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.
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References
Bellinge BS, Copeland CM, Thomas TD, Mazzucchelli RE, O’Neil G, Cohen MJ. The influence of patient insemination on the implantation rate in an in vitro fertilization and embryo transfer program. Fertil Steril. 1986;46:25–6.
Boomsma CM, Kavelaars A, Eijkemans MJC, Lentjes EG, Fauser BCJM, Heijnen CJ, et al. Endometrial secretion analysis identifies a cytokine profile predictive of pregnancy in IVF. Hum Reprod. 2009;24(6):1427–35.
Cicinelli E, de Ziegler D. Transvaginal progesterone: evidence for a new functional “portal system” flowing from the vagina to the uterus. Hum Reprod Updat. 1999;5:365–72.
Coulam CB, Stern JJ. Effect of seminal plasma on implantation rates. Early Pregnancy. 1995;1:33–6.
Einer-Jensen N, Hunter R. Counter-current transfer in reproductive biology. Reproduction. 2005;129:9–18.
Fishel S, Webster J, Jackson P, Faratian B. Evaluation of high vaginal insemination at oocyte recovery in patients undergoing in vitro fertilization. Fertil Steril. 1989;51:135–8.
Flowers WL, Esbenshade KL. Optimizing management of natural and artificial matings in swine. J Reprod Fertil Suppl. 1993;48:217–28.
Gardner DK, Schoolcraft WB. Towards reproductive certainty. In: Jansen R, Mortimer D, editors. Fertility and genetics beyond. Carnforth: Parthenon Publishing; 1999. p. 378–88.
Guerin LR, Prins JR, Robertson SA. Regulatory T-cells and immune tolerance in pregnancy: a new target for infertility treatment? Hum Reprod. 2009;15:517–35.
Gutsche S, von Wolff M, Strowitzki T, Thaler CJ. Seminal plasma induces mRNA expression of IL-1beta, IL-6 and LIF in endometrial epithelial cells in vitro. Mol Hum Reprod. 2003;9:785–91.
Johansson M, Bromfield JJ, Jasper MJ, Robertson SA. Semen activates the female immune response during early pregnancy in mice. Immunology. 2004;112:290–300.
Kelly RW, Carr GC, Critchley HO. A cytokine switch induced by human seminal plasma: an immunemodulation with implications for sexually transmitted disease. Hum Reprod. 1997;12:677–81.
Kolibianakis EM, Bourgain C, Platteau P, Albano C, Van Steirteghem AC, Devroey P. Abnormal endometrial development occurs during the luteal phase of nonsupplemented donor cycles treated with recombinant follicle-stimulating hormone and gonadotropin-releasing hormone antagonists. Fertil Steril. 2003;80:464–6.
Ma WG, Song H, Das SK, Paria BC, Dey SK. Estrogen is a critical determinant that specifies the duration of the window of uterine receptivity for implantation. Proc Natl Acad Sci U S A. 2003;100:2963–8.
Qasim SM, Trias A, Karacan M, Shelden R, Kemmann E. Does the absence or presence of seminal fluid matter in patients undergoing ovulation induction with intrauterine insemination? Hum Reprod. 1996;11(5):1008–10.
Robertson SA, Ingman WV, O’Leary S, Sharkey DJ, Tremellen KP. Transforming growth factor beta—a mediator of immune deviation in seminal plasma. J Reprod Immunol. 2002;57:109–28.
Robertson SA, Guerin LR, Moldenhauer M, Hayball JD. Activating T regulatory cells for tolerance in early pregnancy-the contribution of seminal fluid. J Reprod Immunol. 2009;83:109–16.
Sharkey DJ, Macpherson AM, Tremellen KP, Robertson SA. Seminal plasma differentially regulates inflammatory cytokine gene expression in human cervical and vaginal epithelial cells. Mol Hum Reprod. 2007;13:491–501.
Tremellen KP, Valbuena D, Landeras J, et al. The effect of intercourse on pregnancy rates during assisted human reproduction. Hum Reprod. 2000;15:2653–8.
Trowsdale J, Betz AG. Mother’s little helpers: mechanisms of maternal-fetal tolerance. Nat Immunol. 2006;7:241–6.
Von Wolff M, Rosner S, Thone C, Pinheiro RM, Jauckus J, Bruckner T, et al. 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. Fertil Steril. 2009;91(1):167–72.
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Seminal plasma insemination in IVF.
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Chicea, R., Ispasoiu, F. & Focsa, M. Seminal plasma insemination during ovum-pickup—a method to increase pregnancy rate in IVF/ICSI procedure. A pilot randomized trial. J Assist Reprod Genet 30, 569–574 (2013). https://doi.org/10.1007/s10815-013-9955-7
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DOI: https://doi.org/10.1007/s10815-013-9955-7