Platelet-activating factor significantly enhances intrauterine insemination pregnancy rates in non-male factor infertility

Abstract 

Objective

To determine the efficacy of treating semen specimens with platelet-activating factor (PAF) before IUI.

Design

Prospective randomized double-blinded study of PAF treatment of sperm for patients with a history of infertility undergoing IUI.

Setting

Private infertility center.

Intervention(s)

Patients had ovulation induction therapy with clomiphene citrate (CC) or gonadotropin, two IUIs per month with PAF treatment.

Main outcome measure(s)

Clinical pregnancy rates.

Result(s)

There was a significant difference in IUI pregnancy rates per cycle between control (10/56; 17.9%) and PAF (14/47; 29.8%) treatment groups in the normal male study arm. There was a significant difference in cumulative IUI pregnancy rates between control (10/35; 28.6%) and PAF (14/26; 53.9%) patient groups in the normal male study arm. There was no significant difference in IUI pregnancy rates per cycle between control (12/124; 9.7%) and PAF (14/119; 11.8%) treatment groups in the male factor study arm. There was no significant difference in cumulative IUI pregnancy rates between control (12/46; 26.1%) and PAF (14/38; 36.8%) patient groups in the male factor study arm. There was a significant difference in overall cumulative IUI pregnancy rates between control (21/81; 25.9%) and PAF (27/64; 42.2%) patient groups.

Conclusion(s)

The inclusion of PAF into the IUI sperm wash procedure significantly improves pregnancy rates. However, the significant improvement can only be shown to affect men presenting with normal semen parameters.

Keywords:  Platelet-activating factor, intrauterine insemination, sperm, pregnancy