Prognosis for sperm fertilizability: analysis of different variables in men

Sperm Dna Integrity: Correlation With Sperm Plasma Membrane Integrity In Semen Evaluated For Male Infertility

Previous independent studies have indicated that abnormally low parameters of sperm DNA integrity and sperm membrane integrity correlate to reduced fertility due in part to implantation disorders. The purpose of our study was to evaluate the relationship between sperm plasma membrane functional integrity assessed by the hypo-osmotic swelling test (HOST) and sperm DNA integriy test assesed by DNA fragmentation index (DFI). Semen samples from 102 random patients were evaluated in terms of standard semen parameters and assessed by DFI and HOST. Both tests showed a significant correlation to standard semen parameters (p < .05). In addition, patients with abnormal HOST results had a higher likehood of a subnormal or abnormal DFI result (p < .001). Our results suggest that a common sublethal insult may manifest as abnormalities in both the nucleus and the plasma membrane that act at the implantation and/or subsequent levels of development rather than at the fertilization stage.

Levels of P34H, a sperm protein of epididymal origin, as a predictor of conventional in vitro fertilization outcome

A prospective double-blind study was performed to determine if Western blot detection of P34H, a sperm protein of epididymal origin that is involved in the binding to the zona pellucida, is predictive of standard IVF outcome. Our results demonstrate that the proportion of positive P34H cases that produced embryos in vitro clearly differs from cases with undetectable levels of P34H (P<.001).

Antisperm Antibodies in Semen, Sera and Follicular Fluids of Infertile Patients: Relation to Reproductive Outcome afterIn VitroFertilization

PROBLEM

Data given in the literature, regarding the influence of antisperm antibodies (ASA) in the semen and/or sera on in vitro fertilization (IVF) procedure outcome are controversial. The aim of this study was to compare the prevalence of ASA in semen, peripheral blood and follicular fluid as well as to determine total immunoglobulin concentration in the serum and follicular fluid. Selected parameters were analyzed with regard to IVF outcome.

METHOD OF STUDY

The study enrolled 52 married couples. ASA in the semen was determined by direct immunobead mixed antiglobulin reaction (MAR Screen test), while in the peripheral blood and follicular fluid was determined by indirect immunobead MAR Screen test. Immunoglobulin (IgG, IgM and IgA) concentration in the follicular fluid and serum was determined by a liquid-phase immunoprecipitation assay with nephelometric end-point detection and analyzed with regard to IVF outcome.

RESULTS

Semen MAR test IgG was < 20% in 38 couples, and > 20% in 14 couples. Fertilization (73.2% versus 71.5%) and pregnancy rates (28.9% versus 28.57%) in both groups of patients were not significantly different. The results of direct and indirect MAR test were not associated with fertilization and pregnancy rates. Total serum IgG, IgM and IgA in infertile women were within normal ranges. Follicular fluid IgG was within normal values for serum samples, while IgA and IgM were decreased.

CONCLUSION

The presence of ASA on sperm or in the serum and follicular fluid was not associated with IVF outcome in the couples with good quality semen characteristic.

Effect of an abnormal sperm chromatin structural assay (SCSA) on pregnancy outcome following (IVF) with ICSI in previous IVF failures

A high DNA fragmentation index (DFI) when performing the sperm chromatin structural (SCSA) assay was claimed to be so specific for male subfertility that even IVF and ICSI did not result in live pregnancies. The present study was designed to corroborate or refute these findings. The SCSA test was performed on the male partner from couples failing to have a successful pregnancy despite at least 2 previous IVF attempts. In contrast to the aforementioned studies, ongoing pregnancies were found despite working with a group of recalcitrant patients. Nevertheless, a high DFI score was associated with a trend for lower ongoing pregnancy rates especially related to a high miscarriage rate. Other more recent studies seem to support our conclusions. A high DFI score should influence a patient to choose IVF as a therapeutic modality sooner, especially with ICSI.

Discrepancy between sperm acrosin activity and sperm morphology: significance for fertilization in vitro

BACKGROUND

In routine semen analysis, discrepancies may occur between sperm acrosin activity test results and sperm acrosomal morphology.

METHODS

Discrepant test results of sperm acrosin activity (spectrophotometric assay) vs. sperm morphology (strict criteria) in the initial diagnostic investigation of 107 infertile couples were evaluated with respect to fertilization rate (% oocytes with 2 pronuclei) further obtained in IVF treatment.

RESULTS

Acrosin activity positively correlated with sperm morphology (% normal forms) (r=0.537) and fertilization rate (r=0.526). ROC curves for the prediction of > or =50% fertilization rate were comparable for acrosin activity and sperm morphology, with optimal cutoff values at 25 microIU/10(6) sperm and 10%, respectively. In multiple regression analysis, sperm acrosin activity (P=0.002) predicted fertilization rate independently of sperm morphology (P<0.001) and sperm vitality (eosin-nigrosin stain) (P=0.03). Acrosin activities > or =25 microIU/10(6) sperm were observed in 36% of severe teratozoospermic samples (< or =4% normal spermatozoa) associated with low fertilization rate. Twenty percent of the morphologically normal ejaculates showed a low acrosin activity (<25 microIU/10(6) sperm) and low hypoosmotic swelling test (HOST) scores (31.4+/-7.6%) and were associated with low fertilization rate.

CONCLUSION

The sperm acrosin assay can help to predict sperm fertilizing capacity in IVF independently of sperm morphology.