Single or double sperm wash processing by density gradientcentrifugation: effect on clomiphene citrate induced intrauterine insemination cycle outcomes

Aim: To compare the motility yields of single or double wash after density gradient centrifugation of the ejaculate and their effects on pregnancy rates in clomiphene citrate induced intrauterine insemination (IUI) cycles.Materials and methods: This prospective randomized controlled study included 341 IUI cycles. Sperm specimens processed by density gradient centrifugation either with single wash (the single wash group, n = 170) or double wash treatment (the double wash group, n = 171). Sperm parameters before and after the preparation and the cycle outcomes were evaluated. The main outcome measure was the pregnancy rate.Results: The prewash sperm concentrations, the total motile sperm count, sperm motility and the mean percentage of normal sperm morphology of the groups were similar (P 0.05). Post-wash sperm concentrations and inseminated motile sperm concentrations were similar in both groups (P 0.05). Post-wash fast progressive motility (+4 motility) was significantly higher in the double wash group compared to the single wash group (P = 0.017). A total of 62 (18%) clinic pregnancies were obtained in 341 treatment cycles. Clinical pregnancy rate per insemination cycle was 11.8% for the single wash group and 24.6% for the double wash group (P = 0.003).Conclusion: Double wash treatment after density gradient centrifugation of the ejaculate yields a better post-wash fast progressive sperm motility and higher IUI pregnancy rate after ovarian stimulation with clomiphene citrate.