Post-wash total motile sperm count a useful predictor in the decision to perform IVF/ICSI in patients with non-male factor infertility

  • Sara Mahmood Qureshi Clinical Embryologist, Salma Kafeel Medical Services, Islamabad, Pakistan
  • Salma Kafeel Consultant Gynecologist, Salma Kafeel Medical Services, Islamabad, Pakistan
  • Riffat Bibi Clinical Scientist, Salma Kafeel Medical Services, Islamabad, Pakistan
  • Jawad Mohmand Scientific Director, Imperial Laboratories, Islamabad, Pakistan
Keywords: In Vitro Fertilization, fertilization rate, post wash sperm, total motile sperm count

Abstract

Introduction: The unrestricted use of intracytoplasmic sperm injection (ICSI) for non-male factor infertility is associated with adverse outcomes. Post-wash total motile sperm count (PW-TMSC) offers prognostic value to assess sperm quality and aid in the decision to perform in vitro fertilization (IVF) or ICSI.

Objectives: The aim of this study was to identify the effect of PW-TMSC on fertilization rates in patients undergoing IVF cycles exclusively with non-male factor infertility. It also aimed to identify whether unnecessary ICSI could be avoided in such cases, thus maximizing optimal outcomes.

Materials & Methods: We retrospectively analyzed age, semen volume, prewash TMSC, and PW-TMSC in 68 conventional IVF cycles of infertile couples with non-male factor infertility. Clinical characteristics including female age, number of follicles, level of estradiol on trigger day, mature cumulus-oocyte complexes (COCs) collected, were also included.

Results: Incidence of <30% fertilization was significantly higher in the 4-<10 Million group compared with the ≥20 Million post-wash TMSC group (P<0.001). Furthermore, Receiver operating characteristics (ROC) analysis revealed post-wash TMSC as a significant predictor (P<0.05) of total failed fertilization (TFF) and of ≥30% fertilization (P<0.05) with area under curve (AUC) of 0. 79 and 0.77, respectively, with a deemed cutoff of 10.89 Million.

Conclusion: Post-wash TMSC is a good predictor of fertilization; it can help in avoiding potentially low or even total fertilization failure (TFF). A cut-off point of 10.89 Million or less should warrant the use of ICSI.

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Published
2020-12-23
How to Cite
1.
Qureshi S, Kafeel S, Bibi R, Mohmand J. Post-wash total motile sperm count a useful predictor in the decision to perform IVF/ICSI in patients with non-male factor infertility. JSTMU [Internet]. 23Dec.2020 [cited 19Jun.2021];3(2):99-06. Available from: https://j.stmu.edu.pk/ojs/index.php/jstmu/article/view/108