Successful pregnancy by insemination of spermatozoa in a woman with a human seminal plasma allergy: should in vitro fertilization be considered first?

Objective: To raise the possibility that pregnancy can be obtained by assisted reproductive techniques in patients with human seminal plasma allergy. Design: Case report. Setting: University hospital. Patient(s): A woman consulted for a 3-year primary infertility. She reported lack of intercourse because of a seminal plasma allergy. Intervention(s): One intrauterine insemination associated with antihistamine treatment was performed with carefully washed spermatozoa. Result(s): Immediately after the insemination, the patient had an allergic reaction treated by steroids. Fortunately, this single attempt led to a successful pregnancy, and the patient gave birth to a healthy girl. Conclusion(s): Pregnancies can be obtained in patients with seminal plasma hypersensitivity by means of intrauterine insemination. However, serious complications may occur after performing intrauterine insemination, which is not a totally reliable method to prevent an allergic reaction. Thus a multidisciplinary team should follow such patients carefully and watch for the potential risks and side effects. In vitro fertilization may represent the more cautious option. (Fertil Steril (R) 2010;94:753.e1-e3. (C) 2010 by American Society for Reproductive Medicine.)