# Intrauterine Insemination (IUI) Outcomes With Total Progressive Motile Sperm Count (TPMSC) Above and Below 5 Million

## TL;DR

This study shows that IUI success is significantly higher when sperm count meets a specific threshold, suggesting alternative treatments for lower sperm counts.

## Contribution

The study identifies a TPMSC threshold of 5 million as a critical predictor of IUI success in couples with unexplained infertility.

## Key findings

- Cycles with TPMSC above 5 million had significantly higher chemical, clinical, and live birth rates.
- No pregnancies were observed in cycles with TPMSC below 5 million.
- IUI may not be cost-effective for severe oligoasthenospermia, suggesting IVF as a better alternative.

## Abstract

Objective: The study aims to investigate the impact of total progressive motile sperm count (TPMSC) on pregnancy outcomes in couples diagnosed with unexplained infertility undergoing intrauterine insemination (IUI).

Materials and methods: A retrospective analysis was conducted on 122 IUI cycles from 98 couples with unexplained infertility who received treatment at Zeynep Kamil Women’s and Children’s Diseases Training and Research Hospital between 2021 and 2022. The couples were divided into two groups based on TPMSC: below 5 million and 5 million or above. Key pregnancy outcomes, including chemical pregnancy, clinical pregnancy, and live birth rates, were evaluated and compared between the groups.

Results: Of the 122 IUI cycles analyzed, 69 had a TPMSC of 5 million or above, and 53 cycles had a TPMSC below 5 million. The chemical pregnancy, clinical pregnancy, and live birth rates were significantly higher in the group with TPMSC above 5 million (34.8%, 31.9%, and 23.2%, respectively) compared to the TPMSC below 5 million group, which had no pregnancies. The findings demonstrate that TPMSC is a critical predictor of IUI success, with a TPMSC threshold of 5 million associated with significantly higher pregnancy outcomes.

Conclusion: This study highlights that a TPMSC below 5 million is associated with poor IUI outcomes, suggesting that IUI may not be a cost-effective treatment for couples with severe oligoasthenospermia. For these couples, alternative treatments like in vitro fertilization (IVF) may be more appropriate. The findings provide valuable insights for improving the management and treatment strategies for unexplained infertility.