Abstract
Objective. To evaluate the efficacy of double Fallopian tube sperm perfusion in comparison with single-sperm perfusion in patients with nontubal subfertility undergoing controlled ovarian stimulation. Study Design. Sixty-six patients undergoing standard ovarian stimulation regimen were randomized to receive either single-sperm perfusion group 1 (n = 33) or double-sperm perfusion group 2 (n = 33). The same insemination method was performed in subsequent cycles if the patient does not become pregnant in the first one. A maximum of three cycles was performed. Fallopian tube sperm perfusion was carried out with pediatric Foleys catheter, which prevents reflux of sperm suspension. Semen was prepared by a classical swim-up technique. Results. A total of 133 cycles performed 68 single FSP cycles and 65 FSP cycles. There were group, 19 clinical pregnancies (29.2% per cycle) of which 16 ongoing pregnancies (24.6% per cycle) were obtained. These differences were statistically significant. The prevalence of multiple pregnancies, abortions, and ectopic pregnancies was similar in both groups. Conclusion. The results of this study indicate that there is a significant improvement of pregnancy rates in patients with nontubal subfertility when treated with double-sperm perfusion after controlled ovarian stimulation in comparison with single-sperm perfusion. Double-sperm perfusion is simple, easy to perform, inexpensive, and convenient for the patients with nontubal subfertility before adoption of other methods of assisted reproduction.
Highlights
Artificial insemination in conjunction with ovarian stimulation is usually offered to infertile couples when the woman has patent Fallopian tubes prior to other assisted reproductive methods [1]
Double IUI has been shown to increase the pregnancy rate when compared to single IUI [4, 5]
All patients underwent ovarian stimulation with standard protocols were for ovarian stimulation with Merional (IBSA) starting on cycle day 3 baseline, and transvaginal scanning was performed, and when no ovarian cyst 150 IU of FSH was titrated according to ovarian response and monitored, and by transvaginal scanning when the follicle was >18 mm in diameter and when there were not more than 3 follicles >16 mm in diameter, 10000 I choriomon (IBSA) was given intramuscular in the first treatment cycle, and patients were randomized on day of HCG administration according to computer-generated randomization list, to undergo single or double Fallopian tube sperm perfusion (FSP)
Summary
Artificial insemination in conjunction with ovarian stimulation is usually offered to infertile couples when the woman has patent Fallopian tubes prior to other assisted reproductive methods [1]. The IUI technique is based on the intrauterine injection of 0.2– 0.5 mL of sperms suspension without flushing the tubes. Single IUI during stimulated cycle achieves a 10–15% pregnancy rate per cycle [3]. Double IUI has been shown to improve the success rate. Double IUI has been shown to increase the pregnancy rate when compared to single IUI [4, 5]. Fallopian tube sperm perfusion (FSP) is another simple noninvasive method of delivering sperm to Fallopian tubes. It is based on pressure injection of 3 up to 5 mL of sperm suspension with the attempt of sealing the cervix to prevent sperm reflux [6, 7]
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