In-vivo transperitoneal fertilization

We present the technique of in-vivo transperitoneal fertilization (IVTPF) as a first approach to infertility treatment in couples with male subfertiity or unexplained factors. The technique Is statistically less successful but also less invasive than either gamete intra-Fallopian transfer (GIFT) or in-vitro fertilization-embryo transfer (IVF-ET) and offers considerable advantages over intrauterine insemination (IUI). The IVTPF technique involves trans peritoneal transfer of processed spermatozoa within the pouch of Douglas after Induction of ovulation. We report our 4-year experience with IVTPF which includes 136 treatment cycles in 89 couples. Eight pregnancies were achieved in 89 patients (9%) and 136 treatment cycles (7%). FIfty-one patients (57%) received IVTPF for only one treatment cycle; seven of the eight LVFPF pregnancies occurred in this group. An ectopic pregnancy resulted in one of the eight LVTPF pregnancies (13%). The functional quality of the sperm in those couples who achieved pregnancy was statistically superior to those couples who did not conceive. However, pregnancy was also obtained in cases of severe oligozoospermia. Based on our experience, we feel IVTPF to be a very reasonable first approach in patients with no pelvic pathology and with infertility secondary to male factors or unexplained causes.