Fallopian Tube Sperm Perfusion in Treatment of Nontubal Subfertility: Is It Crucial Step prior to ART?

Objective. To evaluate the efficacy of double Fallopian tube sperm perfusion in comparison with single-sperm perfusion in patients with nontubal subfertility undergoing controlled ovarian stimulation. Study Design. Sixty-six patients undergoing standard ovarian stimulation regimen were randomized to receive either single-sperm perfusion group 1 (n = 33) or double-sperm perfusion group 2 (n = 33). The same insemination method was performed in subsequent cycles if the patient does not become pregnant in the first one. A maximum of three cycles was performed. Fallopian tube sperm perfusion was carried out with pediatric Foleys catheter, which prevents reflux of sperm suspension. Semen was prepared by a classical swim-up technique. Results. A total of 133 cycles performed 68 single FSP cycles and 65 FSP cycles. There were group, 19 clinical pregnancies (29.2% per cycle) of which 16 ongoing pregnancies (24.6% per cycle) were obtained. These differences were statistically significant. The prevalence of multiple pregnancies, abortions, and ectopic pregnancies was similar in both groups. Conclusion. The results of this study indicate that there is a significant improvement of pregnancy rates in patients with nontubal subfertility when treated with double-sperm perfusion after controlled ovarian stimulation in comparison with single-sperm perfusion. Double-sperm perfusion is simple, easy to perform, inexpensive, and convenient for the patients with nontubal subfertility before adoption of other methods of assisted reproduction.