2021, Volume 7, Issue 11
Engineering >> 2021, Volume 7, Issue 11 doi: 10.1016/j.eng.2021.02.012
Semen Analysis and Fecundity Association Among Women with Polycystic Ovary Syndrome Experiencing Ovulatory Dysfunction Treated by Ovulation Induction
a College of Pharmacy, The Department of Medicine, Hangzhou Normal University, Hangzhou 311121, China
b First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150040, China
c Clinical Medical College, Heilongjiang University of Chinese Medicine, Harbin 150040, China
d Department of endocrinology, Xuzhou Central Hospital, Xuzhou 221009, China
e College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
f Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong 999077, China
g Institute of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China
h Heilongjiang Provincial Hospital, Harbin 150030, China
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Abstract
In this study, normal values of semen analysis were set for a general infertile population of couples among which most women had normal ovulation. The predictive capacity values of sperm quality, including concentration, motile count, progressive motile count, and morphology, are unclear for women with polycystic ovary syndrome (PCOS). A secondary analysis was conducted based on a randomized controlled trial investigating infertility among women with PCOS experiencing ovulatory disorder between 2011 and 2016 in China. A total of 1000 women received ovulation induction (acupuncture and clomiphene). We randomized the women with PCOS in 27 hospitals in China who received one of four interventions (acupuncture plus clomiphene, sham acupuncture plus clomiphene, acupuncture plus placebo, or sham acupuncture plus placebo). Semen analysis was performed for every male partner according to the World Health Organization (WHO) criteria. The outcomes included conception, clinical pregnancy, and live birth. Logistic regression was used to evaluate the predictive value of semen analysis among ovulatory women for conception, clinical pregnancy, and live birth. Among the 1000 couples, the number of couples who attained ovulation, conception, clinical pregnancy, and live birth were 780, 320, 235, and 205, respectively. Semen volume and motility were applied and used as prediction parameters for conception (area under the curve (AUC) of 0.62 (95% confidence interval (CI), 0.55–0.69)), clinical pregnancy (AUC of 0.67 (95%CI: 0.61–0.73)), and live birth (AUC of 0.57 (95%CI: 0.50–0.64)). No poor calibration was shown for these models in Hosmer–Lemeshow tests. The predictive capacity of semen analysis for treatment outcome in PCOS women with PCOS experiencing with ovulatory dysfunction is limited.
Keywords
Semen analysis ; Fecundity ; Ovulatory dysfunction ; Predictive capacity
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References
[ 1 ] Baird DT, Balen A, Escobar-Morreale HF, Evers JLH, Fauser BCJM, Franks S, et al. Health and fertility in World Health Organization group 2 anovulatory women. Hum Reprod Update 2012;18(5):586–99. link1
[ 2 ] Khan MJ, Ullah A, Basit S. Genetic basis of polycystic ovary syndrome (PCOS): current perspectives. Appl Clin Genet 2019;12:249–60. link1
[ 3 ] Dilaver N, Pellatt L, Jameson E, Ogunjimi M, Bano G, Homburg R, et al. The regulation and signalling of anti-Müllerian hormone in human granulosa cells: relevance to polycystic ovary syndrome. Hum Reprod 2019;34 (12):2467–79. link1
[ 4 ] Szczuko M, Zapałowska-Chwyc´ M, Drozd A, Maciejewska D, Starczewski A, Stachowska E. Metabolic pathways of oleic and palmitic acid are intensified in PCOS patients with normal androgen levels. Prostaglandins Leukot Essent Fatty Acids 2017;126:105–11. link1
[ 5 ] Balen AH, Morley LC, Misso M, Franks S, Legro RS, Wijeyaratne CN, et al. The management of anovulatory infertility in women with polycystic ovary syndrome: an analysis of the evidence to support the development of global WHO guidance. Hum Reprod Update 2016;22(6):687–708. link1
