Fallopian Tube Sperm Perfusion Research Articles

A Randomised Comparative Study of Standard IUI (sIUI) and Fallopian Tube Sperm Perfusion (FSP) for Clinical Pregnancy.

To compare the pregnancy rates of two methods of intrauterine insemination (IUI), i.e. standard IUI (sIUI) and fallopian tube sperm perfusion (FSP). This prospective randomised parallel study design included 160 infertile women < 38years of age where IUI was indicated. We recorded a detailed history and conducted a careful clinical examination with the performance of baseline investigations. Each patient was randomly allocated into two groups: Group sIUI (n = 80) and Group FSP (n = 80). The patients underwent two cycles of IUI for achieving clinical pregnancy. The conception of pregnancy among both groups was noted and compared. The mean age of the females, mean age of the male partners, and duration of marriage in Group sIUI and FSP were comparable (p > 0.05). Compared to the sIUI group, the FSP group had significantly higher patients who conceived (15.97% vs. 6.54%, P = 0.016). In the cases with unexplained infertility, in cycle 2, in the FSP group, there were significantly more patients who conceived (21.05% vs. 0.00%, P = 0.047). We conclude that FSP over two treatment cycles offers an advantage over the standard IUI and could replace the sIUI in specific indications such as unexplained infertility for artificial insemination. It could be used as an alternative for couples with non-tubal infertility before moving on to IVF treatment.

In women with non-tubal infertility, how does intrauterine insemination compare with fallopian tube sperm perfusion?

In women with non-tubal infertility, how does intrauterine insemination compare with fallopian tube sperm perfusion?

Oral Drugs for Unexplained Infertility.

Of the infertile couples unable to conceive without any identifiable cause, 30% are defined as having unexplained infertility. Management depends on duration of infertility and age of female partner. The treatment of unexplained infertility is empirical, and many different regimens have been used. Among these are expectant management, ovarian stimulation with clomiphene citrate, gonadotropins and aromatase inhibitors, fallopian tube sperm perfusion, tubal flushing, intrauterine insemination, gamete intrafallopian transfer, and IVF. The first approach to treatment of unexplained infertility generally is the use of drugs that stimulate oocyte production. For over four decades, the first-line treatment for ovarian stimulation in unexplained infertility has been clomiphene citrate. Multiple reports suggest that aromatase inhibitors may be effective alternative agents for ovarian stimulation in couples with unexplained infertility. Their administration is reported to be associated with monofollicular development in most cases, which may result in enhanced fertility and a reduced risk of ovarian hyperstimulation and multiple births, as compared to current standard therapies such as gonadotropin and clomiphene. Despite world evidence to the contrary, letrozole has been banned for use for infertility management in India since 2011.

The comparison between Intrauterine Insemination and Fallopian Tube Sperm Perfusion Using FAST®System in Patients with Unexplained Infertility.

Controlled ovarian stimulation (COH) with intrauterine insemination (IUI) is commonly offered to infertile couples with patent fallopian tubes because it is simple, non-invasive and cost-effective technique. Another non-invasive method is fallopian tube sperm perfusion (FSP). This study was performed to compare the relative efficacy between FSP using fallopian sperm transfer (FAST) system and standard IUI in patients with unexplained infertility. This prospective randomized study was conducted at the IVF Unit, Department of Gynecology and Obstetrics, Mazandaran University of Medical Sciences, Sari, Iran, from March 2011 to February 2012. A total of ninety patients with unexplained infertility underwent ovarian stimulation with clomiphene citrate and human menopausal gonadotropin (HMG). Patients were then randomly assigned into either group I (n=45) to undergo standard IUI or group II (n=45) to undergo FSP using FAST system. The patients' basic characteristics, including age, primary infertility and duration of infertility, were not significantly different between two study groups. In the group I, there were 9 pregnancies (a pregnancy rate per cycle of 20%), whereas in the group II, 8 pregnancies occurred (a pregnancy rate per cycle of 17.8%, p>0.05). FSP using FAST system offers no advantage over the standard IUI in order to increase pregnancy rate in patients with unexplained infertility.

