Optimizing post-wash TPMSC for intrauterine insemination: A key strategy to improve pregnancy outcomes

To investigate the impact of both pre- and post-ovulation post-wash total progressive motile sperm count (TPMSC) on pregnancy outcomes in intrauterine insemination (IUI) using husband's sperm (AIH).

This retrospective cohort study analyzed data from infertile couples who underwent IUI treatment at the Reproductive Medicine Center of Xinxiang Central Hospital from January 2020 to June 2024. A total of 462 IUI cycles were included, all of which had consistent pre- and post-ovulation post-wash TPMSC values. Cycles were divided into four groups based on TPMSC: Group A (<10 × 10⁶), Group B (10-20 × 10⁶), Group C (20-30 × 10⁶), and Group D (≥ 30 × 10⁶). Comparisons were made regarding baseline data and pregnancy outcomes among the groups. Multivariate logistic regression was employed to assess the impact of both pre- and post-ovulation post-wash TPMSC on clinical pregnancy rates.

The clinical pregnancy rates differed significantly among TPMSC groups (P = 0.024), with the highest rate in the 10-20 × 10⁶ group (26.13%). Multivariate logistic regression identified this range as an independent predictor of clinical pregnancy (odds ratio [OR] = 1.922, 95% confidence interval [CI]: 1.026-3.600, P = 0.041).

Post-wash TPMSC influences clinical pregnancy rates in IUI. When both pre- and post-ovulation post-wash TPMSC are within the range of 10-20 × 10⁶, this may optimize clinical pregnancy outcomes.