Methods for enhancement of sperm function

From a review of recent advances in human reproduction, it is apparent that therapeutic approaches to male infertility have been revolutionized. While our understanding of sperm function at the molecular level is steadily increasing, the realization of consistent oocyte fertilization by mechanically bypassing natural barriers has given new perspective for future investigation. This chapter reviews current knowledge of adjuvants that enhance sperm function and lend themselves to clinical application. Each compound is presented with recent publications supporting proposed mechanisms of action. Specifically, follicular fluid, progesterone, pentoxifylline, platelet activating factor and other cytokines have been studied for their impact on the in vitro fertilization capacity of spermatozoa. Intracytoplasmic sperm injection (ICSI) has provided infertile couples with hope for successful reproduction without sperm donation. The precise mechanism that allows subsequent pronuclear formation and syngamy is currently unknown and experimental models are few. Adjuvants that can be used in conjunction with controlled ovarian stimulation and intrauterine insemination are prominent areas for further research as this would provide an alternative to the expense and risks of in vitro fertilization and embryo transfer.