Optimizing post-wash TPMSC for intrauterine insemination: A key strategy to improve pregnancy outcomes

OBJECTIVE: To investigate the impact of both pre- and post-ovulation post-wash total progressive motile sperm count (TPMSC) on pregnancy outcomes in intrauterine insemination (IUI) using husband's sperm (AIH). METHODS: This retrospective cohort study analyzed data from infertile couples who underwent IUI treatment at the Reproductive Medicine Center of Xinxiang Central Hospital from January 2020 to June 2024. A total of 462 IUI cycles were included, all of which had consistent pre- and post-ovulation post-wash TPMSC values. Cycles were divided into four groups based on TPMSC: Group A (<10 × 106), Group B (10-20 × 106), Group C (20-30 × 106), and Group D (≥ 30 × 106). Comparisons were made regarding baseline data and pregnancy outcomes among the groups. Multivariate logistic regression was employed to assess the impact of both pre- and post-ovulation post-wash TPMSC on clinical pregnancy rates. RESULTS: The clinical pregnancy rates differed significantly among TPMSC groups (P = 0.024), with the highest rate in the 10-20 × 106 group (26.13%). Multivariate logistic regression identified this range as an independent predictor of clinical pregnancy (odds ratio [OR] = 1.922, 95% confidence interval [CI]: 1.026-3.600, P = 0.041). CONCLUSION: Post-wash TPMSC influences clinical pregnancy rates in IUI. When both pre- and post-ovulation post-wash TPMSC are within the range of 10-20 × 106, this may optimize clinical pregnancy outcomes.