The influence of intracervical and intravaginal application of seminal plasma on the endometrium and life birth rate: a prospective, double-blind, placebo-controlled, randomized study

Study question: Does intracervical and intravaginal application of seminal plasma affect endometrial and subendometrial vascularisation, endometrial volume or life birth rate?

Methods: A 1-year prospective study, double blind, placebo controlled, randomized trial, assessed eligibility: 102 patients. Eligible patients: 81, randomized: 66 patients. Sodium chloride (placebo) or seminal plasma was applied just after follicle aspiration. 3-D-power-Doppler Ultrasound examination was performed 30 minutes prior to oocyte collection and embryo transfer. Patients undergoing first or second IVF/ICSI cycle were randomized. 66 patients received embryo transfer and were divided in group I (n = 32, seminal plasma) and II (n = 34, placebo). Virtual organ computer-aided analyses (VOCAL) and shell-imaging were used. Mean value of two serial measurements was recorded. Clinical course of pregnancy was observed.

Results: There was no significant difference between group I and II concerning age (31.94 vs. 31.03), endometrial volume on day of follicle aspiration (4.02 ml vs. 3.96 ml) and on day of embryo transfer (4.04 ml vs. 3.95 ml). Also power-Doppler results of subendometrium on the day of oocyte collection seemed not different: vascularization index (VI) (5.64 vs. 4.23), flow index (FI) (29.96 vs. 29.80), vascularization flow index (VFI) (1.73 vs. 1.35), as well as endometrial indices: VI (1.75 vs. 1.53), FI (26.90 vs. 26.83), VFI (0.48 vs. 0.42). On the day of embryo transfer perfusion of subendometrium showed similar results: VI (1.98 vs. 1.83), FI (31.28 vs. 29.57), VFI (0.81vs. 0.68); as well as endometrial perfusion: VI (0.99 vs. 0.73), FI (28.39 vs. 27.28), VFI (0.27 vs. 0.19). Life birth rate was 31.25% (10/32) in group I and 29.41% (10/34) in group II, birth weight was 3054.3 g vs. 3044 g – again no statistical significance was reached. Limitations: preliminary data. Conclusio: Intracervical and intravaginal application of seminal plasma on the day of follicle aspiration shows no significant benefit in good prognosis patients undergoing their first or second IVF/ICSI cycle.