Treatment of Sperm With Platelet-activating Factor Does Not Improve Intrauterine Insemination Outcome in Unselected Cases of Mild Male Factor Infertility: A Prospective Double-blind Randomized Crossover Study

OBJECTIVES To evaluate the effect of sperm treatment with exogenous platelet-activating factor (PAF) on intrauterine insemination (IUI) clinical pregnancy rate in cases of mild male factor infertility. PAF is a phospholipid mediator, which is present in human sperm. METHODS The study was performed in the Assisted Reproduction Unit of the 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieion Hospital, Athens, Greece, and included 92 couples who presented with mild male factor infertility-all candidates for IUI. A maximum of 4 IUI cycles per couple with or without exogenous PAF treatment were performed and the main outcome measure was the clinical pregnancy rate (pregnancies confirmed by ultrasonography per 100 cycles). RESULTS The overall clinical pregnancy rate after a maximum of 4 IUI cycles was comparable in cases with and without sperm treatment with PAF (12.24% vs 11-11%). Addition or exclusion of PAF sperm treatment in the same patients did not significantly alter the outcome. CONCLUSIONS The generalized use of exogenous PAF for the preparation of sperm in unselected cases of mild male infertility does not improve the clinical outcome of IUI. UROLCGY 74: 1025-1028, 2009. (C) 2009 Elsevier Inc.