Background
Methods
Subjects
Pregnant Group (n = 468) | Non-pregnant Group (n = 3,054) | p-value | |
---|---|---|---|
Female age | 31.02 ± 3.74 | 31.37 ± 4.05 | 0.133 |
Male age | 32.93 ± 4.36 | 33.29 ± 4.75 | 0.402 |
Cause of infertility | 0.585 | ||
Male-factor | 82 (17.5%) | 595 (19.5%) | |
Both-male-and-female-factor | 65 (13.9%) | 427 (14.0%) | |
Other-factor | 321 (68.6%) | 2,032 (66.5%) | |
Type of infertility | 0.988 | ||
Primary | 287 (61.3%) | 1,874 (61.4%) | |
Secondary | 181 (38.7%) | 1,180 (38.6%) | |
IUI cycle | 0.049 | ||
1 | 265 (56.6%) | 1,659 (54.3%) | |
2 | 143 (30.6%) | 1,085 (35.5%) | |
≥ 3 | 60 (12.8%) | 310 (10.2%) |
Semen collection
Semen analysis
Semen treatment
Artificial insemination by husband
Statistical analysis
Results
Sperm parameters were improved after semen processing
Parameters | Pregnant group (n = 468) | Non-pregnant group (n = 3,054) | ||||||
---|---|---|---|---|---|---|---|---|
Before | After | (After-Before) | p-value | Before | After | (After-Before) | p-value | |
Concentration (× 106/mL) | 50.86 ± 31.47 | 71.14 ± 54.85 | 20.28 ± 37.72 | < 0.001 | 52.21 ± 33.29 | 71.12 ± 54.49 | 18.91 ± 38.43 | < 0.001 |
Motility (%) | 61.69 ± 14.55 | 93.42 ± 7.56 | 31.73 ± 12.08 | < 0.001 | 61.29 ± 14.07 | 93.43 ± 7.89 | 32.14 ± 11.69 | < 0.001 |
TPMSC (× 106/mL) | 75.04 ± 63.50 | 32.97 ± 26.79 | -42.07 ± 37.64 | < 0.001 | 75.60 ± 63.88 | 33.08 ± 26.60 | -42.52 ± 37.99 | < 0.001 |
VAP (µm/s) | 7.82 ± 3.84 | 24.47 ± 5.78 | 16.65 ± 6.67 | < 0.001 | 7.86 ± 3.69 | 23.94 ± 5.83 | 16.08 ± 6.70 | < 0.001 |
VSL (µm/s) | 4.42 ± 2.26 | 14.10 ± 3.75 | 9.69 ± 4.14 | < 0.001 | 4.42 ± 2.14 | 13.66 ± 3.57 | 9.24 ± 4.04 | < 0.001 |
VCL (µm/s) | 14.32 ± 5.87 | 47.39 ± 10.38 | 33.07 ± 11.56 | < 0.001 | 14.37 ± 5.72 | 46.35 ± 10.69 | 31.98 ± 11.82 | < 0.001 |
ALH (µm/s) | 4.16 ± 0.50 | 6.56 ± 0.79 | 2.40 ± 0.91 | < 0.001 | 4.16 ± 0.49 | 6.49 ± 0.80 | 2.33 ± 0.92 | < 0.001 |
BCF (Hz) | 5.45 ± 1.20 | 7.24 ± 0.70 | 1.79 ± 1.36 | < 0.001 | 5.43 ± 1.15 | 7.25 ± 0.75 | 1.81 ± 1.33 | < 0.001 |
STR (%) | 46.73 ± 9.05 | 72.54 ± 7.86 | 65.17 ± 19.48 | < 0.001 | 46.43 ± 8.41 | 71.95 ± 8.75 | 65.55 ± 18.48 | < 0.001 |
LIN (%) | 34.32 ± 6.28 | 47.50 ± 5.15 | 13.18 ± 7.59 | < 0.001 | 34.18 ± 5.81 | 47.19 ± 5.72 | 13.01 ± 7.84 | < 0.001 |
Sperm head area (µm2) | 5.08 ± 0.48 | 5.55 ± 0.58 | 0.47 ± 0.70 | < 0.001 | 5.12 ± 0.49 | 5.55 ± 0.57 | 0.43 ± 0.72 | < 0.001 |
