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Journal of Andrology, Vol. 24, No. 3, May/June 2003
Copyright © American Society of Andrology

The Use of Novel Semen Quality Scores to Predict Pregnancy in Couples With Male-Factor Infertility Undergoing Intrauterine Insemination

MOHAMED A. BEDAIWY*, RAKESH K. SHARMA*, TAREK K. ALHUSSAINI{dagger}, MAHER S. MOHAMED{dagger}, ALI M. ABDEL ALEEM{dagger}, DAVID R. NELSON{ddagger}, ANTHONY J. THOMAS, JR* AND ASHOK AGARWAL*

From the * Center for Advanced Research in Human Reproduction, Infertility, and Sexual Function, Department of Obstetrics-Gynecology and Urological Institute and the{ddagger} Department of Biostatistics and Epidemiology, The Cleveland Clinic Foundation, Cleveland, Ohio; and the{dagger} Department of Obstetrics-Gynecology, Assiut, Egypt.

Correspondence to: Dr Ashok Agarwal, Director, Center for Advanced Research in Human Reproduction, Infertility, and Sexual Function, Urological Institute, The Cleveland Clinic Foundation, 9500 Euclid Ave, Desk A19.1, Cleveland, OH 44195 (e-mail: agarwaa{at}ccf.org).


The purpose of this study was to determine whether 2 new semen quality (SQ) scores could predict pregnancy in patients undergoing intrauterine insemination (IUI) for male-factor infertility and whether an overall score could help in counseling these couples with assisted reproductive technique (ART) options. Ninety-three couples with male-factor infertility were examined for semen analysis. Samples were prepared by density gradient separation (47% and 90%), and IUI was performed. On the basis of the 2 semen scores (SQ and relative quality [RQ]), the IUI-semen pregnancy score (IUI-SPS) was calculated. Of the 192 IUI cycles, 14% (27 of 192) resulted in pregnancy. Both prewash SQ and RQ scores were significantly related to pregnancy (P = .02 and P < .001), as was the postwash RQ score (P < .001). Of the IUI cycles in which the postwash RQ score was greater than 125, 40% (13 of 32) resulted in pregnancy compared to 9% of cycles (14 of 160) in which the postwash SQ score was less than 125. The prewash IUI-SPS score was significantly related to IUI-induced pregnancy (P < .001). Both the pre- and postwash SQ and RQ scores can predict pregnancy in male infertility patients undergoing IUI. Patients with an IUI-SPS less than 150 may be advised to seek in vitro fertilization (IVF), whereas those with an IUI-SPS greater than 150 may be advised to seek IUI.

     Key words: Overall semen quality, relative quality, semen pregnancy score, outcome prediction






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Copyright © 2003 by The American Society of Andrology.