TREATMENT OF MALE-INFERTILITY DUE TO SPERM SURFACE ANTIBODIES - IUI OR IVF

This prospectively designed study was aimed at comparing the results o f two different treatment protocols in 29 infertile couples with prove n male immunological infertility, i.e. a positive (>50%) mixed antiglo bulin reaction (MAR) test (IgG and/or IgA), In the first protocol (gro up I, n = 14) couples were treated with ovarian stimulation/intrauteri ne insemination (IUI), followed by in-vitro fertilization (IVF) if no pregnancy occurred after three IUI cycles. In the second protocol (gro up II, n = 15), patients were treated with IVF as a first choice proce dure, The decision to follow protocol 1 or 2 was made by the couples a fter information about financial costs and expected success rates (acc ording to the literature) for both treatment options, In group I, nine patients (64.3%) conceived after a maximum of three IUI cycles wherea s 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 o f 64.3% after three IUI cycles and 93.3% after three IVF attempts, To conclude, both IUI and IVF yielded unexpectedly high pregnancy rates i n this selected group of patients with long-standing infertility due t o sperm surface (predominantly IgG) antibodies, Since cost benefit ana lysis comparing superovulation IUI with IVF may favour a course of fou r IUI cycles, we advocate superovulation IUI as the first line therapy in male immunological infertility.