Rizk B, Fountain S, Avery S, Palmer C, Blayney M, Macnamee M, Mills C, Brinsden P
Bourn Hall Clinic, Cambridge, UK.
J Assist Reprod Genet. 1995 Nov;12(10):710-4. doi: 10.1007/BF02212898.
Our objective was to determine whether the use of pentoxifylline (PF) would improve the in vitro fertilization (IVF) rate and outcome in couples with male factor infertility and previous failure of fertilization in vitro.
This prospective randomized controlled study was conducted in an assisted conception unit.
Forty-nine couples with previous failed fertilization in vitro attributable to male factor or male-factor infertility without previous IVF were recruited for the study. Controlled ovarian hyperstimulation was performed using a combination of gonadotropin releasing hormone agonist and human menopausal gonadotropin. Oocytes of the same grade and maturity were inseminated with spermatozoa treated with PF or control spermatozoa. A maximum of three embryos was replaced after 48 hr and all other embryos were cryopreserved. Pregnancy outcome was followed up and evidence of fetal or neonatal anomalies reported.
A significantly higher fertilization rate occurred in the group where oocytes were inseminated with spermatozoa treated with PF compared with controls (56.3 versus 30.7%; P < 0.05). Fertilization occurred in 45 of the 49 cycles (92%). In seven cycles, only the oocytes that were inseminated with spermatozoa treated with PF fertilized, in contrast to only one cycle where the oocytes inseminated with control sperm fertilized (P < 0.05). Fifty-seven PF and 31 control embryos were replaced and 11 clinical pregnancies occurred. Three of the pregnancies occurred in the seven cycles in which only PF embryos were replaced, one in the single cycle where control embryos were replaced and seven from the 37 cycles in which both PF and control embryos were replaced. There was no evidence of congenital malformations in any of the offsprings resulting from this study.
This study suggests that PF improves the fertilization rate and outcome in couples with male factor infertility and poor fertilization rates. This study does not suggest any increase in teratogenicity or evidence of congenital malformations in pregnancies following IVF cycles where PF was used.
我们的目的是确定己酮可可碱（PF）的使用是否会提高男性因素不育且既往体外受精失败的夫妇的体外受精（IVF）率及结局。
这项前瞻性随机对照研究在一个辅助受孕单元进行。
招募了49对夫妇，他们既往因男性因素体外受精失败或为男性因素不育且未曾进行过IVF。使用促性腺激素释放激素激动剂和人绝经期促性腺激素联合进行控制性卵巢过度刺激。将相同等级和成熟度的卵母细胞与经PF处理的精子或对照精子进行授精。48小时后最多移植3个胚胎，所有其他胚胎进行冷冻保存。随访妊娠结局并报告胎儿或新生儿异常的证据。
与对照组相比，用经PF处理的精子对卵母细胞进行授精的组受精率显著更高（56.3%对30.7%；P<0.05）。49个周期中有45个发生了受精（92%）。在7个周期中，只有用经PF处理的精子授精的卵母细胞受精，相比之下，用对照精子授精的卵母细胞只有1个周期受精（P<0.05）。移植了57个PF胚胎和31个对照胚胎，发生了11例临床妊娠。其中3例妊娠发生在仅移植PF胚胎的7个周期中，1例发生在移植对照胚胎的单个周期中，7例发生在同时移植PF胚胎和对照胚胎的37个周期中。本研究的任何后代均未发现先天性畸形的证据。
本研究表明，PF可提高男性因素不育且受精率低的夫妇的受精率及结局。本研究未提示在使用PF的IVF周期后的妊娠中致畸性增加或有先天性畸形的证据。
