EFFECT OF MOTILE SPERM COUNT AFTER SWIM-UP ON OUTCOME OF INTRAUTERINEINSEMINATION

Objective: To analyze the prognostic value of motile sperm count after swim-up in IUI with husband's sperm in a large group of subfertile co uples. Design: Retrospective study. Setting: University hospital. Pati ent(s): Nine hundred two couples undergoing 3,037 treatment cycles. In tervention(s): Intrauterine insemination with husband's sperm after sw im-up was performed after mild ovarian stimulation with clomiphene cit rate and hCG under hormonal and ultrasonographic control of follicle d evelopment. Main Outcome Measure(s): Pregnancy rate (PR) in correlatio n to motile sperm count after swim-up. Result(s): A nonlinear increase in PR per treatment cycle was observed with increasing numbers of mot ile sperm used for IUI. Insemination with <0.8 x 10(6) motile sperm af ter swim-up resulted in a PR of <1% per treatment cycle. When the moti le sperm count was above this level, the PR per cycle reached a platea u of 6.9% to 10.2%, with a minor tendency for increase with higher spe rm numbers. Conclusion(s): Strict analysis of motile sperm count after swim-up is a useful prognostic factor for PRs after IUI. There is a g ood chance for conception if greater than or equal to 0.8 x 10(6) moti le sperm are available after appropriate selection methods. Intrauteri ne insemination performed with considerably higher numbers of motile s perm does not lead to a significant increase in PRs. ((C) 1997 by Amer ican Society for Reproductive Medicine.)).