A PROSPECTIVE CLINICAL-STUDY OF THE RELATIONSHIP BETWEEN THE COMPUTER-ASSISTED ASSESSMENT OF HUMAN SEMEN QUALITY AND THE ACHIEVEMENT OF PREGNANCY IN-VIVO

The objective of this study was to examine the clinical predictive val ue for the achievement of pregnancy in vivo of the assessment of human semen quality by computer-assisted semen analysis using the Hamilton- Thorn Motility Analyser (HTM-S), alongside classic World Health Organi zation (WHO) techniques. A prospective follow-up study of 303 couples attending a regional infertility clinic providing tertiary level servi ces to the population of a single geographical region was undertaken. Couples attending the infertility clinic, in whom the female partner w as normal on conventional investigations (history, examination, eviden ce of ovulation, laparoscopy), were studied. After initial assessment, couples were followed for a median of 15 months and treatment-indepen dent pregnancies observed and related to the results of semen assessme nt. During the period of follow-up, the treatment-independent pregnanc y rate was 52%. Several measures of semen quality, determined both man ually and by the HTM-S, were found to be predictive of the achievement of pregnancy and were related to the time taken to conceive. Couples who conceived had higher sperm concentrations and motilities, determin ed both manually and by the HTM-S, as well as differences in sperm hea d morphometry and sperm velocity determined by the HTM-S. Using multip le logistic regression, the prognostic accuracy of the HTM-S alone was similar to manual techniques, although data from the computer assiste d sperm analysis system were preferred, Using proportional hazards reg ression, several variables were related to the achievement of pregnanc y, particularly morphometry and mobility. It was concluded that a stro ng case can be made for the introduction of automated assessment of hu man semen in routine service andrology laboratories.