Thesis Type: Expertise In Medicine
Institution Of The Thesis: Gazi University, Tıp Fakültesi, Cerrahi Tıp Bilimleri, Turkey
Approval Date: 2014
Thesis Language: Turkish
Student: MEHMET SEÇKİN ÖZIŞIK
Supervisor: AHMET ERDEM
Open Archive Collection: AVESIS Open Access Collection
Abstract:In this retrospective study, the impact of sperm morphology on prognosis in the intrauterine insemination treatment devoted to couples suffering from unexplained and mild male subfertility has been evaluated. To this end, the impact of sperm morphology on the treatment success and especially on the pregnancy rate has been compared in 530 IUI cycles belonging to a total of 412 couples where ovarian stimulation has been made with only a low dose of gonadotropin. According to the data obtained from the total group (the unexplained and mild male factor considered together) while the basal sperm morphology (2,4 ± 2.9) and the after washing sperm morphology (5.6 ± 4.7) have been found statistically high in cycles consisting of clinical pregnancies, only the after washing sperm morphology (5.4 ± 4.5) has been found statistically high in cycles with live birth (p< 0.05). When we examine the data of 442 IUI cycles made to 337 patients having unexplained subfertility, while the after washing sperm morphology (5.8 ± 4.7) has been found statistically high in cycles consisting of clinical pregnancy, no difference has been detected in cycles with live birth. As we examine the data of 88 IUI treatment applied to 75 patients having subfertility due to mild male factor, in cycles with clinical pregnancy the basal and after washing total progressive motile sperm number and the basal and after washing sperm morphology have been found statistically high. In the same group of patients, in cycles with live birth, the basal and after washing total progressive motile sperm number and the after washing sperm morphology have been found statistically high (p<0,05). In the ROC analysis made for the prediction of clinical pregnancy and live birth, the threshold value for after washing normal sperm morphology in the total population as well as in the group having mild male subfertility has been calculated as 4.5 %. When the normal sperm morphology is taken as 4.5 %, it is determined that pregnancy ratios and live birth ratios statistically increase in the whole population and especially in the group having mild male subfertility. As a result of this study, it has been shown that in COH/IUI cycles made by using gonadotropins, the threshold value of 4.5 % for the after washing normal sperm morphology is an important parameter in the prognosis of pregnancy.