Parameters | absolute changes vs. overall CPR | Relative changes vs. overall CPR | ||
---|---|---|---|---|
PCC r | p-value | PCC r | p-value | |
Concentration (× 106/mL) | 0.017 | 0.307 | 0.026 | 0.122 |
Motility (%) | − 0.011 | 0.506 | − 0.012 | 0.475 |
TPMSC (× 106/mL) | 0.003 | 0.871 | 0.019 | 0.259 |
VAP (µm/s) | 0.019 | 0.248 | 0.019 | 0.261 |
VSL (µm/s) | 0.027 | 0.103 | 0.024 | 0.162 |
VCL (µm/s) | 0.025 | 0.135 | 0.02 | 0.234 |
ALH (µm/s) | 0.020 | 0.227 | 0.019 | 0.249 |
BCF (Hz) | − 0.007 | 0.687 | − 0.006 | 0.740 |
STR (%) | 0.010 | 0.566 | − 0.006 | 0.726 |
LIN (%) | 0.008 | 0.634 | 0.008 | 0.620 |
Sperm head area (µm2) | 0.022 | 0.190 | 0.023 | 0.175 |
Both pre- and post-processing semen parameters were not correlated with the pregnancy outcome of overall AIH cases
Parameters | Before semen treatment | After semen treatment | ||||
---|---|---|---|---|---|---|
Pregnant (n = 468) | Non-pregnant (n = 3,054) | p-value | Pregnant (n = 468) | Non-pregnant (n = 3,054) | p-value | |
Concentration (× 106/mL) | 50.86 ± 31.47 | 52.21 ± 33.29 | 0.468 | 71.14 ± 54.85 | 71.12 ± 54.49 | 0.896 |
Motility (%) | 61.69 ± 14.55 | 61.29 ± 14.07 | 0.546 | 93.42 ± 7.56 | 33.08 ± 26.60 | 0.582 |
TPMSC (× 106/mL) | 75.04 ± 63.50 | 75.60 ± 63.88 | 0.986 | 93.42 ± 7.56 | 93.43 ± 7.89 | 0.983 |
VAP (µm/s) | 7.82 ± 3.84 | 7.86 ± 3.69 | 0.703 | 24.47 ± 5.78 | 23.94 ± 5.83 | 0.213 |
VSL (µm/s) | 4.42 ± 2.26 | 4.42 ± 2.14 | 0.751 | 14.10 ± 3.75 | 13.66 ± 3.57 | 0.105 |
VCL (µm/s) | 14.32 ± 5.87 | 14.37 ± 5.72 | 0.779 | 47.39 ± 10.38 | 46.35 ± 10.69 | 0.107 |
ALH (µm/s) | 4.16 ± 0.50 | 4.16 ± 0.49 | 0.698 | 6.56 ± 0.79 | 6.49 ± 0.80 | 0.192 |
BCF (Hz) | 5.45 ± 1.20 | 5.43 ± 1.15 | 0.681 | 7.24 ± 0.70 | 7.25 ± 0.75 | 0.415 |
STR (%) | 46.73 ± 9.05 | 46.43 ± 8.41 | 0.64 | 72.54 ± 7.86 | 71.95 ± 8.75 | 0.214 |
LIN (%) | 34.32 ± 6.28 | 34.18 ± 5.81 | 0.837 | 47.50 ± 5.15 | 47.19 ± 5.72 | 0.299 |
Sperm head area (µm2) | 5.08 ± 0.48 | 5.12 ± 0.49 | 0.086 | 5.55 ± 0.58 | 5.55 ± 0.57 | 0.743 |
Parameters | Pregnant (n = 468) | Non-pregnant (n = 3,054) | p-value |
---|---|---|---|
SDI | 1.24 ± 0.11 | 1.24 ± 0.11 | 0.44 |
TZI | 1.30 ± 0.10 | 1.30 ± 0.10 | 0.718 |
H (%) | 94.69 ± 7.54 | 94.79 ± 8.64 | 0.328 |
M (%) | 16.47 ± 5.23 | 16.57 ± 5.08 | 0.559 |
P (%) | 5.15 ± 3.12 | 5.48 ± 3.31 | 0.076 |
C (%) | 6.83 ± 4.74 | 6.84 ± 4.81 | 0.917 |
Normal forms (%) | 4.82 ± 4.24 | 4.42 ± 3.79 | 0.141 |
Abnormal forms (%) | 95.17 ± 4.24 | 95.58 ± 3.79 | 0.113 |
