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; Salma Kafeel; Riffat Bibi; Jawad Mohmand

doi:10.32593/jstmu/Vol3.Iss2.108

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

DOI: https://doi.org/10.32593/jstmu/Vol3.Iss2.108

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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