Intravaginal and intracervical application of seminal plasma in in vitro fertilization or intracytoplasmic sperm injection treatment cycles—a double-blind, placebo-controlled, randomized pilot study

Wolff, Michael von; Rösner, Susanne; Thöne, C.; Pinheiro, Rafael Mota; Jauckus, Julia; Brückner, Thomas; Biolchi, Vanderleyen; Alia, Amal; Strowitzki, T.

doi:10.1016/j.fertnstert.2007.11.036

Cited by 43 publications

(28 citation statements)

References 23 publications

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“…Indeed in our prospective double blinded study patients who underwent SP intravaginal insemination after oocyte pick-up reached higher implantation and clinical pregnancy rates following ET compared to controls, with a relative difference of 44 %, however the difference did not reach statistical significance. Thus our findings corroborate the observations by von Wolff et al, [11] cited above.…”

Section: Discussionsupporting

confidence: 94%

“…Tremellen et al [10] randomized patients during 478 cycles of IVF (including transfer of 1343 embryos) either to abstain from or engage in vaginal intercourse and found similar pregnancy rates (21.2 % vs 23.6 %, respectively) but a significantly higher proportion of viable embryos at 6-8 weeks of pregnancy in the group engaging in vaginal intercourse (11 % vs 7.7 %). Finally, von Wolff et al, [11] performed a pilot study, injecting cryopreserved seminal plasma from the patient's partner or sodium chloride (placebo) into the cervix and the posterior fornix of the vagina just after follicle aspiration. The clinicalpregnancy rate was 25.7 % (18/70) in the placebo group.…”

Section: Discussionmentioning

confidence: 99%

“…SP contains a variety of factors such as Transforming Growth Factor b, [1,4], prostaglandin E and interleukin-8 [7], that may trigger a cascade of events through pro-inflammatory cytokines synthesis leading to maternal endometrial immunomodulation increasing uterine receptivity. A beneficial effect of SP as an adjunctory factor to increase implantation and clinical pregnancy rates after in vitro fertilization and embryo transfer (IVF-ET) was indicated in a few clinical studies that used variable methodologies [8][9][10][11]. Others did not corroborate these observations [12].…”

Section: Introductionmentioning

confidence: 99%

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Effect of seminal plasma application to the vaginal vault in in vitro fertilization or intracytoplasmic sperm injection treatment cycles—a double-blind, placebo-controlled, randomized study

Friedler

Ben‐Ami

Gidoni

et al. 2013

J Assist Reprod Genet

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Purpose To study whether intravaginal application of seminal plasma after follicle aspiration has the potential to increase implantation and clinical pregnancy rates after IVF-ET. Methods We conducted a prospective, double-blind, placebocontrolled randomized study of 230 patients undergoing IVF-ET cycles. 500 μL of Fresh seminal plasma from the patient's partner or culture medium (placebo) were injected in the vaginal vault just after follicle aspiration. The main outcome measured was ongoing clinical-pregnancy rate. Results After ET cancellation in ten patients due to lack of fertilization or embryo cleavage, 220 embryo transfers (103 and 117 in the study and control groups) resulted in a clinical pregnancy rate of 36.9 % and 29.1 % for the study and control groups, corresponding to a relative increase of 26.8 %. After an early pregnancy loss of 13.1 % (5/38) and 23.5 % (8/34) in the study and control groups respectively an ongoing pregnancy rate of 32.0 % (33/103) and 22.2 % (26/117) was achieved corresponding to a relative increase of 44.1 %. Multivariate logistic regression analysis adjusted for study group, age, infertility, and cycle characteristics did not demonstrate any parameter that could predict occurrence of clinical pregnancy rates after IVF-ET. Conclusions Patients who underwent SP intravaginal insemination after oocyte pick-up reached higher implantation and clinical pregnancy rates following ET compared to controls, although the difference did not reach statistical significance. More studies and variable methodologies may clarify the potential clinical effect of SP in improving live birth rates after ART.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of seminal plasma application to the vaginal vault in in vitro fertilization or intracytoplasmic sperm injection treatment cycles—a double-blind, placebo-controlled, randomized study

Friedler

Ben‐Ami

Gidoni

et al. 2013

J Assist Reprod Genet

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“…They described an implantation rate of 80 % in the SP group, compared with 67 % in the placebo group [4]. Von Wolff applied thawed SP at the time of OPU during IVF-ICSI cycles and found a non-significant increase of the pregnancy rate (37.3 % versus 25.7 %) [21].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have investigated the role of SP in implantation with controversial results, some reporting benefits [1,19,21], whereas others showing no effect [6,15].…”

Section: Introductionmentioning

confidence: 99%

Seminal plasma insemination during ovum-pickup—a method to increase pregnancy rate in IVF/ICSI procedure. A pilot randomized trial

