Journal of Clinical and Biomedical Sciences
Year: 2021, Volume: 11, Issue: 3, Pages: 112-117
Original Article
Divyanu Jain1*, Abha Sood2, Ajay K Jain3
1. Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Alberta Faculty of Medicine, 227 Heritage Medical Research Centre, Edmonton-T6G 2S2, Canada. 2. Department of Obstetrics & Gynecology and IVF Center, Jaipur Golden Hospital, Sector-3, Rohini, New Delhi-110085, India.
3. IVF Center, Muzaffarnagar Medical College, Muzaffarnagar (Uttar Pradesh)- 251001, India.
*Corresponding Author
E-mail: [email protected]
Mobile No: 9350829132
Background: The use of pooled sequential ejaculates is a minimally-invasive, cost-effective and yet underutilized technique of increasing total motile sperm counts for intrauterine insemination (IUI) before opting for expensive and unnecessary infertility treatments. At present, no guidelines are available regarding the use of pooled sequential ejaculates for IUI in cases with very low seminal parameters; therefore, we speculated that the use of pooled sequential ejaculates for IUI in patients with male factor infertility may be an efficient technique for achieving a successful pregnancy. The aim of this study is to assess the efficiency of the pooled semen technique by comparing the outcomes of IUI using a single semen sample versus pooled sequential ejaculates in young patients with severe oligospermia. Materials and Methods: Young couples with only male factor infertility were randomly assigned single semen or pooled sequential ejaculates technique for a single cycle of IUI and analyzed. We strictly included males aged 25-30 years with sperm concentration < 6 million/mL, total motile sperm count (TMSC) < 10 million and sperm motility < 50%. The second ejaculate was obtained within two hours of the first ejaculate. Results: Pooling the sequential ejaculates significantly increased the TMSC for insemination (P<0.0001) compared with the single semen sample group. There were 5 successful pregnancies in the pooled sequential ejaculate group (pregnancy rate 33.3%, OR = 1.58; 95% CI 1.04, 2.41) as compared to 1 in the single semen sample group. The receiver operating characteristic analysis showed that the number of TMSC for IUI has a good predictive value for a successful pregnancy outcome in young couples with only male factor infertility (AUC = 0.86, p-value = 0.06). Conclusion: Pooled sequential ejaculates for IUI is an effective and inexpensive minimally-invasive treatment for infertility due to severe oligospermia in young couples.
Keywords: Intrauterine Insemination, Male Factor Infertility, Sperm Count, Oligospermia, Ejaculate, Pregnancy
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