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 (original) (raw)
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Effectiveness of seminal plasma in IVF treatment: a systematic review and meta-analysis
BJOG: An International Journal of Obstetrics & Gynaecology, 2017
Background With in vitro fertilization (IVF) techniques, only 20-25% of the transferred embryos lead to a pregnancy. Objective To evaluate the beneficial effects of seminal plasma (SP) or semen applied at the time of oocyte aspiration or embryo transfer. Search strategy Electronic databases were searched from their inception up to August 2017. Selection criteria We included all randomized controlled trials (RCTs) evaluating the effects of SP or semen in IVF treatment. Trials were considered if women were exposed to any kind of SP or semen (either SP/semen injection or sexual intercourse) around the time of oocyte pickup and embryo transfer. Data collection and analysis The primary outcome was clinical pregnancy rate (CPR). Main results Eight RCTs on women undergoing IVF (2128 in total) were included in the meta-analysis. Women randomized in the intervention group had a significantly higher CPR compared with controls (30.0 versus 25.1%; RR 1.20; 95% CI, 1.04-1.39). No significant differences were found in the secondary outcomes, including livebirth rate, biochemical pregnancy, miscarriage, multiple pregnancies, and birth weight. The subgroup analyses (four RCTs, 780 participants), including only those RCTs in which prepared undiluted SP was injected just after oocyte pickup, conformed with the overall analysis for the primary outcome (46.3 versus 37.2%; RR 1.23; 95% CI, 1.05-1.45). Conclusion Because intravaginal or intracervical SP application around the time of oocyte pickup is associated with higher CPR, local application SP may be considered as a potential treatment to improve implantation.
Intracytoplasmic sperm injection: State of the Art in Humans
Reproduction (Cambridge, England), 2017
Amongst infertile couples, 25% involve both male and female factors, while male factor alone accounts for another 25% due to oligo-, astheno-, terato-zoospermia, a combination of the three, or even a complete absence of sperm cells in the ejaculate and can lead to a poor prognosis even with the help of assisted reproductive technology (ART). Intracytoplasmic sperm injection (ICSI) has been with us now for a quarter of a century and in spite of the controversy generated since its inception, it remains in the forefront of the techniques utilized in ART. The development of ICSI in 1992 has drastically decreased the impact of male factor, resulting in millions of pregnancies worldwide for couples who, without ICSI, would have had little chance of having their own biological child. This review focuses on the state of the art of ICSI regarding utility of bioassays that evaluate male factor infertility beyond the standard semen analysis and describes the current application and advances in...
BACKGROUND: In in vitro fertilization (IVF) techniques only 20 to 25% of the transferred embryos lead to a pregnancy OBJECTIVE: To evaluate the beneficial effects of SP or semen applied at the time of oocyte aspiration or embryo transfer SEARCH STRATEGY: Electronic databases were searched from their inception until August 2017. SELECTION CRITERIA: We included all randomized controlled trials (RCTs) evaluating the effects of SP or semen in IVF treatment. Trials were considered if women were exposed to any kind of SP or semen (either SP/semen injection or sexual intercourse) around the time of oocyte pickup and embryo transfer. DATA COLLECTION AND ANALYSIS: The primary outcome was clinical pregnancy rate (CPR). MAIN RESULTS: Eight RCTs, including 2,128 women undergoing to IVF, were included in the meta-analysis. Women randomized in the intervention group had a significantly higher rate of CPR compared to controls (30.0% vs 25.1%; RR 1.20, 95% CI 1.04 to 1.39). No significant differences were found in the secondary outcomes, including livebirth rate, biochemical pregnancy, miscarriage, multiple pregnancies and birth weight. The subgroup analysis (4 RCTs, 780 participants), including only those RCTs in which prepared undiluted SP was injected just after oocyte pick up, concurred with the overall analysis for the primary outcome (46.3% vs 37.2%; RR 1.23, 95% CI 1.05 to 1.45). CONCLUSIONS: As intravaginal or intracervical SP application around the time of oocyte pickup was associated with higher CPR. Local application SP may be considered as a potential treatment to improve implantation. This article is protected by copyright. All rights reserved.