THERAPEUTIC CUP INSEMINATION WITH CRYOPRESERVED DONOR SPERM - PROGNOSTIC VALUE OF CERVICAL-MUCUS SCORE AT INSEMINATION AND THE NUMBER OF MOTILE SPERM IN MUCUS AT 24 HOURS

Objective: To examine the prognostic value of cervical mucus score at insemination and the number of motile sperm in mucus 24 hours after th erapeutic cup insemination with cryopreserved donor sperm. Design: Ret rospective analysis. Setting: Academic tertiary medical center. Patien ts: One hundred thirty-eight women with confirmed bilateral tubal pate ncy who received therapeutic cup inseminations with cryopreserved dono r sperm between 1986 and 1993. Interventions: All insemination cycles were monitored with serial daily urinary LH determinations with a sing le (n = 312) insemination or two inseminations (n = 212) performed on and/ or 1 day after the day of LH surge detection. A single examiner a ssigned cervical mucus scores in all insemination cycles and recorded the number of motile sperm in mucus 24 hours after the first inseminat ion in dual insemination cycles. Main Outcome Measure: Pregnancy rate during various cervical mucus and motile sperm scores. Results: Ninety -one women conceived (66%) and seven of these achieved two pregnancies . The overall pregnancy rate per insemination cycle was 18.7%. Age and day of insemination were the only variables identified as having sign ificant influence on cycle outcome. Pregnancy occurred with decreasing frequency as patient age increased and was nearly twice as likely aft er insemination on the day after the urinary LH surge as on the day of surge detection. Conclusions: Insemination the day after the urinary LH surge is superior to the day of surge detection. Cervical mucus sco re and the number of motile sperm in mucus 24 hours after therapeutic cup insemination with cryopreserved donor sperm do not correlate with cycle outcome.