EFFECTIVENESS OF PENTOXIFYLLINE IN SEMEN PREPARATION FOR INTRAUTERINEINSEMINATION

Pentoxifylline, an inhibitor of cAMP phosphodiesterase activity, favou rs intracellular cAMP concentration increase, In-vitro treatment of se men with pentoxifylline leads to marked augmentation of sperm motility , enhancement of acrosome reaction, increase of sperm penetration into zona-free hamster oocytes, and protection of the sperm plasma membran e, Such properties indicate that the drug may be a useful tool for sem en preparation in assisted reproduction, but its real effectiveness in improving fertilization rates is still uncertain, mainly in associati on with intrauterine insemination (IUI), Theoretically sperm motility should play an extremely important role for positive results in IUI, T herefore a retrospective clinical trial was planned in order to evalua te whether addition of pentoxifylline to the previously standardized i n-vitro treatment of semen had improved the percentage of pregnancies after homologous IUI, The study involved 55 sterile couples (33 classi fied infertile for male factor and 22 for other factors) who underwent a total of 150 cycles of homologous IUI: 101 for male factor infertil ity and 49 for other factors (anovulation n = 26, endometriosis n = 2, idiopathic n = 21). Out of the 101 cycles performed for male factor i nfertility, 61 underwent the standard preparation of semen and were fo llowed by seven pregnancies (pregnancy rate = 11.5%) while 40 had a se men preparation with pentoxifylline addition and were followed by 11 p regnancies (pregnancy rate = 27.5%) with a significant difference betw een the two procedures (P < 0.05), Out of the 49 cycles carried out fo r factors different from male infertility, 10 underwent the standard p reparation of semen and were followed by two pregnancies (pregnancy ra te = 20.0%), while 39 had pentoxifylline addition and were followed by nine pregnancies (pregnancy rate = 23.1%), The difference between the two groups was not significant. Abortions and malformations were equa lly distributed in the standard treatment and in the pentoxifylline gr oup.