Fatores preditivos do sucesso da inseminação intrauterina: A morfologia espermática de acordo com o novo manual de laboratório da Organização Mundial de Saúde

• Autor(a) principal: Lopes, Fabio Biaggioni
• Data de Publicação: 2010
• Outros Autores: Setti, Amanda Souza, Braga, Daniela Paes de Almeida Ferreira, Figueira, Rita de Cássia Savio, Iaconelli Jr., Assumpto, Borges Jr., Edson [UNESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNESP
• Texto Completo: http://www.jbra.com.br/archive/JBRA_3_2010.pdf; http://hdl.handle.net/11449/71769
• topic: Intrauterine insemination; Pregnancy rate; Sperm morphology; recombinant chorionic gonadotropin; recombinant follitropin; adult; body mass; cell structure; controlled study; endometrium; female; female infertility; gestational age; human; human cell; intrauterine insemination; luteal phase; major clinical study; male; male infertility; maternal age; ovary follicle development; ovulation induction; paternal age; prediction; predictive value; pregnancy; pregnancy outcome; pregnancy rate; probability; reference value; retrospective study; sampling; semen analysis; spermatozoon; spermatozoon count; spermatozoon motility; transvaginal echography; treatment outcome; world health organization

Objective: The aim of our study was to assess the likelihood of IUI success as a function of the previously described predictive factors, including sperm morphology according to the new reference values defined by WHO. Material and Methods: This retrospective study enrolled 300 couples which underwent IUI. Regression analyses were used to correlate maternal age, number of preovulatory follicles on the day of hCG administration, number of inseminated motile sperm, and normal sperm morphology with clinical pregnancy. Results are expressed as odds ratio (OR) with 95% of confidence intervals (CI). Results: Women older than 35 years showed a lower pregnancy rate (6.5% vs 18.2%, p=0.017). Logistic regression models confirmed the lower chance of pregnancy occurrence for older women (OR: 0.39; CI: 0.16-0.96; p=0.040). The presence of two or more preovulatory follicles on the day of hCG administration resulted in higher pregnancy rate when compared to cases in which only one preovulatory follicle was present (18.6% vs 8.2%, p=0.011). The regression model showed a more than two fold increase on probability of pregnancy when two or more preovulatory follicles were detected (OR: 2.58; CI: 1.22-5.46, p=0.013). The number of inseminated motile sperm positively influenced pregnancy occurrence (OR: 1.47; CI: 0.88-3.14, p=0.027). Similar pregnancy rates were observed when semen samples were classified as having normal or abnormal morphology (10.6% vs 10.2%, p=0.936). Conclusion: Our results demonstrate that sperm morphological normalcy, according to the new reference value, has no predictive value on IUI outcomes. © Todos os direitos reservados a SBRA - Sociedade Brasileira de Reprodução Assistida.