Application of seminal plasma to female genital tract prior to embryo transfer in assisted reproductive technology cycles (IVF, ICSI and frozen embryo transfer)

Abstract

We included 11 RCTs (3215 women). The quality of the evidence ranged from very low to low. The main limitations were risk of bias (associated with poor reporting of allocation concealment and other methods) and imprecision for the primary outcome of live birth rate.Live birth rates: There was insufficient evidence to determine whether there was a difference between the groups with respect to live birth rates (RR 1.10, 95% CI 0.86 to 1.43; participants = 948; studies = 3; I = 0%). Low quality evidence suggests that if the live birth rate following standard ART is 19% it will be between 16% and 27% with seminal plasma application.Miscarriage rate: There was insufficient evidence to determine whether there was a difference between the groups (RR 1.01, 95% CI 0.57 to 1.79; participants = 1209; studies = 4; I = 0%). Low quality evidence suggests that if the miscarriage rate following standard ART is 3.7%, the miscarriage rate following seminal plasma application will be between 2.1% and 6.6%.Live birth or ongoing pregnancy rates: Seminal plasma application makes little or no difference in live birth or ongoing pregnancy rates (RR 1.19, 95% CI 0.95 to 1.49; participants = 1178; studies = 4; I = 4%, low quality evidence). The evidence suggests that if the live birth or ongoing pregnancy rate following standard ART is 19.5% it will be between 18.5% and 29% with seminal plasma application.Clinical pregnancy rates: Seminal plasma application may increase clinical pregnancy rates (RR 1.15, 95% CI 1.01 to 1.31; participants = 2768; studies = 10; I = 0%). Very low quality evidence suggests that if the clinical pregnancy rate following standard ART is 22.0% it will be between 22.2% and 28.8% with seminal plasma application. This finding should be regarded with caution, as a post-hoc sensitivity analysis restricted to studies at overall low risk of bias did not find a significant difference between the groups (RR 1.06, 95% CI 0.81 to 1.39; participants = 547; studies = 3; I = 0%).Multiple pregnancy rate: Seminal plasma application may make little or no difference to multiple pregnancy rates (RR 1.11, 95% CI 0.76 to 1.64; participants = 1642; studies = 5; I = 9%). Low quality evidence suggests that if the multiple pregnancy rate following standard ART is 7%, the multiple pregnancy rate following seminal plasma application will be between 5% and 11.4%.Ectopic pregnancy: There was insufficient evidence to determine whether seminal plasma application influences the risk of ectopic pregnancy (RR 1.59, 95% CI 0.20 to 12.78, participants =1521; studies = 5; I = 0%) .Infectious complications or other adverse events: No data were available on these outcomes AUTHORS' CONCLUSIONS: In women undergoing ART, there was insufficient evidence to determine whether there was a difference between the seminal plasma and the standard ART group in rates of live birth (low-quality evidence) or miscarriage (low quality evidence). There was low quality evidence suggesting little or no difference between the groups in rates of live birth or ongoing pregn...

Endometrial Immune Dysfunction in Recurrent Pregnancy Loss

“…Future perspectives in the treatment of RPL of immune etiology could be aimed to correct abnormal decidualization as well as dysfunctions of the immune mechanisms occurring in the endometrium and decidua, on the basis of the emerging evidence. As an example, the effects of seminal plasma on the expansion of Tregs could allow an innovative therapeutic approach, that is already being used in assisted reproductive technologies (ART), even though with still controversial results [196][197][198]. Table 6.…”

Clinical adjuncts in in vitro fertilization: a growing list

“…The Cochrane review that compiled these RCTs concluded that there was no clear evidence of a difference in LBR with seminal plasma application or exposure (RR 1.10; 95% CI, 0.86-1.43; 3 RCTs, n ¼ 948) (17). There was an improvement in clinical pregnancy rates noted with seminal plasma application (RR 1.15; 95% CI, 1.01-1.31; 10 RCTs, n ¼ 2768), but when the analysis was restricted to studies at low risk of bias this difference was no longer present (RR 1.06; 95% CI, 0.81-1.39; 3 RCTs, n ¼ 547).…”

Investigation of Sperm and Seminal Plasma Candidate MicroRNAs of Bulls with Differing Fertility and In Silico Prediction of miRNA-mRNA Interaction Network of Reproductive Function

“…However, transformed offspring phenotype was ascribed to sperm damage and absence of seminal fluid [ 136 ]. It is evident that seminal plasma and sperm-borne mediators are critical for signaling events that lead to successful pregnancy and healthy offspring; however, there are differences across species [ 119 , 127 , 137 ] that raise the question of whether seminal plasma is a prerequisite in cattle breeding. It should be noted that the interaction of hub genes of DE-miRNAs in the PPI network was found in this current study.…”