Diagnostic significance of sperm-zona pellucida interaction

Relation between stallion sperm binding to homologous hemizonae and fertility

The hemizona assay (HZA) has been developed as a diagnostic test to predict the fertilisation potential of human spermatozoa. The aim of this study was to develop an HZA for stallion spermatozoa and to investigate a possible relationship between fertility and the outcome of the HZA in this species. Equine oocytes were obtained from ovaries collected at a slaughterhouse and by transvaginal, ultrasound-guided follicle aspiration. They were then denuded from cumulus cells and stored in salt solution at 4 degrees C until use. On the day of the experiments the oocytes were bisected, thus providing 2 equal matching hemizonae from each oocyte. Semen samples from Dutch Warmblood stallions with known fertility data were used to assess the number of spermatozoa bound to the outer side of the hemizona after incubation in vitro. Sperm binding to matching hemizonae of a particular stallion was similar and confirmed the feasibility of using the HZA for the horse. Sperm hemizona binding capacity of 10 pairs of stallions was compared by incubating 1 hemizona with the semen of a stallion and the matching hemizona with the semen of another stallion from the same stud farm. Five matching pairs of hemizonae were used for each pair of stallions. There was a significant relationship between the mean number of spermatozoa bound to matching hemizonae and the fertility indices of stallions from each stud farm (P < 0.0001). It is concluded that HZA can be used as a valuable parameter in stallion semen analysis.

Differences in the DNA-stainability of spermatozoa from fertile and suspected infertile men

The aim of this work was to determine whether it is possible to distinguish between fertile (control group, already fathers) and infertile men (suspected infertility), by comparing the fluorescence intensity of the sperm-DNA after incubation with appropriate dyes. First we examined two different DNA-specific dyes (DAPI and YOYO-1) using bull spermatozoa. Based on good results in immunohistochemical applications, YOYO-1 was chosen for further work. The fluorescence-intensity of 200 single, morphologically normal spermatozoa in each semen sample were measured in a cytophotometer, means + SD determined and histograms delineated. Of 20 samples from the control group, 17 had markedly higher fluorescence-intensity than did 7/15 of the suspected infertile men. It is concluded that the DNA of the latter seven samples was less accessible to the dye than was the DNA of the control group. There are cases of infertility known in which there is loss of one or more of the DNA-binding proteins, which in spermatozoa are mainly (85%) protamines. The relationship between the stainability of the sperm-DNA and the packaging with DNA-binding proteins is discussed. Two of the histograms showed abnormalities in the distribution of the fluorescence-intensities, one sample was extremely fragile and most of the sperm lysed during the staining-procedure. Five samples showed normal histograms in comparison with the control group.

Evaluation of the contraceptive potential of recombinant human ZP3 and human ZP3 peptides in a primate model: their safety and efficacy

PROBLEM

The unique recognition events that result in the avid binding of mammalian spermatozoa to the surface of the zona pellucida (ZP) are being exploited in the development of contraceptive vaccines. In this study, the safety and efficacy of a vaccination strategy based on the induction of active immunity against purified, glycosylated, recombinant human ZP3 (rhZP3) has been evaluated in a primate model, Callithrix jacchus.

METHOD OF STUDY

Long-term infertility was established after immunization with rhZP3 and the resulting immune sera reacted with rhZP3 on an enzyme-linked immunosorbent assay (ELISA) and immunolocalized exclusively to the outer surface of native ZP on marmoset ovarian sections. However, this contraceptive effect was inevitably associated with the eventual appearance of an ovarian pathology characterized by a depletion of primordial follicles. In an attempt to circumvent this side effect, human ZP3 (hZP3) was epitope mapped and four continuous, immunodominant B-cell epitopes (hZP3(45-64), hZP3(93-110), hZP3(172-190) and hZP3(341-360) were evaluated for contraceptive efficacy in vivo. Using peptide-tetanus toxoid (TT) conjugates to enhance immunogenicity, antipeptide antibodies were raised against these immunogens, which also cross-reacted with rhZP3 on ELISA. In addition, antibodies against hZP3(45-64) and hZP3(172-190) recognized native ZP on marmoset ovarian sections when a microwave technique was used to enhance epitope presentation.