[ 6 ] Rowe PJ, Comhaire FH, Hargreave TB, Mahmoud AMA. WHO manual for the standardized investigation, diagnosis and management of the infertile male. Cambridge: Cambridge University Press; 2000. link1
[ 7 ] Cao XW, Lin K, Li CY, Yuan CW. A review of WHO laboratory manual for the examination and processing of human semen (5th edition). Natl J Androl 2011;17(12):1059–63. Chinese. link1
[ 8 ] Hunault CC, Eijkemans MJC, te Velde ER, Collins JA, Habbema JDF. Validation of a model predicting spontaneous pregnancy among subfertile untreated couples. Fertil Steril 2002;78(3):500–6. link1
[ 9 ] Hunault CC, Habbema JDF, Eijkemans MJC, Collins JA, Evers JLH, te Velde ER. Two new prediction rules for spontaneous pregnancy leading to live birth among subfertile couples, based on the synthesis of three previous models. Hum Reprod 2004;19(9):2019–26. link1
[10] Li HWR, Liao SB, Chiu PCN, Tam WW, Ho JC, Ng EHY, et al. Expression of adrenomedullin in human oviduct, its regulation by the hormonal cycle and contact with spermatozoa, and its effect on ciliary beat frequency of the oviductal epithelium. J Clin Endocrinol Metab 2010;95(9):E18–25. link1
[11] Pacey AA, Hill CJ, Scudamore IW, Warren MA, Barratt CLR, Cooke ID. The interaction in vitro of human spermatozoa with epithelial cells from the human uterine (fallopian) tube. Hum Reprod 1995;10(2):360–6. link1
[12] Patel S, Carr B. Oocyte quality in adult polycystic ovary syndrome. Semin Reprod Med 2008;26(2):196–203. link1
[13] Kuang H, Li Y, Wu X, Hou L, Wu T, Liu J, et al. Acupuncture and clomiphene citrate for live birth in polycystic ovary syndrome: study design of a randomized controlled trial. Evid Based Complement Alternat Med 2013;2013:1–11. link1
[14] The Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 2004;19 (1):41–7. link1
[15] Leushuis E, van der Steeg JW, Steures P, Repping S, Bossuyt PM, Mol BW, et al. Semen analysis and prediction of natural conception. Hum Reprod 2014;29 (7):1360–7. link1
[16] Evgeni E, Lymberopoulos G, Gazouli M, Asimakopoulos B. Conventional semen parameters and DNA fragmentation in relation to fertility status in a Greek population. Eur J Obstet Gynecol Reprod Biol 2015;188:17–23. link1
[17] Buck Louis GM, Sundaram R, Schisterman EF, Sweeney A, Lynch CD, Kim S, et al. Semen quality and time to pregnancy: the Longitudinal Investigation of Fertility and the Environment Study. Fertil Steril 2014;101(2):453–62. link1
[18] Kruger TF, Acosta AA, Simmons KF, Swanson RJ, Matta JF, Oehninger S. Predictive value of abnormal sperm morphology in in vitro fertilization. Fertil Steril 1988;49(1):112–7. link1
[19] Guan HT, Zheng Y, Wang JJ, Meng TQ, Xia W, Hu SH, et al. Relationship between donor sperm parameters and pregnancy outcome after intrauterine insemination: analysis of 2821 cycles in 1355 couples. Andrologia 2016;48 (1):29–36. link1
[20] Kasman AM, Li S, Zhao Q, Behr B, Eisenberg ML. Relationship between male age, semen parameters and assisted reproductive technology outcomes. Andrology 2021;9(1):245–52. link1
[21] Liu Z, Shi X, Wang L, Yang Y, Fu Q, Tao M. Associations between male reproductive characteristics and the outcome of assisted reproductive technology (ART). Biosci Rep 2017;37(3):BSR20170095. link1
[22] Legro RS, Barnhart HX, Schlaff WD, Carr BR, Diamond MP, Carson SA, et al.; Cooperative Multicenter Reproductive Medicine Network. Clomiphene, metformin, or both for infertility in the polycystic ovary syndrome. N Engl J Med 2007;356(6):551–66. link1
[23] Legro RS, Brzyski RG, Diamond MP, Coutifaris C, Schlaff WD, Casson P, et al.; NICHD Reproductive Medicine Network. Letrozole versus clomiphene for infertility in the polycystic ovary syndrome. N Engl J Med 2014;371 (2):119–29. link1
[24] Kuang H, Jin S, Hansen KR, Diamond MP, Coutifaris C, Casson P, et al.; Reproductive Medicine Network. Identification and replication of prediction models for ovulation, pregnancy and live birth in infertile women with polycystic ovary syndrome. Hum Reprod 2015;30(9):2222–33. link1
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