The Effect of Semen Parameters and Insemination Preparation Period on Intrauterine Insemination Success

Öz

In intrauterine insemination (IUI), which is the first step in assisted reproductive techniques (ART), female age, body mass index (BMI), stimulation time, abstinence duration and semen parameters are among prognostic factors that affect success. Considering clinical success achieved by each ART center as a result of routine treatment approaches and laboratory practices, its prognostic factors should be established and management of the treatment process should be arranged in this perspective. In this retrospective study, 245 IUI cycles performed in our ART center between January 2019 and February 2020 were evaluated. Etiology, age, BMI, sperm parameters of ejaculate before and after washing, abstinence duration and time periods during ejaculate preparation were evaluated. While there was no difference between groups in terms of female and male age, female BMI, etiology, duration of infertility, number of cycles and abstinence duration, it was found that increased male BMI decreased pregnancy success. It was observed that semen volume, sperm concentration before and after washing and total motile sperm count did not have a determining effect on pregnancy success, and the percentage of motile sperm and immotile sperm after washing was determinant. It was determined that the time from sampling and washing to the time of IUI procedure did not affect clinical success, but the long incubation period before washing decreased the pregnancy rate. In this study conducted with a small sample group, it was concluded that pre-wash semen parameters do not have a determinant effect on clinical success in IUI treatment, and male obesity and sample preparation processes should be considered as prognostic factors.

Anahtar Kelimeler

• Infertility
• intrauterine insemination
• prognostic factors
• pregnancy rates
• sperm parameters

Semen Parametrelerinin ve İnseminasyon Öncesi Hazırlık Periyodunun İntrauterin İnseminasyon Başarısına Etkisi

Öz

Üremeye yardımcı tedavi (ÜYT) uygulamalarında ilk basamak olan intrauterin inseminasyonda (IUI) kadın yaşı, vücut kitle indeksi (VKİ), stimülasyon süresi, abstinens süresi ve semen parametreleri başarıyı etkileyen prognostik faktörler arasındadır. Her ÜYT merkezinin rutin tedavi yaklaşımları ve laboratuvar uygulamaları sonucunda elde ettiği klinik başarı dikkate alınarak kendi prognostik faktörleri oluşturulmalı ve tedavi sürecinin yönetimi bu perspektifte düzenlenmelidir. Bu retrospektif çalışmada Ocak 2019-Şubat 2020 tarihleri arasında ÜYT merkezimizde gerçekleştirilen 245 IUI siklusu değerlendirilmiştir. IUI tedavisi uygulanan hastaların etiyoloji, yaş, VKİ, ejakülatın yıkama öncesi ve yıkama sonrası sperm parametreleri, abstinens süresi ve ejakulat yıkama işlemi boyunca geçen zaman periyotları değerlendirilmiştir. Kadın ve erkek yaşı, kadın VKİ, etiyoloji, infertilite süresi, siklus sayısı ve abstinens süresi bakımından gruplar arası farklılık saptanmaz iken, erkek VKİ artışının gebelik başarısını azalttığı saptandı. Semen volümü, yıkama öncesi ve sonrası sperm konsantrasyonu ve total motil sperm sayısının gebelik başarısı açısından belirleyici etkisinin olmadığı, yıkama sonrası motil sperm ve immotil sperm yüzdesinin belirleyici olduğu görüldü. Numune verilmesi ve yıkama sonrasından IUI işlemine kadar geçen sürelerin klinik başarıyı etkilemediği, fakat yıkama öncesi uzun inkübasyon süresinin gebelik şansını azalttığı saptandı. Küçük örneklem grubuyla yapılan bu çalışmada IUI tedavisinde klinik başarıda yıkama öncesi semen parametrelerinin belirleyici bir etkisinin olmadığı, erkek obezitesi ve numune hazırlama süreçlerinin prognostik faktörler olarak göz önünde bulundurulması gerektiği sonucuna varıldı.

Anahtar Kelimeler

• İnfertilite
• intrauterin inseminasyon
• prognostik faktörler
• gebelik oranları
• sperm parametreleri

Kaynakça

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