Single Versus Double Fallopian Tube Sperm Perfusion in the Treatment of Unexplained Infertility: A Prospective Randomized Study

Objective: To evaluate the efficacy of double Fallopian tube sperm perfusion (FSP) in comparison with single FSP in patients with unexplained infertility undergoing controlled ovarian stimulation. Study design: Sixty six patients with unexplained infertility undergoing a standard ovarian stimulation regimen were randomized to receive either single FSP (group I, n=33) or double FSP (group II, n=33). The same insemination method was performed in subsequent cycles if the patient does not become pregnant in the first one. A maximum of three cycles was performed. Fallopian tube sperm perfusion was carried out with pediatric Foley s catheter, which prevents reflux of sperm suspension. Semen was prepared by a classical swimup technique. Results: A total of 133 cycles were completed; 68 single FSP cycles and 65 double FSP cycles. There were no differences in demographic data, ovarian stimulation and insemination characteristics between the two study groups. In the single FSP group, there were 10 clinical pregnancies (14.7% per cycle) of which 8 were ongoing (11.7% per cycle). In the double FSP group, 19 clinical pregnancies (29.2% per cycle) of which 16 ongoing pregnancies (24.6% per cycle) were obtained. These differences were statistically significant. The prevalence of multiple pregnancies, abortions, and ectopic pregnancies was similar in the two groups. Conclusion: The results of this study indicate that there is significant improvement of pregnancy rates in patients with unexplained infertility when treated with double FSP after controlled ovarian stimulation in comparison with single FSP. Double FSP method is simple, easy to perform, inexpensive and convenient for the patients. Trials of this method in patients with unexplained infertility may be useful before the adoption of the expensive assisted reproductive techniques.