Semen analysis and fecundity association among women with polycystic ovary syndrome experiencing ovulatory dysfunction treated by ovulation induction

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.