Intrauterine insemination versus fallopian tube sperm perfusion for non-tubal infertility

Intrauterine insemination (IUI) is a common treatment for couples with subfertility that does not involve the fallopian tubes. It is used to bring the sperm close to the released oocyte. Another method of introducing sperm is fallopian tube sperm perfusion (FSP). Fallopian tube sperm perfusion ensures the presence of higher sperm densities in the fallopian tubes at the time of ovulation than does standard IUI. These treatments are often used in combination with ovarian hyperstimulation. To compare intrauterine insemination versus fallopian tube sperm perfusion in the treatment of non-tubal subfertility, for live birth and pregnancy outcomes. We searched the Menstrual Disorders and Subfertility Group Trials Register, MEDLINE, CINAHL and EMBASE from inception to September 2013. We also searched study reference lists and trial registers. Randomised controlled trials (RCTs) comparing IUI with FSP in couples with non-tubal subfertility were included. Two review authors independently selected studies for inclusion, assessed study quality and extracted the data. If studies were sufficiently similar, data were combined using a fixed-effect model to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs). A random-effects model was used if substantial statistical heterogeneity was detected. Studies that included participants with unexplained or mixed (non-tubal) subfertility were analysed separately from studies restricted to participants with mild or moderate male factor subfertility. The overall quality of evidence for the main outcomes was summarised using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. The review included 16 RCTs. Fourteen RCTs (1745 women) were included in the meta-analysis. Only three studies reported live birth per couple. No evidence of a statistically significant difference was noted between IUI and FSP in live birth (OR 0.94, 95% CI 0.59 to 1.49, three RCTs, 633 women, I(2) = 0%, low-quality evidence) or clinical pregnancy (OR 0.75, 95% CI 0.49 to 1.12, 14 RCTs, 1745 women, I(2) = 52%, low-quality evidence). These findings suggest that for a couple with a 13% chance of live birth using FSP, the chance when using IUI will be between 8% and 19%; and that for a couple with a 19% chance of pregnancy using FSP, the chance of pregnancy when using IUI will be between 10% and 20%. Nor was evidence found of a statistically significant difference between IUI and FSP in per-pregnancy of multiple pregnancy (OR 0.96, 95% CI 0.44 to 2.07, eight RCTs, 197 women, I(2) = 0%, low-quality evidence), miscarriage (OR 1.23, 95% CI 0.60 to 2.53, seven RCTs, 199 women, I(2) = 0%, low-quality evidence) or ectopic pregnancy (OR 1.71, 95% CI 0.42 to 6.88, four RCTs, 111 women, I(2) = 0%, very low quality evidence). Substantial heterogeneity was noted for the outcome of clinical pregnancy (I(2) = 54%), for which no clear explanation was provided. Currently no clear evidence suggests any difference between IUI and FSP with respect to their effectiveness and safety for treating couples with non-tubal subfertility. However, a high level of uncertainty is evident in the findings, and additional research may be useful.

A randomized controlled trial of fallopian tube sperm perfusion compared with standard intrauterine insemination for women with non-tubal infertility

Does fallopian tube sperm perfusion (FSP) result in better pregnancy and live birth rates than standard intrauterine insemination (SIUI) for couples with non-tubal infertility with or without gonadotrophin or clomiphene stimulation? There was no evidence of an improvement in live birth rates with FSP compared with SIUI. Previous randomized controlled trials have suggested improved live birth rates with FSP but these trials were small. A systematic review published in 2004 suggested heterogeneity in results. This pragmatic, multicentre, randomized controlled trial compared SIUI and FSP in 417 women with non-tubal infertility. The patients were treated at fertility clinics in New Zealand, Australia and the United Arab Emirates. Four hundred and seventeen women were randomized to SIUI (n = 210) or FSP (n = 207). Data were available for analysis from 198 women in the SIUI group and 198 women in the FSP group. There were 19 women with incomplete data because of cycle cancellation or withdrawals and 2 women who conceived prior to commencing treatment. There were no significant differences in live birth rates between the two groups with 27 (12.9%) in the SIUI group and 21 in the FSP group (10.1%) [Odds Ratio (OR) 1.31 (0.71, 2.39), P = 0.48]. Two ectopic pregnancies were reported in the SIUI group and one was reported in the FSP group. Different ovulation protocols were used in the different clinics. Approximately 10% of the cycles involved donor sperm and ∼5% of the cycles did not complete the assigned intervention. There was no evidence of an improvement in live birth rates with FSP compared with SIUI. The study was funded in part by the A+ trust of the Auckland District Health Board. No commercial funding was received. ANZCTR Number ACTRN12612001303831.