Comparison of semen parameters between different etiological groups of AIH
Parameters | Before sperm processing | After sperm processing | ||||||
---|---|---|---|---|---|---|---|---|
Male-factor (n = 677) | Both-factor (n = 492) | Other-factor (n = 2,353) | p-value | Male-factor (n = 677) | Both-factor (n = 492) | Other-factor (n = 2,353) | p-value | |
Concentration (× 106/mL) | 44.02 ± 31.41a | 44.81 ± 29.91a | 55.85 ± 33.48b | < 0.001 | 53.45 ± 47.32a | 56.11 ± 45.65a | 79.35 ± 56.28b | < 0.001 |
Motility (%) | 54.95 ± 14.31a | 57.29 ± 14.14b | 64.03 ± 13.26c | < 0.001 | 90.26 ± 10.31a | 91.45 ± 9.29a | 94.75 ± 6.17b | < 0.001 |
TPMSC (× 106/mL) | 54.81 ± 53.70a | 59.03 ± 55.44b | 84.94 ± 66.01c | < 0.001 | 24.06 ± 22.97a | 25.69 ± 22.28a | 37.20 ± 27.45b | < 0.001 |
VAP (µm/s) | 6.55 ± 3.53a | 6.80 ± 3.45a | 8.45 ± 3.68b | < 0.001 | 23.66 ± 6.03 | 23.49 ± 5.61 | 24.23 ± 5.80 | 0.113 |
VSL (µm/s) | 3.69 ± 2.08a | 3.84 ± 2.00a | 4.74 ± 2.14b | < 0.001 | 13.46 ± 3.75 | 13.46 ± 3.35 | 13.84 ± 3.60 | 0.231 |
VCL (µm/s) | 12.45 ± 5.38a | 12.82 ± 5.37a | 15.24 ± 5.71b | < 0.001 | 45.96 ± 11.04ab | 45.42 ± 10.37a | 46.87 ± 10.58b | 0.018 |
ALH (µm/s) | 3.99 ± 0.46a | 4.03 ± 0.46a | 4.24 ± 0.49b | < 0.001 | 6.46 ± 0.84 | 6.42 ± 0.78 | 6.53 ± 0.80 | 0.128 |
BCF (Hz) | 4.97 ± 1.17a | 5.11 ± 1.15a | 5.64 ± 1.09b | < 0.001 | 7.16 ± 0.78a | 7.28 ± 0.72ab | 7.26 ± 0.74b | 0.025 |
STR (%) | 43.24 ± 8.29a | 44.21 ± 8.18a | 47.87 ± 8.26b | < 0.001 | 71.32 ± 9.02 | 72.05 ± 8.38 | 72.23 ± 8.57 | 0.104 |
LIN (%) | 31.88 ± 5.67a | 32.60 ± 5.59a | 35.20 ± 5.73b | < 0.001 | 46.74 ± 5.85 | 47.32 ± 5.50 | 47.36 ± 5.62 | 0.056 |
Sperm head area (µm2) | 5.27 ± 0.57a | 5.20 ± 0.50a | 5.05 ± 0.44b | < 0.001 | 5.61 ± 0.61a | 5.57 ± 0.56ab | 5.53 ± 0.57b | 0.002 |
Parameters | Male-factor (n = 677) | Both-factor (n = 492) | Other-factor (n = 2,353) | p-value |
---|---|---|---|---|
SDI | 1.27 ± 0.11a | 1.28 ± 0.11a | 1.22 ± 0.11b | < 0.001 |
TZI | 1.31 ± 0.11ab | 1.31 ± 0.10a | 1.30 ± 0.10b | 0.009 |
H (%) | 97.02 ± 6.95a | 97.32 ± 5.16a | 93.60 ± 9.19b | < 0.001 |
M (%) | 17.23 ± 5.62a | 17.52 ± 5.05a | 16.17 ± 4.91b | < 0.001 |
P (%) | 5.64 ± 3.36a | 5.91 ± 3.36a | 5.28 ± 3.23b | < 0.001 |
C (%) | 7.19 ± 5.29 | 7.02 ± 5.01 | 6.70 ± 4.60 | 0.364 |
Normal forms (%) | 2.48 ± 2.49a | 2.38 ± 2.58a | 5.49 ± 3.99b | < 0.001 |
Abnormal forms (%) | 97.52 ± 2.49a | 97.62 ± 2.58a | 94.51 ± 4.00b | < 0.001 |
