Official websites use. Share sensitive information only on official, secure websites. Correspondence address. Division of Urology, Department of Surgery, University of Utah School of Medicine, 30 North East, Salt Lake City, UTUSA. What thresholds for total sperm count, sperm concentration, progressive motility, and total progressive motile sperm count TPMC are associated with earlier time-to-conception in couples undergoing fertility evaluation? Values well above the World Health Organization WHO references for total sperm count, concentration, and progressive motility, and values up to million for TPMC were consistently associated with earlier time-to-conception and higher conception rates. Although individual semen parameters are generally not able to distinguish between fertile and infertile men, they can provide clinically useful information on time-to-pregnancy for counseling patients seeking fertility treatment. Compared to the conventional semen parameters, TPMC might be a better index for evaluating the severity of male infertility. We used data from a longitudinal cohort study on subfertile men from to and included men with initial semen analysis SA in the study. Men from subfertile couples who underwent a SA within the study period were included, and 5-year follow-up data were collected to capture conception data. We also plotted continuous values of semen parameters in predicting 5-year conception rates and time-to-conception. These patients were younger and had higher values of sperm concentration, progressive motility, and TPMC. Similar results were observed in the natural conception cohort. For the natural conception cohort without major female factor, the TPMC cut-off was 20 million. In the visual assessment of the graphs for the continuous semen parameter values, 5-year conception rates and time-to-conception consistently plateaued at higher values of sperm concentration, total sperm count, progressive motility, and TPMC compared to the WHO reference levels and our calculated thresholds. For TPMC, values up to — million were still associated with a better conception rate and time-to-conception in the visual assessment of the curves. There was limited information on female partners and potential for inaccuracies in capturing less severe female infertility diagnoses. We only used the initial SA and sperm morphology, another potentially important parameter, was not included in the analyses. Importantly, our data might lack the generalizability to other populations. Our results suggest that a TPMC threshold of 50 million sperm provided the best predictive power to estimate earlier time-to-conception in couples evaluated for male factor infertility. Higher values of sperm count, concentration and i had sex 3 days before my ovulation date motility beyond the WHO references were still associated with better conception rates and time-to-conception. This provides an opportunity to optimize semen parameters in those with semen values that are low but not abnormal according to the WHO reference values. These data can be used to better inform patients regarding their chances of conception per year when SA results are used for patient counseling. Keywords: total motile sperm count, total progressive motile sperm count, semen analysis, semen parameters, sperm count, sperm motility, time-to-pregnancy, infertility, male. Semen analysis SA i had sex 3 days before my ovulation date usually the first and often the only test used to evaluate the reproductive function of a male partner in couples seeking infertility counseling Practice Committee of the American Society for Reproductive Medicine, The World Health Organization WHO recommendations are commonly used to interpret SA results World Health Organization, These thresholds, however, do not strongly correlate with fertility outcomes and cannot be reliably used to differentiate fertile from infertile men Nagler, Moreover, several studies have shown an increased probability of pregnancy with semen parameter values well above the WHO reference levels Guzick et al. While the overall ability of semen parameters to differentiate fertile from infertile men remains limited Polansky and Lamb, ; Guzick et al. Thus, longitudinal studies with adequate follow-up time are needed to assess the relations between semen parameters and time-to-conception, rather than conception success. Time to conception is a more clinically meaningful parameter for counseling patients seeking fertility treatment. The concept of total motile sperm count TMCor more accurately total progressive motile sperm count TPMCwas first introduced in the s as a better way to assess the severity of male factor infertility by combining information on semen volume, sperm concentration, and progressive motility Smith et al. Smith et al. Further studies reinforced the idea that TPMC has a better correlation with natural pregnancy rates than other individual semen parameters Small et al. TPMC is also correlated with IUI success and might be useful in selecting patients for IUI over IVF Brasch et al. InHamilton et al. However, the methodology and the evidence underpinning these thresholds remain unclear and population-based data are lacking to define the optimal TPMC threshold for fertility prediction. We hypothesized that higher values of semen parameters are associated with higher conception rates and earlier time-to-conception in men undergoing fertility evaluation. We integrated data from the Subfertility Health and Assisted Reproduction and the Environment SHARE study with those from the Utah Population Database UPDB to define the cohort of men undergoing male fertility evaluation. SHARE combines medical, genealogic, and administrative data with biospecimen data to create a unique resource that currently includes the University of Utah and Intermountain Healthcare's SA results collected from to
Doing so would likely result in significantly more men being evaluated for male infertility by a reproductive urologist and may result in earlier and more cost-effective treatments for these men. After an ovary releases an oocyte immature egg , there is a rise in the hormone progesterone 1. The overall study cohort consisted of all men evaluated with a SA for male infertility in the SHARE database. We searched the Cochrane Gynaecology and Fertility CGF Group Specialised Register, CENTRAL, MEDLINE, and Embase in January Similar to the overall cohort, conception rates and time-to-conception consistently reached a relative plateau at values well beyond the WHO reference values and our selected thresholds.