Intrauterine insemination versus fallopian tube sperm perfusion in non-tubal infertility

BackgroundControlled ovarian hyperstimulation (COH) combined with intrauterine insemination (IUI), using a volume of 0.5 ml of inseminate is commonly offered to couples with non-tubal sub fertility. Another method is Fallopian tube sperm perfusion (FSP) which is based on a pressure injection of 4ml of sperm suspension while attempting to seal the cervix to prevent semen reflux. This technique ensures the presence of higher sperm density in the fallopian tubes at the time of ovulation than standard IUI. The aim of this study was to compare the efficiency of standard intrauterine insemination (IUI) and Fallopian tube sperm perfusion (FSP) in the treatment of non-tubal infertility. Methods200 consecutive patients with infertility in 404 stimulated cycles were included in the study. Those randomized to standard IUI included 100 patients in 184 cycles [158 clomiphene citrate/human menopausal gonadotrophin cycles and 26 Letrozole/FSH cycles exclusively for polycystic ovarian disease patients] (group A). Patients subjected to FSP included 100 patients in 220 cycles (193 clomiphene citrate/human menopausal gonadotrophin cycles and 27 Letrozole/FSH cycles exclusively for polycystic ovarian disease patients] (group B). Swim up semen preparation technique was used in all cases. Insemination was performed in both groups 34–37h after hCG administration. Standard IUI was performed using 0.5ml of inseminate. In FSP 4ml inseminate was used. ResultsIn group A (184 IUI cycles in 100 patients), 22 clinical pregnancies (presence of gestational sac with fetal cardiac activity) occurred (11.95% per cycle over four cycles). In group B, (220 cycles of FSP in 100 patients), 48 clinical pregnancies occurred (21.81% per cycle over four cycles) and this difference was statistically significant (p<0.05). ConclusionsFor non-tubal sub fertility, the results indicate clear benefit for FSP (Fallopian tube sperm perfusion) over IUI (Intrauterine insemination).

The value of fallopian tube sperm perfusion in the management of mild–moderate male factor infertility

ObjectiveTo investigate whether fallopian tube sperm perfusion (FSP) would improve pregnancy rates compared with standard intrauterine insemination (IUI) in cases of male factor infertility. MethodsIn a randomized controlled trial at a university teaching hospital in Egypt, 120 couples with mild or moderate male factor infertility underwent a mild controlled ovarian stimulation protocol (clomiphene citrate plus human menopausal gonadotropin). Women were randomly allocated to group 1 (FSP via Foley catheter with 4mL of inseminate) or group 2 (standard IUI with 0.5mL of inseminate) (n=60 for both). The main outcome measure was clinical pregnancy rate. ResultsThere were no significant differences between the groups in terms of baseline clinical characteristics, semen parameters, or characteristics of stimulation cycles. The pregnancy rate was significantly higher in group 1 than in group 2 (16 [26.7%] vs 7 [11.7%]; P<0.04). There was no significant difference in the incidence of multiple pregnancy, abortion, or ectopic pregnancy between the groups. ConclusionFallopian tube sperm perfusion is an effective technique in the management of mild–moderate male factor infertility and should, therefore, be considered before resorting to more sophisticated techniques of assisted reproduction.

Fallopian Tube Sperm Perfusion in Treatment of Nontubal Subfertility: Is It Crucial Step prior to ART?

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.

