Type of publication:
*Cloete H., *Binnersley S., *Henderson A., *Mitchell A., *Kasraie J.
Poster presentation at the ACE Annual Conference, 5-6 January 2016.
Aim: To investigate the effect of unprotected intercourse on embryo implantation in patients undergoing fertility treatment. Evidence suggests that seminal plasma elicits an endometrial immune response that promotes tolerance towards an invading conceptus. However, in assisted reproductive techniques (ART), seminal plasma is usually excluded and does not come into contact with the female reproductive tract. In humans, investigators have shown that intra-vaginal and/or intra-cervical application of seminal plasma at the time of fertility treatment may improve pregnancy outcomes.
Method: Women were asked to share information about timing and frequency of intercourse in the week of, and 2 weeks prior to, fresh and frozen embryo transfer (FET). Women who had unprotected intercourse in the 5 days prior to ovulation and up to the day of embryo transfer were assigned to the study group (n = 40). Women who abstained in this period were assigned to the control group (n = 66).
Main study outcomes: Biochemical pregnancy rate, clinical pregnancy rate and implantation rate. Statistical analysis showed no significant difference in main outcomes between groups when results were pooled for all treatment types (in vitro fertilisation (IVF)/intra-cytoplasmic sperm injection (ICSI) and FET cycles). However, a significantly reduced implantation rate was observed in the study group when considering the IVF/ICSI stratum alone (24% versus 44%, p = 0.03).
Conclusion: This pilot study supports intercourse abstinence during fertility treatment, however study limitations such as small sample size and patient recall means further investigation is recommended.