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Like these two, there have been several studies that have concluded that libido does peak during or around ovulation (5). Feel free to send us a DM or comment below! Women were found to. Got questions? Patients who achieved live birth were younger and had higher values of total sperm count, sperm concentration, progressive motility, and TPMC. So you really want to make sure you're having sex the five days before ovulation and ovulation day. How to support progesterone levels naturally? Here are some simple tips to help! Sperm can live up to five days in the body.A large sample size enabled us to analyze subcategories of initial semen parameters, including different TPMC categories. TPMC is also correlated with IUI success and might be useful in selecting patients for IUI over IVF Brasch et al. Median income and abstinence days were not different between the two groups. Research ethical approval for this study has been granted by the University of Utah's Institutional Review Board and the Utah Resource for Genetic and Epidemiological Research. Due to insufficient evidence, we are uncertain whether timed intercourse using FABM resulted in a difference in live birth rate compared to intercourse without ovulation prediction RR 0. The World Health Organization WHO recommendations are commonly used to interpret SA results World Health Organization, This study has some strengths and limitations that are worth discussing. In the visual assessment of our graphs, men with TPMC values up to — million depending on the cohort of interest still had higher conception rates and earlier time-to-conception before reaching a plateau. Clue Conceive can help increase your chances. PERMALINK Copy. Evidence was insufficient to determine the effect of urine ovulation tests on time to pregnancy or quality of life. Enzyklopädie Fertility Trying to Conceive Does tracking basal body temperature predict ovulation? These rates are comparable to other longitudinal studies assessing conception rates in couples undergoing male infertility assessment Ayala et al. Estimated conception rates and time-to-conception in the natural conception cohort without major female factor infertility from the Cox regression models for individual semen parameters. Mean male and female age at the time of SA were The overall concordance index for these thresholds was similar between different semen parameters and also between the calculated thresholds and the WHO reference values. However, there are insufficient data to determine the effects of urine ovulation tests on adverse events, clinical pregnancy, time to pregnancy, and quality of life. Natural conception without major female factor. We concluded that timing intercourse around the fertile period identified using a urine ovulation test probably increased the chances of pregnancy and live birth in women under 40 trying to conceive for under 12 months compared to intercourse without ovulation prediction. The conception rates in different TPMC deciles and the HRs for 5-year conception are provided in Supplementary Table SI. BBT changes are very small 1. Second, distinction should also be made between pre-wash and post-wash TPMC values and the outcomes of interest in different studies. Thus, it may be reasonable to consider higher threshold values if a single TPMC value is to be used before excluding male factor as a contributing factor. After an ovary releases an oocyte immature egg , there is a rise in the hormone progesterone 1. Values well above the World Health Organization WHO references for total sperm count, concentration, and progressive motility, and values up to million for TPMC were consistently associated with earlier time-to-conception and higher conception rates. For TPMC and when concerning all couples who underwent infertility assessment with a SA, a threshold of 50 million sperm provided the best predictive power to estimate earlier time-to-conception as a dichotomous threshold. Chi-square test or Wilcoxon rank-sum test were used to compare values between the conception groups. Received Jun 24; Revised Apr 25; Collection date Aug.