The value of fallopian tube sperm perfusion in the management of male factor infertility: a randomized controlled trial

To investigate whether fallopian tube sperm perfusion (FSP) improves pregnancy rates over standard intrauterine insemination (IUI) in male factor infertility. Randomized controlled trial. The study population consisted of 120 couples allocated into two equal groups: group I (n = 60): FSP with 4 ml of inseminate; and group II (n = 60): IUI with 0.5 ml of inseminate. The study was done at Cairo University. All women underwent the same mild controlled ovarian stimulation protocol. Clomiphene citrate (Clomid; Aventis pharma S.AE, Global Napi Pharmaceuticals, Cairo, Egypt) 100 mg / day were administered orally from day 3 to 7 of the cycle. HMG (Merional; IBSA, Lugano, Switzerland) 75 IU / day was administered intramuscularly from day 6 to 8. Follicullometry was performed on day 9 of the cycle & HMG dose was adjusted, if necessary. When 2 to 3 follicles ≥18 mm in diameter were present, HCG (Choriomon; IBSA, Lugano, Switzerland) 10,000 IU was administered intramuscularly. A single insemination was performed 36 hours after HCG administration. On the insemination day, women were allocated into two groups with a ratio of 1:1 using computer-generated random numbers: group I (FSP using pediatric Foley catheter) and group II (standard IUI). Data analysis was performed using the Statistical Package for the Social Sciences, v16.0 (SPSS, Chicago, IL, USA). There was no statistically significant difference regarding patient or cycle characteristics. The pregnancy rate was significantly higher (P = 0.0369) in group I (16/60; 26.7%) compared with group II (7/60; 11.7%). One case of twin pregnancy occurred in each group. Two abortions occurred in group I and one in group II, while one case of ectopic pregnancy occurred in group I. The FSP is a simple and effective technique in the management of mild or moderate male infertility.

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

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.

Fallopian tube sperm perfusion comparison between 4 ml and 10 ml of inseminate

Fallopian tube sperm perfusion comparison between 4 ml and 10 ml of inseminate

Premature ovarian failure and dehydroepiandrosterone

Since the first successful birth at our center following treatment with DHEA in a patient with premature ovarian failure (POF), all subsequent patients with POF underwent the same treatment protocol. Receiving very encouraging results (FSH level was decreased in the first five patients and all achieved pregnancy), it was decided to study the action of DHEA for a reasonable length of time and in a larger number of patients to confirm the effectiveness of this particular therapeutic regime.

Live birth by fallopian tube sperm perfusion in hyperprolactinemic woman after failed in vitro- fertilization

The case presented describes a live birth following treatment of a 35-year-old woman with fallopian tube sperm perfusion (FTSP) using donor sperm after three-repeated unsuccessful courses of In-vitro fertilization (IVF) with Percutaneous Epididymal Sperm Aspiration (PESA), Testicular Sperm Extraction (TESE), and donor sperm. The indication of FTSP is hereby explored and discussed. Key words: Male infertility, intrauterine insemination, hyper-prolactinemia, azoospermia, donor sperm, Lagos.

P-1003: Fallopian tube sperm perfusion, 4 years of experience

To evaluate the results of Fallopian tube Sperm Perfusion (FSP) with 4 ml of inseminate without any blocking device, in terms of pregnancy rate. Retrospective study of patients undergoing controlled ovarian hyper stimulation for FSP in private infertility center. 407 infertile couples, undergoing 635 cycles, with unexplained, anovulatory and masculine factors infertility used husband semen and 51 infertile couples, undergoing 60 cycles, used donor semen. FSP was performed using a regular CCD catheter for intra uterine insemination (IUI) without any blocking device. A two-layer gradient technique was used for sperm preparation and inseminated in 4ml of Ham′s F-10 (5%SS) media, all patients were undergoing controlled ovarian hyper stimulation and insemination was 36 h after hCG administration, the speculum was kept locked, and clamping the cervix for at least 10 min., patients rested for 20 min after FSP. In the husband semen group the pregnancy rates were 20% per cycle and 34% per patient. In the donor semen group the pregnancy rates were 43% per cycle and 51% per patient. We obtain results that are comparable with other FSP studies, with or without blocking device, and higher than those in patients treated with standard IUI. FSP was easy to perform, and no case reflux was observed. The FSP is a comfortable and non expensive technique.

