Objective To study the changes of total progressive motile sperm count (TPMSC) after semen optimization treatment and its influence on the clinical pregnancy outcome of artificial insemination with husband's sperm. Methods A retrospective analysis was conducted on the clinical data of 169 couples who received artificial insemination with husband's sperm by intrauterine insemination (AIH-IUI) for a total of 314 cycles in our hospital from February 2019 to December 2024. Compare the changes of TPMSC after semen optimization treatment; According to whether clinical pregnancy outcome of AIH-IUI was clinical pregnancy, the patients were divided into the pregnancy group (n=69) and the non-pregnancy group (n=100). The ages of both spouses, the duration of infertility, the number of inseminations, the incubation temperature of the inseminated semen, and the TPMSC after semen optimization treatment were compared between the two groups. According to the TPMSC values after semen optimization treatment, the patients were divided into three groups: Group A with TPMSC values of (0-9) ×106, Group B with (10-50) ×106 and Group C with>50×106. The clinical pregnancy rates of AIH-IUI among the groups were compared. Logistic multivariate regression analysis was conducted on the age of the female, the incubation time of the optimized sperm, and the clinical pregnancy results of TPMSC and AIH-IUI after optimized treatment. Results (1) The TPMSC value of semen after optimized processing was significantly lower than that before processing (P<0.05), and sperm viability and progressive motility ratio were generally improved after treatment; (2) There was no statistically significant difference in the age of the male partner, the duration of infertility, the frequency of insemination and the incubation temperature of the inseminated semen between the pregnant group and the non-pregnant group (P>0.05). However, the female age of the two groups, the incubation time of the optimized sperm and the TPMSC after semen optimization treatment were statistically significant (P<0.05). (3) After semen optimization treatment, the clinical pregnancy rate of group A was 14.29%, that of group B was 40.00%, and that of group C was 13.04%. The rate of group B was significantly higher than that of groups A and C (P<0.05). (4) Logistic regression analysis showed that the age of the female would affect the clinical pregnancy rate, and the pregnancy rate decreased with the increase of the female's age (OR=0.81, 95% CI: 0.78-0.91, P<0.05), while the optimized sperm incubation time was 18-40 minutes (OR=2.19, 95% CI: 1.83-3.24, P<0.05) and treated TPMSC (10-50) ×106[OR=2.23, 95% CI: 1.87-3.16, P<0.05) could significantly increase the clinical pregnancy rate. Conclusion TPMSC decreases after semen optimization treatment, and TPMSC after semen optimization treatment has a certain impact on the clinical pregnancy outcome of AIH-IUI.
Key words
semen optimization /
total progressive motile sperm count /
AIH-IUI clinical pregnancy outcome /
relevance
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