Split ejaculate insemination with and without the addition of kallikrein.

48 couples with primary sterility and a therapy-resistant male factor (oligoasthenozoospermia, asthenozoospermia) were subjected to a split ejaculate insemination therapy with and without addition of kallikrein. In all men, in vitro stimulation of sperm motility by kallikrein was possible. 468 inseminations were performed in 341 ovulatory cycles according to the BBT and the cervical score. To the sperm-rich fraction of the split ejaculate physiological saline or physiological saline containing pancreatic kallikrein in a final concentration of 5 units/ml was added and inseminated alternatively over another cycle for a period of one year. The conception optimum was around the 7th insemination cycle. 11 conceptions were obtained after split insemination with kallikrein and 6 conceptions after split insemination without kallikrein. Conception rate was 35%, abortion rate 18%. The sex ratio showed 8 healthy girls to 4 healthy boys. Within the oligoasthenozoospermic group a conception rate of 28% was obtained, whereas the conception rate of the asthenozoospermic group was 43%. In the latter, more than the double number of conceptions were achieved with kallikrein addition. Kallikrein addition showed a beneficial effect particularly in ejaculates with less than 30% progressively motile spermatozoa. The investigation shows the usefulness of split ejaculate inseminations. Furthermore, addition of kallikrein to the ejaculate for the purpose of insemination may be beneficial particularly in patients with therapy-resistant asthenozoospermia.