Vlstreli Sperm

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Affiliations

1 Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT, USA.

2 Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA.

3 Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA.

4 Huntsman Cancer Institute, Salt Lake City, UT, USA.

Sorena Keihani et al.

Hum Reprod .

2021 .

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1 Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT, USA.

2 Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA.

3 Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA.

4 Huntsman Cancer Institute, Salt Lake City, UT, USA.

Kaplan–Meier curves comparing 5-year conception…
Kaplan–Meier curves comparing 5-year conception probability within 10 different categories of total progressive…
Kaplan–Meier curves comparing 5-year conception probability within 10 different categories of total progressive motile sperm count. ( A ) Overall cohort; ( B ) natural conception cohort; ( C ) natural conception cohort without major female factor. Categories are total progressive motile sperm count (TMPC) <1, 1–4, 5–9, 10–19, 20–49, 50–99, 100–149, 150–199, 200–249, and ≥250 million from bottom to top. Solid lines mark categories with TPMC < 50 million and dashed lines are categories with TPMC ≥ 50 million. Solid blue line is TPMC 20–49 and the dashed red line is TPMC 50–99.
Estimated conception rates and time-to-conception…
Estimated conception rates and time-to-conception in the overall cohort from the Cox regression…
Estimated conception rates and time-to-conception in the overall cohort from the Cox regression models for individual semen parameters. ( A ) Sperm concentration; ( B ) total sperm count; ( C ) progressive motility; ( D ) total progressive motile sperm count (TPMC). Solid lines and shaded areas correspond to point estimates and their 95% CIs, respectively (conception rates: green, time-to-conception: purple).
Estimated conception rates and time-to-conception…
Estimated conception rates and time-to-conception in the natural conception cohort from the Cox…
Estimated conception rates and time-to-conception in the natural conception cohort from the Cox regression models for individual semen parameters. ( A ) Sperm concentration; ( B ) total sperm count; ( C ) progressive motility; ( D ) total progressive motile sperm count (TPMC). Solid lines and shaded areas correspond to point estimates and their 95% CIs, respectively (conception rates: green, time-to-conception: purple).
Estimated conception rates and time-to-conception…
Estimated conception rates and time-to-conception in the natural conception cohort without major female…
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. ( A ) Sperm concentration; ( B ) total sperm count; ( C ) progressive motility; ( D ) total progressive motile sperm count (TPMC). Solid lines and shaded areas correspond to point estimates and their 95% CIs, respectively (conception rates: green, time-to-conception: purple).

Hanson HA, Mayer EN, Anderson RE, Aston KI, Carrell DT, Berger J, Lowrance WT, Smith KR, Hotaling JM.
Hanson HA, et al.
Hum Reprod. 2017 Jan;32(1):239-247. doi: 10.1093/humrep/dew289. Epub 2016 Dec 6.
Hum Reprod. 2017.

PMID: 27927843
Free PMC article.

Pastuszak AW, Herati AS, Eisenberg ML, Cengiz C, Langlois PH, Kohn TP, Lamb DJ, Lipshultz LI.
Pastuszak AW, et al.
Hum Reprod. 2019 Apr 1;34(4):733-739. doi: 10.1093/humrep/dez005.
Hum Reprod. 2019.

PMID: 30753581
Free PMC article.

Hamilton JA, Cissen M, Brandes M, Smeenk JM, de Bruin JP, Kremer JA, Nelen WL, Hamilton CJ.
Hamilton JA, et al.
Hum Reprod. 2015 May;30(5):1110-21. doi: 10.1093/humrep/dev058. Epub 2015 Mar 18.
Hum Reprod. 2015.

PMID: 25788568

Showell MG, Mackenzie-Proctor R, Brown J, Yazdani A, Stankiewicz MT, Hart RJ.
Showell MG, et al.
Cochrane Database Syst Rev. 2014;(12):CD007411. doi: 10.1002/14651858.CD007411.pub3. Epub 2014 Dec 15.
Cochrane Database Syst Rev. 2014.

PMID: 25504418

Updated.
Review.

Harmer B, Lee S, Duong TVH, Saadabadi A.
Harmer B, et al.
2022 May 18. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–.
2022 May 18. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–.

PMID: 33351435
Free Books & Documents.

Shrem G, Azani L, Feferkorn I, Listovsky T, Hussaini S, Farber B, Dahan MH, Salmon-Divon M.
Shrem G, et al.
Life (Basel). 2022 Jun 20;12(6):922. doi: 10.3390/life12060922.
Life (Basel). 2022.

PMID: 35743953
Free PMC article.

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Study question:

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?

Summary answer:

Values well above the World Health Organization (WHO) references for total sperm count, concentration, and progressive motility, and values up to 100 million for TPMC were consistently associated with earlier time-to-conception and higher conception rates.

What is known already:

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.

Study design, size, duration:

We used data from a longitudinal cohort study on subfertile men from 2002 to 2017 and included 6061 men with initial semen analysis (SA) in the study.

Participants/materials, setting, methods:

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. Couples were further categorized into two subgroups: natural conception (n = 5126), after separating those who achieved conception using ART or IUI; natural conception without major female factor (n = 3753), after separating those with severe female factor infertility diagnoses. TPMC was calculated by multiplying the semen volume (ml) by sperm concentration (million/ml) and the percentage of progressively motile sperm (%). Cox proportional hazard models were used to report hazard ratios (HRs) with 95% CIs before and after adjusting for male age, the number of previous children before the first SA, and income. Using the regression tree method, we calculated thresholds for total sperm count, sperm concentration, progressive motility, and TPMC to best differentiate those who were more likely to conceive within 5 years after first SA from those less likely to conceive. We also plotted continuous values of semen parameters in predicting 5-year conception rates and time-to-conception.

Main results and the role of chance:

Overall, the median time to conception was 22 months (95% CI: 21-23). A total of 3957 (65%) couples were known to have achieved conception within 5 years of the first SA. These patients were younger and had higher values of sperm concentration, progressive motility, and TPMC. In the overall cohort, a TPMC of 50 million best differentiated men who were more likely to father a child within 5 years. Partners of men with TPMC ≥50 million had a 45% greater chance of conception within 5 years in the adjusted model (HR: 1.45; 95% CI: 1.34-1.58) and achieved pregnancy earlier compared to those men with TPMC < 50 million (median 19 months (95% CI: 18-20) versus 36 months (95% CI: 32-41)). 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 100-150 million were still associated with a better conception rate and time-to-conception in the visual assessment of the curves.

Limitations, reasons for caution:

There was limited information on female partners and potential for inaccuracies in capturing less severe female infertility
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