Objectives: To search the role of semen parameters in the likelyhood of pregnancy of the couples with unexplained infertility during the intrauterine insemination.
Materials- methods: 545 cycles of IUI performed in our clinic due to unexplained infertility were included in the study. The IUI cycles were divided into two groups: group 1 pregnancy(77 cycles) and group 2 nonpregnancy(468 cycles). Sperm parameters were statistically evaluated before and after the washing. Logistic regression analysis was performed to assess the impact of sperm parameters on the prediction of pregnancy. ROC( Receiver Operating Characteristic) analysis was performed to identify the effective cut off values to detect pregnancy. P<0.05 was considered significant.
Findings: One of the sperm parameters, morphology was observed to be statistically higher in the pregnant group than nonpregnant group before and after the washing( p= 0.033 and p= 0.028 respectively). Not any other statistically significant difference was observed in other parameters( p> 0.05). As a result of the pre-wash ROC analysis performed with sperm parameters only morphology was found to be significant for the pregnancy to be detected( p= 0.029). When different cut-off values were analyzed in terms of morphology, the highest cut-off value in sensitivity and specificity was observed to be 4.5. As a result of post-wash ROC analysis, it was detected that morphology, +4 and +3 values of sperm motility had statistically significant effects on the detection of pregnancy( p= 0.029, p= 0.020 and p= 0.043 respectively). Other parameters were not observed to have any significant effects on the detection of pregnancy( p= 0.05). When cut-off value was 2.5 for post-wash morphology, it was identified to have 92.9% sensitivity and 75.5% specificity.
Result: Pre and post-wash morphology may effect the result of pregnancy by IUI in unexplained infertility, and by checking out the cut off values of morphology the likelyhood of pregnancy may be predicted and this could let advance treatments start sooner.