Use of dimethylxanthine theophylline (SpermMobil®) does not affect clinical, obstetric or perinatal outcomes
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To evaluate whether the use of a commercially available dimethylxanthine theophylline compound (SpermMobil®) for artificial sperm activation would negatively affect clinical, obstetric and perinatal outcomes.
Artificial sperm activation (ASA) was used when sperm motility after preparation was low or absent in our clinical standard procedure practice. ICSI cycles using either testicular or ejaculated sperm with concentration smaller than 5 million/ml from August 2012 to January 2018 were retrospectively analyzed (n = 815) and divided into two groups, a control group where no ASA was needed and the SpermMobil® group with ASA.
The fertilization rate was significantly higher in the control group, but pregnancy and implantation rates did not differ significantly. Number of embryos transferred, good quality embryos for ET and number of frozen blastocysts were similar in both groups. Clinical pregnancy loss was significantly reduced in the SpermMobil® group, which was reflected in slightly better live birth rates than in the control group. Furthermore, there were no significant differences regarding gestational age, weight, height and z score for singletons or multiples in the SpermMobil® (n = 27 and n = 10) or control (n = 144 and n = 67) groups. There were no reports of malformation, perinatal mortality or intensive therapy in the SpermMobil® group, whereas in the control group, 12 babies needed intensive care, besides one intrauterine death.
The use of SpermMobil® in samples with mostly immotile sperm not only facilitates the embryologists work but also optimizes the treatment outcomes for those patients with a bad prognosis. This is the first report of obstetric and perinatal outcomes after applying a theophylline derivative in human clinical use.
KeywordsSpermMobil® ICSI Dimethylxanthine theophylline Perinatal outcomes Obstetric outcomes Artificial sperm activation
We are thankful for all colleagues working in the IVF clinic involved in patient management and data collection.
NLSM: project development, data collection and management, data analysis and manuscript writing; SM: data collection and manuscript editing; DZ: data collection and manuscript editing; SZ: data collection and manuscript editing; AV: data collection and manuscript editing; NR: data collection and manuscript editing; KE: data collection and manuscript editing; KB: project development, data collection, and manuscript editing; FG: project development, data collection, and manuscript editing.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest and no funding was received.
Ethical approval was not considered necessary by our Ethics Committee, as we retrospectively analyzed the outcomes of our standard clinical practice with a CE-certified compound and there was neither allocation of treatment nor patient information disclosed to third parties.
No informed consent was obtained.
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