Chicea¹,

Ispasoiu²,

Focşa

2013

J Assist Reprod Genet

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Purpose In IVF procedures, endometrial function is a limiting factor of the pregnancy rate and the aims of this study is to determine whether seminal plasma insemination at ovum pick-up in IVF has any effect on pregnancy rate. Methods We designed a single center, 2 parallel groups, randomized pilot study. All couples undergoing an IVF procedure in our clinic between January 2010 and December 2011 were considered for enrollment in the study. The patients who met the inclusion criteria were randomized into two groups by simple randomization: the seminal plasma group (SP group) and the reference group (noSP group). We applied seminal plasma into the cervix and vaginal vault at the time of the OPU in the patients of the SP group. The primary outcome was the clinical pregnancy rate in the SP group compared with the noSP group and the secondary outcome measure was the implantation rate. Results 400 patients met the inclusion criteria and were randomized. 54 patients were excluded from the study mainly because they didn't undergo the embryo transfer. Finally, 164 patients were included in the SP group and 182 patients in the noSP group and analyzed. We found a statistically non-significant increase in the pregnancy rate in the SP group (55.5 % versus 44 %, p=0.09) and a statistically significant increase in the implantation rate (34.7 % versus 27.5 %, p=0.026). Conclusions Our results support the idea that SP insemination may have the potential to increase pregnancy rate in IVF procedures but further studies must be carried out.

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Application of seminal plasma to female genital tract prior to embryo transfer in assisted reproductive technology cycles (IVF, ICSI and frozen embryo transfer)

Ata

Abou‐Setta

Seyhan

et al. 2018

Cochrane Database of Systematic Reviews

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We included 11 RCTs (3215 women). The quality of the evidence ranged from very low to low. The main limitations were risk of bias (associated with poor reporting of allocation concealment and other methods) and imprecision for the primary outcome of live birth rate.Live birth rates: There was insufficient evidence to determine whether there was a difference between the groups with respect to live birth rates (RR 1.10, 95% CI 0.86 to 1.43; participants = 948; studies = 3; I = 0%). Low quality evidence suggests that if the live birth rate following standard ART is 19% it will be between 16% and 27% with seminal plasma application.Miscarriage rate: There was insufficient evidence to determine whether there was a difference between the groups (RR 1.01, 95% CI 0.57 to 1.79; participants = 1209; studies = 4; I = 0%). Low quality evidence suggests that if the miscarriage rate following standard ART is 3.7%, the miscarriage rate following seminal plasma application will be between 2.1% and 6.6%.Live birth or ongoing pregnancy rates: Seminal plasma application makes little or no difference in live birth or ongoing pregnancy rates (RR 1.19, 95% CI 0.95 to 1.49; participants = 1178; studies = 4; I = 4%, low quality evidence). The evidence suggests that if the live birth or ongoing pregnancy rate following standard ART is 19.5% it will be between 18.5% and 29% with seminal plasma application.Clinical pregnancy rates: Seminal plasma application may increase clinical pregnancy rates (RR 1.15, 95% CI 1.01 to 1.31; participants = 2768; studies = 10; I = 0%). Very low quality evidence suggests that if the clinical pregnancy rate following standard ART is 22.0% it will be between 22.2% and 28.8% with seminal plasma application. This finding should be regarded with caution, as a post-hoc sensitivity analysis restricted to studies at overall low risk of bias did not find a significant difference between the groups (RR 1.06, 95% CI 0.81 to 1.39; participants = 547; studies = 3; I = 0%).Multiple pregnancy rate: Seminal plasma application may make little or no difference to multiple pregnancy rates (RR 1.11, 95% CI 0.76 to 1.64; participants = 1642; studies = 5; I = 9%). Low quality evidence suggests that if the multiple pregnancy rate following standard ART is 7%, the multiple pregnancy rate following seminal plasma application will be between 5% and 11.4%.Ectopic pregnancy: There was insufficient evidence to determine whether seminal plasma application influences the risk of ectopic pregnancy (RR 1.59, 95% CI 0.20 to 12.78, participants =1521; studies = 5; I = 0%) .Infectious complications or other adverse events: No data were available on these outcomes AUTHORS' CONCLUSIONS: In women undergoing ART, there was insufficient evidence to determine whether there was a difference between the seminal plasma and the standard ART group in rates of live birth (low-quality evidence) or miscarriage (low quality evidence). There was low quality evidence suggesting little or no difference between the groups in rates of live birth or ongoing pregn...

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Intravaginal and intracervical application of seminal plasma in in vitro fertilization or intracytoplasmic sperm injection treatment cycles—a double-blind, placebo-controlled, randomized pilot study

Cited by 43 publications

References 23 publications

Effect of seminal plasma application to the vaginal vault in in vitro fertilization or intracytoplasmic sperm injection treatment cycles—a double-blind, placebo-controlled, randomized study

Effect of seminal plasma application to the vaginal vault in in vitro fertilization or intracytoplasmic sperm injection treatment cycles—a double-blind, placebo-controlled, randomized study

Seminal plasma insemination during ovum-pickup—a method to increase pregnancy rate in IVF/ICSI procedure. A pilot randomized trial

Application of seminal plasma to female genital tract prior to embryo transfer in assisted reproductive technology cycles (IVF, ICSI and frozen embryo transfer)

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