Split ejaculate insemination with and without the addition of kallikrein

Area of Science:

• Reproductive Medicine
• Andrology
• Biochemistry

Background:

• Male factor infertility affects numerous couples seeking conception.
• Therapy-resistant cases of oligoasthenozoospermia and asthenozoospermia present significant challenges.
• Split ejaculate insemination is a technique used to optimize sperm for intrauterine insemination.

Purpose of the Study:

• To evaluate the efficacy of pancreatic kallikrein addition to split ejaculate insemination in couples with male factor infertility.
• To determine if kallikrein enhances sperm motility and improves conception rates in therapy-resistant cases.

Main Methods:

• 48 couples with primary sterility and male factor infertility participated.
• Split ejaculate insemination was performed with and without pancreatic kallikrein (5 units/ml).
• Inseminations were alternated between kallikrein and control groups over one year, guided by BBT and cervical score.

Main Results:

• Kallikrein demonstrated in vitro stimulation of sperm motility in all participants.
• 11 conceptions occurred with kallikrein addition versus 6 without, yielding a 35% overall conception rate.
• Kallikrein was particularly beneficial for asthenozoospermic patients and ejaculates with <30% progressive motility.

Conclusions:

• Split ejaculate insemination is a useful therapeutic approach for male factor infertility.
• Pancreatic kallikrein addition may enhance conception rates, especially in patients with asthenozoospermia and reduced sperm motility.