How can we check male fertility?

Abstract:

Objectives:

To determine prognostic factors for achieving a pregnancy with intrauterine insemination (IUI) and IVF. To compare the effectiveness and cost-effectiveness of IUI and IVF based on semen analysis results.

Design:

Retrospective cohort study.

Setting:

Academic university hospital-based infertility "center".

Patients:

One thousand thirty-nine infertile couples undergoing 3,479 IUI cycles. Four hundred twenty-four infertile couples undergoing 551 IVF cycles.

Interventions:

IUI and IVF treatment.

Main Outcome Measure(s):

Multiple logistic regression analysis was used to assess the significance of prognostic factors including a woman's age, gravidity, duration of infertility, diagnoses, use of ovulation induction, and sperm parameters for predicting the outcomes of clinical pregnancy and live birth rate after the first cycle of IUI and IVF. The relative effectiveness and cost-effectiveness of these treatments were then determined based on sperm count results.

Results:

Female age, gravidity, and use of ovulation induction were all independent factors in predicting pregnancy after IUI. The average total motile sperm count in the ejaculate was also an important factor, with a threshold value of 10 million. For IVF, only female age was an important predictor for both clinical and ongoing pregnancy. When the average total motile sperm count was under 10 million, IVF with ICSI was more cost-effective than IUI in our clinic.

Conclusion(s):

An average total motile sperm count of 10 million may be a useful threshold value for decisions about treating a couple with IUI or IVF. Copyright (C) 2001 American Society for Reproductive Medicine.

Please click on the required question.

• 1 What is infertility?
• 2 How prevalent are infertility problems?
• 3 What are the main causes of infertility?
• 4 What are the objectives of our infertility investigations?
• 5 Have there been any noticeable changes in fertility requirements in recent years?
• 6  What is the effect of our age on fertility?
• 7 I smoke cigarettes. Can this have an effect on my fertility?
• 8 Does my weight influence fertility?
• 8A Obesity! How can I lose weight?
• 9 I have fibroids. Could these reduce my fertility?
• 10 I have been told that my womb has an abnormal shape and that was the way that I was born. Could this reduce my fertility?
• 11 I have endometriosis. Could this reduce my fertility?
• 12 I have been told that I have cervicitis or a cervical ectopy (erosion). Could this impair my fertility?
• 13 My doctor tells me that my womb is retroverted (tilts backwards). Could this reduce my fertility?
• 14 I have had an ectopic pregnancy. Does this affect my future fertility?
• 15  We are worried that we may have a fertility problem. What should we do?
• 16 How will our doctor be able to identify the cause of our infertility?
• 17 How can we tell if I am releasing my eggs (ovulating)?
• 18 Investigations have shown that I have a problem releasing my eggs (anovulation). What could be the cause of this?
• 19 How important are my Fallopian tubes in fertility?
• 20 How can we tell if my Fallopian tubes are functioning?
• 21a What are the causes of male factor infertility?
• 21 How can we assess male fertility?
• 22  What is the purpose of a post-coital test (PCT)?
• 23 We have had our infertility investigations and our problem remains unexplained. How can this be?
• 24 What are our chances of achieving a pregnancy?
• 25 Where can I obtain more information?
• 26 Could we have some recommended infertility support groups?
  

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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

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