Semen preparation techniques for intrauterine insemination

Area of Science:

• Reproductive Medicine
• Assisted Reproductive Technology
• Spermatozoa Analysis

Background:

• Semen preparation techniques aim to isolate motile, morphologically normal spermatozoa for assisted reproduction.
• The choice of technique can influence treatment outcomes in procedures like intrauterine insemination (IUI).

Purpose of the Study:

• To compare the effectiveness of three semen preparation techniques (gradient, swim-up, wash and centrifugation) on clinical outcomes in subfertile couples undergoing IUI.
• To evaluate live birth rate and clinical pregnancy rate as primary outcomes.

Main Methods:

• A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted.
• Searches included major databases and trial registries up to March 2019.
• Seven RCTs were identified, with six included in the meta-analysis (485 couples).

Main Results:

• No trials reported live birth rates; evidence quality was very low due to bias, imprecision, and small sample sizes.
• Uncertainty exists regarding differences in clinical pregnancy rates between swim-up, gradient, and wash techniques.
• No significant differences were consistently found for ongoing pregnancy, multiple pregnancy, or miscarriage rates across techniques.

Conclusions:

• Insufficient evidence exists to recommend any specific semen preparation technique for IUI.
• Further RCTs are crucial, particularly those reporting live birth data, to guide clinical practice.