Corticosteroid treatment does not improve the results of intrauterine insemination in male subfertility caused by antisperm antibodies.
OBJECTIVE
To determine whether corticosteroid immunosuppression (CS) administered to the male partner together with intrauterine insemination (IUI) is preferable compared to IUI alone in treating male autoimmune subfertility.


METHODS
Thirty-six couples with proven male immunological subfertility were randomly assigned to begin CS + IUI (n = 18) or IUI (n = 18) treatment and progressed alternatively to receiving each treatment modality for three cycles unless pregnancy occurred. Each couple served as their own control. The administered corticosteroid was soluble prednisolone.


RESULTS
Five pregnancies were achieved with 77 cycles of CS + IUI and seven pregnancies with IUI alone. The pregnancy rates per cycle were 6.5% with CS + IUI and 9.21% with IUI, while the pregnancy rates per couple were 16.13% with CS + IUI and 21.2% with IUI alone. These rates do not differ to a statistically significant degree (P > 10%).


CONCLUSIONS
The addition of corticosteroid immunosuppression does not seem to significantly enhance the pregnancy rate in couples with male autoimmune subfertility treated with IUI as compared to the treatment with IUI alone. Considering the possible side-effects of corticosteroid intake, we conclude that IUI alone might be preferable to the combination of IUI with corticosteroid administration.
Grigoriou
O
O
2nd Department of Obstetrics and Gynaecology, University of Athens, Greece.
Konidaris
S
S
Antonaki
V
V
Papadias
C
C
Antoniou
G
G
Gargaropoulos
A
A
D000328:Adult; D001323:Autoantibodies / Q000276:immunology; D001327:Autoimmune Diseases / Q000188:drug therapy* / Q000276:immunology; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007248:Infertility, Male / Q000188:drug therapy* / Q000276:immunology; D007317:Insemination, Artificial, Homologous; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use*; D011247:Pregnancy; D013094:Spermatozoa / Q000276:immunology
D001323:Autoantibodies; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D011239:Prednisolone