The effect of pentoxifylline on in-vitro fertilization in the presence of anti-sperm antibodies.

In cases of severe immunological male-factor infertility, impairment of spermatozoal motility and of acrosome reaction resulting in reduced fertilization capacity have been described by several authors. The present study investigated the use of pentoxifylline in enhancing in-vitro fertilization (IVF) in the presence of anti-sperm antibodies. Thirty-seven IVF cycles were conducted in 28 different couples suffering from immunological male-factor infertility with at least 50% antibody-coated spermatozoa. Sibling oocytes were inseminated at random with spermatozoa incubated with or without 3.6 mM pentoxifylline after selection by a Percoll gradient. No difference in motility of the final sperm preparations was observed prior to insemination. Fertilization rate, cleavage rate and embryo quality were similar in both treatment and control groups. Nine out of ten pregnancies were achieved after the replacement of embryos both from the treatment and control group. Although pentoxifylline is known to enhance motility in-vitro and to promote induced acrosomal loss, its indiscriminate use failed to improve IVF performance in patients with anti-sperm antibodies. Further research may be necessary in order to elucidate whether a given subpopulation of these patients may benefit from a selective application of pentoxifylline.