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

Abstract

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.

Effectiveness of seminal plasma in in vitro fertilisation treatment: a systematic review and meta‐analysis

“…The flow of study identification is shown in Figure . Eight RCTs on women undergoing IVF (2128 in total) were identified as relevant and included in the meta‐analysis . No quasi‐randomized trials were identified.…”

Influence of intracervical and intravaginal seminal plasma on the endometrium in assisted reproduction: a double‐blind, placebo‐controlled, randomized study

“…A possible explanation is that the mode of action of SP has not yet been clarified. As no significant impact on pregnancy rate could be demonstrated, only the potential of improving pregnancy rates has been discussed. In addition, intrauterine instillation of diluted SP at the time of oocyte retrieval failed to show significant impact on pregnancy rate or live‐birth rate per transfer.…”

“…SP seems to have the potential to improve pregnancy rates if used intracervically and intravaginally at the time of oocyte collection, although no significant impact has yet been shown. However, Chicea et al found a significantly higher implantation rate when using SP and sexual intercourse; thus, exposure to semen at the embryo peri‐transfer period in an IVF cycle seems to increase the likelihood of successful early embryo implantation and development. Intrauterine instillation of diluted SP at oocyte pick‐up does not increase pregnancy rate or live‐birth rate, most probably owing to the effects of dilution.…”

Difference in the seminal plasma protein expression in unexplained infertile men with successful and unsuccessful in vitro fertilisation outcome

“…The high concentration of proteins involved in fertility present in SP makes them a potential source of male fertility biomarker. In line with the importance of SP in a successful pregnancy, some studies showed that patients who underwent SP intravaginal insemination around the time of ovum pickup or embryo transfer reached higher implantation and clinical pregnancy rates compared to the controls (Chicea, Ispasoiu, & Focsa, ; Crawford, Ray, Gudi, Shah, & Homburg, ; Friedler et al, ).…”