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To assess the performance and clinical value of the postwash total motile sper m count (postwash TMC) as a test to predict intrauterine insemination (IUI) outc ome. Meta-analysis of diagnostic tests. Tertiary fertility center. Patients und ergoing IUI. We detected 16 studies that reported on postwash TMC at inseminatio n and IUI outcome. Summary receiver operating characteristics (ROC) curves indic ated a reasonable predictive performance toward IUI outcome, and, at cut-off le vels between 0.8 to 5 million motile spermatozoa, the postwash TMC provided a su bstantial discriminative performance. At these cut-off levels, the specificity of the postwash TMC, defined as the ability to predict failure to become pregnan t, was as high as 100%; the sensitivity of the test, defined as the ability to predict pregnancy, was limited. The postwash TMC at insemination could potential ly be used in counseling patients for either IUI or IVF. However, to enable pati ent counseling before the start of treatment, further studies are needed to esta blish the accuracy of a postwash TMC during the fertility workup rather than at insemination.
To assess the performance and clinical value of the postwash total motile sper m count (postwash TMC) as a test to predict intrauterine insemination (IUI) outc ome. Meta-analysis of diagnostic tests. 16 studies that reported on postwash TMC at inseminatio n and IUI outcome. Summary receiver operating characteristics (ROC) curves indic ated a reasonable predictive performance toward IUI outcome, and, at cut-off levels between 0.8 to 5 million motile spermatozoa, the postwash TMC provided a su bstantial discriminative performance. At these cut-off levels, the specificity of the postwash TMC, defined as the ability to predict failure to become pregnan t, was as high as 100%; the sensitivity of the test, defined as the ability to predict pregnancy, was limited. The postwash TMC at insemination could potential ly be used in counseling patients for either IUI or IVF. However, to enable pati ent counseling before the start of t reatment, further studies are needed to esta blish the accuracy of a postwash TMC during the fertility workup rather than at insemination.