SUCCESSFUL USE OF PENTOXIFYLLINE IN MALE-FACTOR INFERTILITY AND PREVIOUS FAILURE OF IN-VITRO FERTILIZATION - A PROSPECTIVE RANDOMIZED STUDY

Objective: Objective was to determine whether the use of pentoxifyllin e (PF) would improve the in vitro fertilization (IVF) rate and outcome in couples with male factor infertility and previous failure of ferti lization in vitro. Design: This prospective randomized controlled stud y was conducted in an assisted conception unit. Materials and Methods: Ferry-nine couples with previous failed fertilization in vitro attrib utable to male factor or male-factor infertility without previous IVF were recruited for the study. Controlled ovarian hyperstimulation was performed using a combination of gonadotropin releasing hormone agonis t and human menopausal gonadotropin. Oocytes of the same grade and mat urity were inseminated with spermatozoa treated with PF or control spe rmatozoa. A maximum of three embryos nas replaced after 48 hr and all other embryos were cryopreserved. Pregnancy outcome was followed rip a nd evidence of fetal or neonatal anomalies reported. Results: A signif icantly higher fertilization rate occurred in the group where oocytes were inseminated with spermatozoa treated with PF compared with contro ls (56.3 ver sus 30.7%; P < 0.05). Fertilization occurred in 45 of the 49 cycles (92%). In seven cycles, only the oocytes that were insemina ted with spermatozoa treated with PF-fertilized, in contrast to only o ne cycle where the oocytes inseminated with control sperm fertilized ( P < 0.05). Fifty-seven PF and 31 control embryos were replaced and 11 clinical pregnancies occurred. Three of the pregnancies occurred in th e seven cycles in which only PF embryos were replaced, one in the sing le cycle where control embryos were replaced and seven from the 37 cyc les in which both PF and control embryos Ir ere replaced. There was no evidence of congenital malformations in any of the offsprings resulti ng from this study. Conclusion: This study suggests that PF improves t he fertilization rate and outcome in couples with male factor infertil ity and poor fertilization rates. This study does not suggest any incr ease in teratogenicity or evidence of congenital malformations in preg nancies following IVF cycles where PF was used.