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Smartphone-Assisted CSCTAS-Derived Sperm Kinematics and Clinical Pregnancy after Intrauterine Insemination in a Turkish Cohort of Couples with Unexplained Infertility
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DOI：10.1007/s43032-026-02165-w.png)
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Abstract
En 中文
Conventional semen analysis provides limited information on sperm kinematic behavior in couples with unexplained infertility undergoing intrauterine insemination (IUI). We used a laboratory based, microscope mounted smartphone-assisted Computerized Sperm Counting and Tracking Analysis System (CSCTAS) to characterize sperm kinematics in prepared samples and compare them by ultrasound-confirmed clinical pregnancy after IUI. In this retrospective single-center Turkish cohort, 184 first IUI cycles between January 2018 and December 2019 were analyzed. Prepared samples were assessed under standardized Makler chamber conditions. Manual–CSCTAS agreement for total motility was assessed by Bland–Altman analysis, and single-variable receiver operating characteristic analyses were supplementary. Clinical pregnancy occurred in 29 cycles (15.8%). Pre- and post-preparation semen parameters were similar between groups. Mean CSCTAS-derived wobble (WOB) was higher in pregnancy-positive cycles (0.83 ± 0.03 vs. 0.81 ± 0.09; p = 0.004; Cohen’s d = 0.24), whereas beat-cross frequency (BCF) was lower at the nominal level (7.28 ± 0.70 vs. 7.61 ± 1.05 Hz; p = 0.039; d = − 0.33). Although statistically significant, the differences had small effect sizes. Bland–Altman analysis showed a mean bias of − 3.44% points, 95% limits of agreement of − 24.69 to 17.81, and proportional bias. Single-variable area under the curve (AUC) values were 0.526 for WOB and 0.555 for BCF, and both 95% confidence intervals included 0.50. These findings suggest exploratory population-level digital motility signals; however, the small effect sizes and near-chance single-variable AUC values indicate limited predictive performance and do not support their use as standalone predictors of individual IUI outcome.
Keywords:
Intrauterine insemination
Unexplained infertility
Clinical pregnancy
CSCTAS
Sperm kinematics
Computer-assisted sperm analysis
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