Effectiveness of Combined Empirical Therapies and Double IUI Procedures in Treatment of Male Factor Infertility

Abstract

Objective: Current information on using anti-estrogenic compounds, antioxidant vitamins and minerals in treatment of male factor infertility still remains controversial. Herein, we investigated the pregnancy outcome in male factor infertile patients using a combination of non-specific empiric modalities and Intra Uterine Insemination (IUI) procedures. Subjects and Methods: The study involved a group of 33 infertile couples with mild male factor infertility who previously failed two IUI attempts. The patients received tamoxifen, vitamin E, zinc, and selenium for three months prior to their third IUI treatment cycle. Four important parameters were mainly noted: sperm concentration, motility, forward progression and the percentage normal forms. Results: There was no difference between these parameters in semen samples of our study group in the first and second IUI treatment cycles (p<0.96, p<0.23, p<0.59, p<0.84 respectively). However, after completion of the empiric therapy course and in the third IUI treatment cycle, significant differences in overall values for the four semen parameters were detected in comparison to the earlier two IUI cycles (range p<0.005 to p<0.0005), except for semen volume and sperm normal forms, resulting in a chemical pregnancy rate of 30.3%, a clinical pregnancy rate of 21.2% and a delivery rate of 18.1%. Grouping the female patients according to the Body Mass Index (BMI) showed imperative differences in pregnancy outcome, yet there was no clear effect of age over pregnancy success rates in our study group. Conclusion: Combined empirical therapies can improve semen parameters in infertile men with mild male factor. Double insemination procedures with improved semen samples, can contribute in increasing the chances of pregnancy and life birth more significantly in females with lower BMI.