VALUE OF SPERM MORPHOLOGY ASSESSED BY STRICT CRITERIA FOR PREDICTION OF THE OUTCOME OF ARTIFICIAL (INTRAUTERINE) INSEMINATION

The purpose of this study was to investigate the relationship between sperm parameters and the outcome of artifical (intrauterine) inseminat ion (IUI). One hundred and twenty-six patients undergoing 395 consecut ive IUI cycles in a 1-year period in our institution were studied. In all cases, controlled ovarian stimulation and hCG-timed IUI were perfo rmed, followed by progesterone supplementation of the luteal phase. In 86 patients, (243 cycles) the husband's sperm was utilized, whereas i n 40 couples (152 cycles), donor sperm was used due to severe male fac tor infertility. Among the sperm parameters of the original ejaculate, % normal morphology (assessed by strict criteria) was the most signif icant predictor of pregnancy (stepwise regression analysis, P=0.003). Using logistic regression, morphology was the best predictor of pregna ncy (r=0.12); linearity of movement significantly enhanced the predict ive value of morphology alone (r=0.17, P=0.004). Overall, the pregnanc y rates were significantly higher (P=0.01) in cases with, greater than or equal to 14% normal morphology (15% per cycle) compared to cases w ith < 14% normal morphology (7% per cycle). This threshold level for m orphology is in agreement with previously published IVF results. These results underscore the significance of sperm morphology assessed by s trict criteria as a predictor of pregnancy outcome in the IUI setting.