RESULTS

No ovarian pathology was observed after the long-term administration of these peptide immunogens, and fertility was suppressed when compared with TT controls but could not be correlated to the antibody titer.

CONCLUSION

Clearly, further research is required to identify optimal B-cell epitopes that will reliably induce infertility, free from any ovarian pathology.

Sperm characteristics and zona pellucida binding in relation to field fertility of frozen-thawed semen from dairy AI bulls

The present study examined the relationship between bull sperm characteristics immediately post-thaw and some characteristics registered after swim-up, including the ability of spermatozoa to bind to homologous zona pellucidae (ZP) in vitro, and fertility after artificial insemination (AI) of 9426 females. Frozen-thawed semen from 22 AI bulls of the Swedish Red and White Breed, represented by 43 different frozen batches (1-4 batches/bull, 2 consecutive ejaculates/batch), was examined with the aim of determining concentration, motility patterns, morphology and membrane integrity. In addition, the frozen-thawed spermatozoa were subjected to a swim-up procedure and those separated in this way were tested with two assays of sperm-binding to the ZP of homologous oocytes in vitro (ZBA), using either a relative ZBA index against a control bull of proven high fertility or absolute binding (Absolute ZBA). The correlations of the various sperm traits and 56-day non-return rates (NRR) after field AI were retrospectively examined as single traits and as combinations of traits (combined measures), including regression analysis of significant traits. Among the sperm characteristics, positively significant (p < 0.01) correlations with NRR were found for linear motility post-thawing (r = 0.45-0.59) and the concentration of motile spermatozoa after swim-up (r = 0.43-0.63). Results obtained with the absolute ZBA approach were significantly (p < 0.05) correlated with NRR (r = 0.50), whereas the correlation between NRR and the ZBA index was not significant. The use of combined measures of sperm traits, including the ability to bind to ZP, showed a stronger predictive correlation with NRR (r = 0.68-0.75), compared with single traits. The results suggest that the combined analysis of sperm linear-motility patterns, swim-up separated sperm motility and absolute ZBA can provide a valuable assessment of the fertilizing capacity of AI bull semen.

Predicting the fertilizing potential of human sperm suspensions in vitro: importance of sperm morphology and leukocyte contamination

OBJECTIVE

To determine the relationships between sperm function tests and fertilization of human oocytes in vitro.

DESIGN

Analysis of infertile patients undergoing IVF therapy.

SETTING

Diagnostic Andrology Laboratory and Assisted Conception Service.

PATIENTS

Forty-one couples who underwent IVF-ET therapy were studied.

INTERVENTIONS

None.

MAIN OUTCOME MEASURES

The ability of human spermatozoa to achieve fertilization in vitro was examined in relation to numerous criteria of semen quality, including the conventional semen profile, the computer-aided assessment of sperm movement, ionophore-induced acrosome reaction, acridine orange staining, sperm morphology, and chemiluminescent signals induced by phorbol ester and N-formyl-methionyl-leucyl-phenylalanine (FMLP).

RESULTS

Significant correlations were observed between fertilization rates and several attributes of the sperm preparations, including elements of sperm function (acrosome reaction), movement (percentage motile, hyperactivation, the amplitude of lateral sperm head displacement), morphology (normal morphology, midpiece defects, multiple anomalies index), nuclear normality (acridine orange staining), and reactive oxygen species generation (chemiluminescence induced by phorbol ester and FMLP). In a stepwise multiple regression analysis, an accurate prediction of fertilization rates was obtained using a multiple regression equation incorporating six variables of which sperm morphology and FMLP-induced chemiluminescence were the most informative.

CONCLUSIONS

A set of criteria have been identified that accurately predict the fertilizing potential of human sperm suspensions in vitro and that place particular emphasis on sperm morphology and the degree of leukocyte contamination.

The hemizona assay is of good prognostic value for the ability of sperm to fertilize oocytes in vitro

OBJECTIVES

To assess the prognostic value of hemizona assay (HZA) in predicting the success of IVF.

