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Prediction of in vitro fertilization rates from semen variables
W W Duncan1, M J Glew, X J Wang
1Department of Obstetrics and Gynaecology, University of Adelaide, Queen Elizabeth Hospital, Woodville, Australia.
Objective:
To assess the value of semen variables for predicting fertilization rates.
Design:
Measures of the fresh semen and the motile sperm fraction used for insemination were related to the fertilization rate by multiple regression analysis. The regression model was then used to construct a two-dimensional clinical chart.
Setting:
University-affiliated reproductive medicine unit.
Patients:
The results of 294 IVF cycles were analyzed retrospectively. Selection criteria were: [1] first cycle of IVF; [2] tubal and/or male factor infertility; and [3] four or more oocytes inseminated.
Interventions:
None.
Main Outcome Measures:
The fertilization rate was related to measured variables of the fresh semen and the motile sperm fraction used for insemination. Fertilization rate was categorized as poor (< 35%) or acceptable (> or = 35%).
Results:
Multiple regression analysis demonstrated a strong correlation between the fertilization rate and the combined indexes of percentage normal morphology and grade of motility in the fresh semen and percentage progressive motility in the motile sperm fraction. A two-dimensional chart that expressed these relationships was constructed. Its accuracy of prediction was 77% for poor fertilization and 95% for acceptable fertilization.
Conclusions:
The fertilization rate is strongly correlated with percentage normal sperm morphology in the fresh semen and the percentage progressive motility in the motile sperm fraction used for insemination. The clinical chart provides a simple but powerful tool for predicting fertilization outcome.