Comparison of the effectiveness of fallopian tube sperm perfusion (FSP) with intrauterine insemination (IUI) in the treatment of non-tubal infertility: a prospective randomized study

Abstract

OBJECTIVE: Since Kahn et al. (1992) first described a method of Fallopian tube sperm perfusion (FSP), some promising results have been reported using FSP in comparison with intrauterine insemination (IUI). The aim of this study is to re-assess the relative efficacy of FSP versus IUI in the treatment of non-tubal infertile women who had failed to conceive by several IUI cycles. DESIGN: A prospective randomized study. MATERIALS AND METHODS: 158 infertile women with non-tubal factor, who had not conceived by three times or more standard IUI cycles, were enrolled in this study. They were randomized for treatment with either FSP(Group A: using 4 ml of sperm suspension) or further continuing IUI(group B; using 0.5ml of serm suspension). They were treated up to three attempts by allocated method. The number of clinical pregnancies was compared between groups. When pregnancy had not occurred even after three cycles using allocated method, treatment cycles by an alternative non-allocated method were further attempted. RESULTS: No pregnancy occurred with subsequent IUI cycles in 16 cases of Group A, who had failed to conceive by FSP. Three pregnancies out of 20 cases of Group B, who had failed to conceive by IUI, were finally attained with subsequent FSP maneuver.Tabled 1The distribution of pregnancy rates per cycle after three cycles by allocated treatment method (n=158, 322 cycles)GROUP A (FSP n=78)GROUP B (IUI n=80)Treatment cycleNo. of cyclesNo. of pregnanciesPregnancy rate (%)No. of cyclesNo. of pregnaciesPregnancy rate(%)1 st78911.58067.52nd56610.75135.93rd3226.32500Total1661710.2∗: N.S.15695.8∗: N.S.∗ : N.S. Open table in a new tab CONCLUSION: 1) FSP itself could not offer statistically significant advantage over standard IUI in the treatment of non-tubal infertility of our study population. 2) Since some cases who could conceive only by FSP certainly exist, we might consider to apply more FSP technique to practical use before proceeding to ART.