Comparison of fallopian tube sperm perfusion and intrauterine tuboperitoneal insemination: a prospective randomized study

To evaluate the results of two different methods of insemination: fallopian tube sperm perfusion (FSP) with 4 mL of inseminate and intrauterine tuboperitoneal insemination (IUTPI) with 10 mL of inseminate. Prospective randomized clinical study. Private infertility center. Two hundred seventy-six couples, undergoing 403 cycles, with unexplained infertility, mild or moderate male infertility, or mild or moderate endometriosis. Patients were assigned randomly to either FSP (group A, n = 138) or IUTPI (group B, n = 138) treatment. Both groups followed the same mild ovarian stimulation protocol. Ninety-five overall pregnancies: 35 in group A (FSP) and 60 in group B (IUTPI). The pregnancy rate per cycle (presence of gestational sac with heart beats) was 17.6% in group A (n = 199) and 29.4% in group B (n = 204). These differences were statistically significant (P < .007). The odds ratio of getting pregnant, per patient, in group B was 2.26 (95% confidence interval 1.36-3.77) compared with group A. The results of this study indicate that IUTPI may prove to be a useful technique in the treatment of unexplained infertility, mild or moderate male infertility, and mild or moderate endometriosis. Three attempts of IUTPI may be beneficial before moving on to more invasive and expensive methods of assisted reproduction techniques.

Intrauterine insemination versus Fallopian tube sperm perfusion in non-tubal subfertility: a systematic review based on a Cochrane review*

The objective of this review was to compare the efficacy of Fallopian tube sperm perfusion (FSP) with intrauterine insemination (IUI) in the treatment of non-tubal subfertility. The principles of the Cochrane Menstrual Disorders and Subfertility Group were employed. Only randomized controlled studies comparing FSP with IUI were included in this review. The main outcome measures included live birth rates and pregnancy rates per couple. Twenty-eight studies were found performing the comparison of interest. Overall six studies involving 474 couples were included in the meta-analysis. One study only assessed live birth rates, which resulted in no difference in outcome between FSP and IUI [odds ratio (OR) 1.17, 95% confidence interval (CI) 0.39-3.53]. The results in pregnancy rate per couple revealed no statistically significant difference between FSP and IUI (OR 1.76, 95% CI 0.77-4.05). Subgroup analysis revealed that couples suffering from unexplained subfertility clearly benefit from FSP over IUI (OR 2.88, 95% CI 1.73-4.78). Excluding studies which used the Foley catheter for tubal perfusion resulted in a significant difference favouring FSP for all indications (OR 2.42, 95% CI 1.54-3.80). There is firm evidence that FSP gives rise to higher pregnancy rates in couples with unexplained subfertility and should therefore be advised in these couples. For other indications FSP has not been proven more effective compared with IUI. Results showed that the Foley catheter might not be effective for FSP. Future research should focus on comparing different types of catheters.

Intrauterine insemination versus fallopian tube sperm perfusion for non tubal infertility.

