Influence of Borderline and Pathological Sperm Morphology on Pregnancy Outcomes following Intrauterine Insemination in Pregnant Women: A Retrospective Study
نویسندگان
1 Department of Anatomical Sciences, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
2 Health Education Research Department, Infertility Research and Treatment Center, ACECR, Ahvaz, Iran
3 Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
4 Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
5 Infertility Research and Treatment Center, ACECR, Ahvaz, Iran
6 Infertility Research and Treatment Center, ACECR, Ahvaz, Iran
7 Infertility Research and Treatment Center, ACECR, Ahvaz, Iran
8 Infertility Research and Treatment Center, ACECR, Ahvaz, Iran
doi
10.22074/ijfs.2025.2042418.1769چکیده
Background: The prognostic value of borderline and pathological sperm morphology (SM) in infertility treatmentremains unclear. This study aims to evaluate the potential impact of SM on clinical pregnancy outcomes followingintrauterine insemination (IUI).Materials and Methods: This retrospective study reviewed IUI outcomes conducted between July 2012 to January2017 at an infertility treatment center. Couples who underwent IUI and subsequently achieved a clinical pregnancywere included. Based on semen analysis according to the 6th edition of World Health Organization (WHO) guidelines,the couples were divided into two groups: borderline (4-13% normal forms) and pathological (<4% normal forms)SM. The study assessed the association between SM and pregnancy outcomes, specifically live birth and spontaneousabortion rates.Results: A total of 111 IUI cycles with confirmed clinical pregnancy were analyzed. Gestational complication rateswere 8.3% in the borderline SM group and 17.3% in the pathological SM group, this difference was not statisticallysignificant (P=0.255). However, live birth rates differed significantly between the two groups (borderline: 91.7%,pathological: 69.3%; P=0.009). Overall abortion rates were significantly higher in the Pathological SM group (borderline:2.8%, pathological: 26.7%; P=0.001). First-trimester abortion rates were 5.6% and 18.7% in the borderlineand pathological SM groups, respectively. Logistic regression analysis revealed that for every one-unit increase in thepercentage of morphologically normal sperm, the odds of abortion decreased by a factor of 0.6 (P=0.017; OR=0.614;95% CI: 0.412-0.916).Conclusion: Pathological SM is associated with a significantly higher risk of first-trimester abortion. Therefore, SMis highlighted as a potential predictor of IUI outcomes following clinical pregnancy. Subsequently, SM should beconsidered a critical factor in fertility assessments, and alternative treatment strategies may be more appropriate forcouples with pathological SM undergoing infertility treatment.