DESIGN

Samples from 133 patients, who were referred for semen evaluation, were tested by HZA. Thirty samples were tested twice to assess interassay variation. Seventy couples were also referred for IVF. Results of HZA were compared with standard parameters of sperm quality, fertilization rates, and pregnancies.

RESULTS

The intra-assay and interassay coefficient of variation were 8% and 14%, respectively. Hemizona assay results had the highest correlation with sperm morphology (r = 0.60). Of all parameters evaluated, fertilization rates were best predicted by hemizona index (HZI) (r = 0.75). The assay was found to have high sensitivity and specificity rates, at a threshold HZI of 23%.

CONCLUSIONS

The HZA is a valuable prognostic test for IVF. With a threshold HZI of 23%, it has a good predictive value for fertilization rates in IVF, and may thus be used for patient preselection before IVF.

Anti-ZP3 antibodies binding to the human zona pellucida: effect of oocyte-storage conditions

PROBLEM

The zona pellucida protein 3 (ZP3) is a zona pellucida (ZP) glycoprotein crucially involved in fertilization. ZP3 plays a major role in sperm binding and induction of the acrosome reaction. In different species, ZP3 proteins differ in their primary structure as derived from cDNA clones. The hemizona assay (HZA) is a bioassay that evaluates binding of human sperm to human ZP and is highly predictive of fertilization outcome under in vitro conditions.

METHOD

In these studies, we used antisera generated against synthetic ZP3 peptides to compare antibody binding patterns to ZP with sperm-ZP binding capacity under different HZA conditions.

RESULTS

Analysis of antibody binding to hemizonae derived from metaphase II human oocytes that were used either after refrigeration at 4 degrees C or stored in a hyperosmotic salt solution revealed a strong reaction with human ZP3. However, treatment of human oocytes using a protocol to freeze embryos with the addition of 1,2 propanediol drastically reduced binding of ZP3 antibodies to the hemizonae. Nevertheless, no significant difference of sperm binding occurred under HZA conditions when oocytes were refrigerated, salt-stored, or frozen with 1,2 propanediol.

CONCLUSIONS

Our results indicate that the ZP3 protein backbone might be altered by 1,2 propanediol-treatment while the glycoprotein-receptor remains intact. We conclude that antisera against ZP3 peptides can be used as markers for the ZP3 protein backbone in human oocytes and might be useful tools for the evaluation of ZP3 protein integrity.

Sperm function and its manipulation for microassisted fertilization

Comprehension of the intricate complexities of sperm function is clearly crucial to the success of attempts to manipulate it for the purposes of assisted conception. This is particularly important when considering various procedures for microassisted fertilization since these bypass critical physiological events that are mandatory for normal fertilization, to varying degrees. Methylxanthine derivatives such as pentoxifylline are useful agents for the management of oligoasthenozoospermic patients. This is particularly so for procedures such as SUZI where adequate motility of spermatozoa injected into the perivitelline space is crucial for fusion with the vitelline membrane to achieve fertilization. The generation of minute concentrations of reactive oxygen species in vitro may prove to be a valuable technique in this respect, in the light of recent evidence for their involvement in capacitation and hyperactivation. Induction of the acrosome reaction by non-invasive, non-toxic agents should markedly improve success rates for microassisted fertilization. Acrosin appears to play a central role in this and, therefore, it would seem prudent to monitor levels of acrosin activity in samples of spermatozoa used in assisted conception procedures. With respect to microassisted fertilization, the potential to select recently acrosome-reacted spermatozoa coated by activated acrosin promises to be a major improvement. Current methods employed for determination of the fertilization potential of spermatozoa are clearly inadequate (Polansky and Lamb, 1988; Aitken, 1990). In fact, the prevailing evidence suggests that no single parameter of sperm function reflects this potential (Zaneveld and Jeyendran, 1988). Therefore, we have both a scientific and a moral responsibility to investigate these processes further. Subsequently, we should be in a position to identify individual gametes with the potential for fertilization and so utilize procedures that result in maximal fertilization rates with minimal risk of polyploidy or abnormality.

