scholar
  • 25 Erdem M, Erdem A, Mutlu MF. , et al. The impact of sperm morphology on the outcome of intrauterine insemination cycles with gonadotropins in unexplained and male subfertility. Eur J Obstet Gynecol Reprod Biol 2016; 197: 120-124
    CrossrefPubMedSearch in Google Scholar
  • 26 Deveneau NE, Sinno O, Krause M. , et al. Impact of sperm morphology on the likelihood of pregnancy after intrauterine insemination. Fertil Steril 2014; 102 (06) 1584-90.e2
    CrossrefPubMedSearch in Google Scholar
  • 27 Butcher MJ, Janoo J, Broce M, Seybold DJ, Gantt P, Randall G. Use of Sperm Parameters to Predict Clinical Pregnancy with Intrauterine Insemination. J Reprod Med 2016; 61 (5-6): 263-269
    PubMedSearch in Google Scholar
  • 28 J. Ruiter-Ligeti CA. Dahan M. The impact of semen processing on sperm quality and pregnancy rates with intrauterine inseminations. Fertil Steril 2015; 104 (03) e246
    PubMedSearch in Google Scholar
  • 29 Bellver J, Garrido N, Remohí J, Pellicer A, Meseguer M. Influence of paternal age on assisted reproduction outcome. Reprod Biomed Online 2008; 17 (05) 595-604
    CrossrefPubMedSearch in Google Scholar
  • 30 Frattarelli JL, Miller KA, Miller BT, Elkind-Hirsch K, Scott Jr RT. Male age negatively impacts embryo development and reproductive outcome in donor oocyte assisted reproductive technology cycles. Fertil Steril 2008; 90 (01) 97-103
    CrossrefPubMedSearch in Google Scholar
  • 31 Luna M, Finkler E, Barritt J. , et al. Paternal age and assisted reproductive technology outcome in ovum recipients. Fertil Steril 2009; 92 (05) 1772-1775
    CrossrefPubMedSearch in Google Scholar
  • 32 Dain L, Auslander R, Dirnfeld M. The effect of paternal age on assisted reproduction outcome. Fertil Steril 2011; 95 (01) 1-8
    CrossrefPubMedSearch in Google Scholar
  • 33 Hayakawa T, Naya Y, Kojima M. Significant changes in volume of seminal vesicles as determined by transrectal sonography in relation to age and benign prostatic hyperplasia. Tohoku J Exp Med 1998; 186 (03) 193-204
    CrossrefPubMedSearch in Google Scholar
  • 34 Goldman N, Montgomery M. Fecundability and husband's age. Soc Biol 1989; 36 (3-4): 146-166
    PubMedSearch in Google Scholar
  • 35 Harman S. Clinical aspects of aging of the male reproductive system. In: Schneider EL. , editor. The aging reproductive system. New York: Raven Press; 1978
    Search in Google Scholar
  • 36 Kidd SA, Eskenazi B, Wyrobek AJ. Effects of male age on semen quality and fertility: a review of the literature. Fertil Steril 2001; 75 (02) 237-248
    CrossrefPubMedSearch in Google Scholar
  • 37 Hassan MAM, Killick SR. Effect of male age on fertility: evidence for the decline in male fertility with increasing age. Fertil Steril 2003; 79 (Suppl. 03) 1520-1527
    CrossrefPubMedSearch in Google Scholar
  • 38 Klonoff-Cohen HS, Natarajan L. The effect of advancing paternal age on pregnancy and live birth rates in couples undergoing in vitro fertilization or gamete intrafallopian transfer. Am J Obstet Gynecol 2004; 191 (02) 507-514
    CrossrefPubMedSearch in Google Scholar
  • 39 Duran EH, Dowling-Lacey D, Bocca S, Stadtmauer L, Oehninger S. Impact of male age on the outcome of assisted reproductive technology cycles using donor oocytes. Reprod Biomed Online 2010; 20 (06) 848-856
    CrossrefPubMedSearch in Google Scholar
  • 40 Raberi A, Rozis G, Alfarawati S. , et al. A comprehensive study into the effects of advancing male age on semen parameters, sperm genetic integrity and the outcome of assisted reproductive treatments. Fertil Steril 2016; 106 (03) e304
    PubMedSearch in Google Scholar
  • 41 de La Rochebrochard E, Thonneau P. Paternal age >or=40 years: an important risk factor for infertility. Am J Obstet Gynecol 2003; 189 (04) 901-905
    CrossrefPubMedSearch in Google Scholar