Multivariate logistic regression analysis of the influencing factors for different etiological groups of AIH
Parameters | β | Odd Ratio (95% CI) | p-value |
---|---|---|---|
pre-VSL | -0.155 | 0.856 (0.740–0.991) | 0.037 |
pre-STR | 0.037 | 1.037 (1.000–1.076) | 0.048 |
post-VSL | 0.035 | 1.036 (1.008–1.064) | 0.011 |
P | -0.027 | 0.973 (0.943–1.004) | 0.086 |
Abnormal forms | -0.017 | 0.983 (0.966–1.001) | 0.061 |
Constant | -1.65 | 0.192 | 0.125 |
Parameters | β | Odd Ratio (95% CI) | p-value |
---|---|---|---|
pre-VAP | -0.707 | 0.493 (0.247–0.984) | 0.045 |
pre-VSL | -1.765 | 0.171 (0.045–0.658) | 0.01 |
pre-VCL | 0.74 | 2.096 (1.218–3.607) | 0.008 |
pre-BCF | -1.487 | 0.226 (0.084–0.611) | 0.003 |
pre-LIN | 0.657 | 1.93 (1.276–2.919) | 0.002 |
pre-Sperm head area | -0.585 | 0.557 (0.294–1.056) | 0.073 |
post-VAP | -0.117 | 0.89 (0.797–0.993) | 0.037 |
post-VSL | 0.275 | 1.316 (1.039–1.666) | 0.023 |
post-BCF | 0.483 | 1.621 (0.991–2.652) | 0.054 |
post-STR | -0.062 | 0.939 (0.878–1.005) | 0.071 |
H | 0.354 | 1.424 (0.808–2.513) | 0.222 |
Normal forms | 0.476 | 1.61 (0.899–2.883) | 0.109 |
Constant | -46.353 | 0 | 0.116 |
Parameters | β | Odd Ratio (95% CI) | p-value |
---|---|---|---|
pre-VAP | -0.634 | 0.53 (0.34–0.827) | 0.005 |
pre-VCL | 0.372 | 1.451 (1.104–1.906) | 0.008 |
post-motility | 0.197 | 1.218 (1.000–1.484) | 0.049 |
post-VCL | 0.186 | 1.204 (0.995–1.458) | 0.056 |
post-ALH | -2.209 | 0.11 (0.008–1.431) | 0.092 |
P | -0.102 | 0.903 (0.826–0.988) | 0.026 |
Constant | -1.054 | 0.349 | 0.828 |
Parameters | β | Odd Ratio (95% CI) | p-value |
---|---|---|---|
pre-VAP | 0.539 | 1.715 (1.073–2.74) | 0.024 |
pre-VCL | -0.342 | 0.71 (0.537–0.94) | 0.017 |
pre-STR | 0.182 | 1.2 (1.042–1.382) | 0.011 |
pre-LIN | -0.283 | 0.754 (0.601–0.945) | 0.014 |
post-VSL | 0.039 | 1.04 (1.007–1.074) | 0.017 |
Constant | -0.528 | 0.59 | 0.602 |
Semen parameters pre- and post-processing had greater prognostic powers in Male- and Both-factor Groups of AIH
Multivariate logistic regression models | AUC | 95% CI | p-value | Cut-off | Sensitivity | Specificity |
---|---|---|---|---|---|---|
Overall | 0.551 ± 0.014 | 0.523–0.58 | < 0.001 | 14.77 | 32.7 | 77.7 |
Male-factor Group | 0.668 ± 0.031 | 0.606–0.729 | < 0.001 | 12.46 | 59.8 | 65.7 |
Both-male-and-female-factor Group | 0.655 ± 0.034 | 0.588–0.722 | < 0.001 | 8.74 | 90.8 | 33.0 |
Other-factor Group | 0.544 ± 0.017 | 0.51–0.578 | 0.011 | 14.82 | 35.8 | 73.2 |