Subzonal insemination: a prospective randomized study in patients with abnormal sperm morphology

OBJECTIVE

To evaluate in a prospective randomized study the outcome of subzonal insemination (SUZI) in patients with male subfertility.

DESIGN

In a period of 7 months, 48 patients underwent IVF treatment for male subfertility reasons. Normal insemination and SUZI were performed on sibling oocytes. Patients were divided into three groups depending on the sperm morphology (strict criteria): group 1, 10% to 14%; group 2, 5% to 10%; group 3, 0% to 5%.

SETTING

Private fertility center in Leuven, Belgium.

MAIN OUTCOME MEASURES

The fertilization rates, cleavage rates, implantation rates, and pregnancy rates between the normally inseminated and the SUZI-treated group were compared.

RESULTS

The fertilization rate with SUZI was significantly higher (32%) than after normal insemination (7%). The difference was striking in groups 2 and 3 (35% and 33% versus 11% and 4%).

CONCLUSION

This study indicates that SUZI increases the fertility outcome in patients with male subfertility and that there is a marked difference in fertilization rate when morphology, using strict criteria, is < 10%.

The hemizona assay: its role in identifying male factor infertility in assisted reproduction

OBJECTIVES

To identify male factor infertility among a group of patients in an assisted reproductive program (phase 1) and to evaluate the hemizona assay (HZA) in the diagnosis and prognosis of such a program (phase 2).

DESIGN

The IVF performance of normal gametes in the Tygerberg program were critically evaluated. Female patients were classified as pure tubal factor infertility, having a normal FSH:LH ratio on day 3 of the menstrual cycle. All participating women produced three or more preovulatory oocytes at retrieval and were inseminated with sperm considered normal by all present diagnostic criteria. The total and normal fertilization rate thresholds were defined in that group. Using those thresholds, couples tested for sperm binding in the HZA (n = 48) were used and divided into two groups according to their fertilization rates, namely group 1, low fertilization (< 55%) and group 2, normal fertilization (> 55%).

SETTING

University-based tertiary care center.

PATIENTS

Ninety-nine couples (589 oocytes) with pure tubal factor infertility and normal male factor were used in phase 1. Forty-eight couples with normal and abnormal male factors that had both HZA performed and IVF treatment were included in phase 2.

RESULTS

Investigation of the performance of normal gametes in 99 couples (589 oocytes) revealed the total fertilization rate (total number of oocytes fertilized/total number of oocytes inseminated) was (mean +/- SD) 88.6% +/- 16.8% and the normal fertilization rate (total number of oocytes with normal fertilization/total number of oocytes inseminated) was 81.3% +/- 22%. The minimum total fertilization rate that can be considered normal in the Tygerberg program using mean--2 SD is therefore 55% and for normal fertilization rate is 37%. The group with low fertilization rate (< 55%) showed a mean hemizona index (HZI) significantly lower; nevertheless, the distribution overlapping indicates a low discriminating power of the HZA. A sensitivity of 75% and a specificity of 75% were found; the positive and negative predictive values were 81% and 68%, respectively.

CONCLUSIONS

The results indicated the HZA and HZI contribute important information and can serve in conjunction with other semen characteristics as useful tools during the diagnosis of the male factor in assisted reproduction.

Methods to evaluate reproductive health of the human male

The proportion of men suffering from subfertility has increased and sperm quality of the general population has decreased rather dramatically during the last decades. Conventional methods to measure sperm concentration, motility, and morphology give a rough estimate of the fertilizing capacity of semen. Objective assessment of motility characteristics and morphometric image analysis may give more precise information, but technology still needs to be refined. Some aspects of the functional capacity of spermatozoa may be impaired before measurable changes occur in their number or morphology. A battery of tests is described to evaluate sperm migration and capacitation, acrosome reaction and acrosin activity, zona adhesion and binding, sperm oolemma fusion, sperm head decondensation, and chromatin make-up. Also methods are described to localize the possible site of impairment of the genital tract. Implementation of these methods may enhance our capability to detect minor effects of environmental hazards on male reproductive health.