Correlation between semen parameters of electroejaculates and achieving pregnancy by intrauterine insemination

Objective: To investigate whether any parameter in the routine semen analysis of electroejaculates is correlated with success in achieving pregnancy by IUI. Design: Retrospective observational study. Setting: An Assisted Reproductive Program at a tertiary care university center. Patient(s): Twenty-seven anejaculatory men with spinal cord injury (n = 24) or history of retroperitoneal lymph node dissection (n = 3), thirteen of whom attempted conception with their wives. Intervention(s): Anejaculatory men underwent rectal probe electroejaculation and electroejaculates were used for IUI. Main Outcome Measure(s): Statistical correlation of semen parameters between electroejaculates that resulted in pregnancy and those that did not. Result(s): Seven pregnancies resulted from 56 IUIs using electroejaculates (pregnancy rate = 12.5% per IUI), The total motile sperm count and percentage of normal morphology were significantly higher in the specimens that resulted in pregnancies than those that did not. However, there was no statistically significant difference observed in pH, sperm concentration, or percentage of motility between the two groups. Swim-up techniques used to process electroejaculates significantly improved the motility of the specimens. No pregnancy occurred beyond the fifth IUI attempt. Repeated electroejaculation and duration of spinal cord injury had no effect on the quality of the ejaculates. Conclusion(s): The total motile sperm count and the percentage normal morphology of electroejaculates correlate with success in achieving pregnancy by IUI. Because repeated electroejaculation does not improve quality of ejaculate, the initial semen analysis of electroejaculates is not only useful in counseling couples undergoing such treatment program but should be planned for use as an inseminate.