Do sperm motility, morphology or associated factors predict the success rate of intrauterine insemination?

Objective: Infertility is a global health issue among couples of reproductive age. Intrauterine insemination (IUI) is a fertility treatment method where the processed sperms are deposited in the female uterus during the time of ovulation. The aim of this study was to explore the factors predicting the success rate of IUI (IUI-SR).

Materials and Methods: A descriptive retrospective study was conducted analysing SFA and corresponding IUI reports of couples who underwent IUI from January 2017 to August 2021 at the Professorial unit of Colombo South Teaching Hospital, Sri Lanka. The data were analysed using SPSS version 22.0.

Results: A total of 140 SFA and corresponding IUI reports were used. The IUI-SR was 18.57% (n=26). A significantly high IUI-SR was noted when the female partner aged <30 years compared to >30 years (p=0.000, OR=1.87), with first two IUI attempts compared to multiple IUI attempts (p=0.017, OR=0.271), pre-processed sperm concentration >30M/ml compared to <30M/ml (p=0.019, OR=3.12), and pre-processed sperm motility (progressive and non-progressive)>40% compared to <40% {p=0.039, OR=5.31). The period of abstinence (p-value=0.222), pre-processed sperm parameters such as total count (p-value=0.093), normal form morphology (p-value=0.082), viability (p-value=0.093), or post-processed sperm parameters such as concentration, progressive motility did not significantly influence the IUI-SR.

Conclusion: A significantly high success rate of IUI can be achieved when the female partner is aged <30 years and with the first two IUI attempts. Pre-processed sperm concentration >30M/ml, and pre-processed sperm motility of progressive >32% and non-progressive <15% also predict a higher success rate of IUI.