Freeman MR, Archibong AE, Mrotek JJ, Whitworth CM, Weitzman GA, Hill GA. Male partner screening before in vitro fertilization: preselecting patients who require intracytoplasmic sperm injection with the sperm penetration assay.
Fertil Steril 2001;
76:1113-8. [PMID:
11730736 DOI:
10.1016/s0015-0282(01)02890-4]
[Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES
To determine the diagnostic accuracy of the sperm penetration assay (SPA) and standard semen parameters for subsequent fertilization in in vitro fertilization-embryo transfer (IVF-ET).
DESIGN
Prospective study.
SETTING
Andrology Laboratory, and university research laboratory.
PATIENTS
Two hundred sixteen couples undergoing male-partner screening before IVF-ET (265 cycles).
INTERVENTION(S)
Male-partner screening (semen analyses [SA] and SPA), standard IVF-ET procedures, follow-up of fertilization in IVF-ET.
MAIN OUTCOME MEASURE(S)
Diagnostic accuracy of SA and SPA for prediction of fertilization in IVF-ET.
RESULT(S)
The SPA predicted IVF fertilization with high negative (84%) and positive (98%) predictive rates, and correct prediction in 88% of cycles. In contrast, sperm concentration, motility, morphology, and complete SA showed poor diagnostic accuracy, with correct prediction of IVF fertilization in 64%, 65%, 45%, and 68% of cycles, respectively.
CONCLUSION(S)
Very low sperm concentration and/or motility were good predictors of poor IVF fertilization, however, low to normal semen parameters were not predictive of successful IVF fertilization. The SPA is a useful screening tool that predicts IVF fertilization with high diagnostic accuracy. The SPA may be useful to discriminate between those couples with a high probability of normal fertilization in IVF and those with a low probability of normal fertilization that may benefit from assisted fertilization by intracytoplasmic sperm injection (ICSI).
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