Controlled ovarian hyperstimulation (COH) together with intrauterine insemination (IUI) is commonly offered to couples with infertility factors not involving the fallopian tubes. Intrauterine insemination gained its popularity because it is simple, non-invasive and cost-effective technique. Another simple non invasive method was introduced called fallopian tube sperm perfusion (FSP). This technique was developed to ensure the presence of higher sperm densities in the fallopian tubes at the time of ovulation than standard IUI provides. Fallopian tube sperm perfusion is based on pressure injection of 4 ml of sperm suspension with attempt of sealing of the cervix to prevent semen reflux. The IUI technique on the other hand is based on intrauterine injection of 0.5 ml of sperm suspension without flushing the tubes. A number of randomised controlled trials have been published comparing the efficacy of FSP with standard IUI. There were considerable variations in the results. The aim of this review was to determine whether outcomes differ between FSP and IUI in improving the probability of conception. To investigate whether outcomes differ between fallopian tube sperm perfusion and intrauterine insemination in the treatment of non tubal subfertility resulting in pregnancies and live births. We searched the Menstrual Disorders & Subfertility Group trials register (24 March 2003), MEDLINE (January 1966 to July 2003) and EMBASE (January 1988 to July 2003). Abstracts of the American Society for Reproductive Medicine (1987 to 2003) and European Society for Human Reproduction and Embryology (1987 to 2003) meetings were searched with the same key- or text words. Only randomised controlled studies comparing fallopian tube sperm perfusion with intrauterine insemination were included in this review. The method of allocation was assessed to determine whether each study was truly randomised or pseudo-randomised. Only first period data of cross-over trials were included for analysis. Couples who have been trying to conceive for at least one year were included but only when the female partner had patent tubes. Two independent reviewers (AC and MJ) selected the trials for inclusion based on the quality of the studies. Overall six studies involving 474 couples were included in the meta-analysis. Only one study assessed live birth rates (OR 1.17, 95% CI 0.39 3.53). The results for pregnancy rate per couple were statistically significant with FSP showing higher pregnancy rates (OR 1.85, 95% CI 1.23 to 2.79 using the odds ratio with the fixed effect model. To check the results the random effect model was used, which gave a wider confidence interval which crossed the line of no significance (OR 1.76, 95% CI 0.77 to 4.05). As a result, these outcomes should be interpreted with caution. Subgroup analysis revealed that couples suffering from unexplained subfertility benefit from FSP over IUI, resulting in significantly higher pregnancy rates (OR 2.88, 95% CI 1.73 to 4.78). Excluding studies which used the Foley catheter for tubal perfusion resulted in a significant difference favouring FSP for all indications (OR 2.42, 95% CI 1.54 to 3.80). FSP may be more effective for non-tubal subfertility, but the significant heterogeneity should be taken into account. As a result no advice based on the meta-analysis could be given for the treatment of non-tubal subfertility. Subgroup analysis, which did not show evidence of statistical heterogeneity, suggested that couples with unexplained infertility may benefit from FSP over IUI in terms of higher pregnancy rates. FSP may therefore be advised in couples with unexplained subfertility. Results suggested the possibility of differential effectiveness of FSP depending on catheter choice.

Fallopian tube sperm perfusion versus intrauterine insemination in unexplained infertility: a randomized, prospective, cross-over trial

Objective To compare the results of fallopian tube sperm perfusion (FSP) versus standard intrauterine insemination (IUI) in patients with unexplained infertility undergoing controlled ovarian hyperstimulation (COH). Design Randomized, prospective, cross-over study. Setting Reproductive medicine unit of a university hospital. Patient(s) Fifty-six couples with unexplained infertility. Intervention(s) COH was induced by recombinant FSH and monitored by serial transvaginal ultrasound. On the day of hCG administration during the first treatment cycle, patients were randomized to either IUI or FSP. Thereafter, in case no pregnancy was achieved, patients went on being treated with FSP and IUI in alternate cycles. A maximum of four treatment cycles per couple was performed. FSP was performed using a pediatric Foley's catheter inseminating 4 mL of sperm-enriched suspension; a Kremer-Delafontaine catheter delivering 0.5 mL of sperm suspension was used for IUI. Main outcome measure(s) Clinical pregnancy rate per cycle. Result(s) One hundred twenty-seven cycles (58 FSP, 69 IUI) were performed. The clinical pregnancy rate per cycle was 21.7% for IUI and 8.6% for FSP, respectively. No major adverse effects were recorded for either technique. Conclusion(s) After COH, FSP is less effective than IUI in couples with unexplained infertility.

Fallopian tube sperm perfusion offers any advantage in comparison with the conventional IUI technique?: What more after 10 years of use?

This article summarise brifley the recent data about the Fallopian tube Sperm (FSP) with review of literature. After 10 yeas of the initial description of the FSP, there is still a great debate about its efficacy and best use versus the classic Intruterine isnemination technique (IUI).