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Human Reproduction, Vol 12, 1165-1170, Copyright © 1997 by Oxford University Press

ARTICLES

Treatment of male infertility due to sperm surface antibodies: IUI or IVF?

W Ombelet, H Vandeput, M Janssen, A Cox, C Vossen, H Pollet, O Steeno and E Bosmans
Genk Institute for Fertility Technology, St Jansziekenhuis, Belgium.

This prospectively designed study was aimed at comparing the results of two different treatment protocols in 29 infertile couples with proven male immunological infertility, i.e. a positive (>50%) mixed antiglobulin reaction (MAR) test (IgG and/or IgA). In the first protocol (group I, n = 14) couples were treated with ovarian stimulation/ intrauterine insemination (IUI), followed by in-vitro fertilization (IVF) if no pregnancy occurred after three IUI cycles. In the second protocol (group II, n = 15), patients were treated with IVF as a first choice procedure. The decision to follow protocol 1 or 2 was made by the couples after information about financial costs and expected success rates (according to the literature) for both treatment options. In group I, nine patients (64.3%) conceived after a maximum of three IUI cycles whereas seven patients (46.6%) of group II became pregnant during the first IVF cycle. The take-home baby rate per started IUI or IVF cycle was 27.3% (9/33) and 44.4% (16/36) respectively with a take-home baby rate of 64.3% after three IUI cycles and 93.3% after three IVF attempts. To conclude, both IUI and IVF yielded unexpectedly high pregnancy rates in this selected group of patients with long-standing infertility due to sperm surface (predominantly IgG) antibodies. Since cost benefit analysis comparing superovulation IUI with IVF may favour a course of four IUI cycles, we advocate superovulation IUI as the first line therapy in male immunological infertility.
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 ESHRE MonogrHome page
W. Ombelet, R. Campo, E. Bosmans, and M. Nijs
Intrauterine insemination (IUI) as a first-line treatment in developing countries and methodological aspects that might influence IUI success
ESHRE Monogr, July 1, 2008; 2008(1): 64 - 72.
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