Pentoxifylline Initiates Motility in Spontaneously Immotile Epididymal and Testicular Spermatozoa and Allows Normal Fertilization, Pregnancy, and Birth After Intracytoplasmic Sperm Injection
Purpose: Pentoxifylline (PF) has been used to enhancesperm motility in many in vitro fertilization programs. Thetwofold purpose of this study was to determine whether PFstimulates fresh or frozen epididymal and testicular totallyimmotile spermatozoa and whether it can be used to selectviable spermatozoa for intracytoplasmic sperm injection(ICSI).
Methods: To test the effect of PF on motility, 10 samplesof totally immotile spermatozoa were incubated for 10 minwith 3.6 mM PF. Motility was initiated in all cases (14.8%mean motility after PF treatment of five samples of fresh orfrozen epididymal spermatozoa and 13.6% mean motility offive samples of fresh or frozen testicular spermatozoa). Toassess PF for selection of viable spermatozoa before ICSI,we compared the outcome of ICSI in 20 cycles using freshor frozen epididymal or testicular PF-treated immotilespermatozoa and 139 control ICSI using fresh or frozenepididymal or testicular spontaneously motile spermatozoa.
Results: Fertilization rates were similar in the PF andcontrol groups (45.2% vs. 51.0%). Embryo quality and divisionstages at the time of transfer were comparable. Sixpregnancies occurred in PF-ICSI group (30.0% per cycle vs. 26.6%in control group) including two deliveries of healthy childrenand four ongoing pregnancies.
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