Abstract：
Background: The role of motile sperm count in intrauterine insemination (IUI) success rate is controversial. This retrospective cohort study performed among unselected infertile couples undergoing IUI was to explore the association between the total progressive motile sperm count (TPMSC) and the live birth rate (LBR) following IUI.Methods: The total cohort of 5363 cycles, 2666 infertile couples between January 2015 and December 2018 and finally 5171 cycles, 2647 couples were included for analysis in Sun Yat-sen memorial hospital of Sun Yat-sen University. The primary outcome was LBR per cycle. And the secondary outcome measure was clinical pregnancy rate (CPR) per cycle.Results: From the receiver operating characteristic (ROC) analysis of female age predicting live birth, female age cutoff was defined as 28 years. With a female age of ≤28 years, the CPRs were 11.5%, 14.9%, 16.1%, and 15.8% in quartile groups of pre-wash TPMSC, respectively. For the LBRs the values were 9.4%, 12.9%, 14.4%, and 11.3%, and there were also no significant differences in quartile groups of pre-wash TPMSC with ≤24 million (M), [24M-50M], [50M-97M], >97M. No statistically significant differences in the CPRs (p = .051) and LBRs (p = .088) were also observed in the quartiles groups of post-wash TPMSC. With a female age of >28 years, the CPR in couples with post-wash TPMSC ≤22.32 M was significantly lower than with post-wash TPMSC >81.0 M (p = .007). There was an obvious trend in which CPRs and LBRs increased with the post-wash TPMSC during the <81 M interval in women >28 years.Conclusions: The optimal female age cutoff for live birth was 28 years in IUI cycles. Pre-wash and post-wash TPMSC were not significantly associated with CPR and LBR per cycle. When female age >28 years, there was a better outcome with post-wash TPMSC >22.32 million.
摘要：
背景：活动精子计数在宫腔内人工授精（IUI）成功率中的作用存在争议。在接受IUI的未经选择的不育夫妇中进行的这项回顾性队列研究旨在探索IUI后总进行性活动精子计数（TPMSC）与活产率（LBR）之间的关系。方法:队列共5363个周期,在2015年1月至2018年12月之间有2666对不孕夫妇，最后有5171个周期，中山大学中山纪念医院纳入2647对夫妇进行分析。主要结果是每个周期的LBR。次要结局指标是每个周期的临床妊娠率（CPR）。结果：根据女性年龄预测活产的接受者工作特征（ROC）分析，女性年龄截止定义为28岁.女性年龄≤28岁，CPRs为11.5%，14.9%,16.1%,预洗TPMSC四分位数为15.8%，分别。对于LBR，该值为9.4%，12.9%,14.4%,和11.3%，≤2400万（M）的预洗TPMSC四分位数组也没有显着差异，[24M-50M],[50M-97M],>97M.在洗涤后TPMSC的四分位数组中也没有观察到CPR(p=.051)和LBR(p=.088)的统计学显著差异。女性年龄>28岁，洗后TPMSC≤22.32M的夫妇的CPR显著低于洗后TPMSC>81.0M的夫妇(p=.007).在28岁以上的女性中，CPRs和LBRs在<81M间隔内随着洗后TPMSC的增加而增加。结论：在IUI周期中，活产的最佳女性年龄为28岁。洗涤前和洗涤后TPMSC与每个周期的CPR和LBR没有显著相关。当女性年龄>28岁时，洗后TPMSC>2232万的结果更好。
