TEST-egg yolk buffer storage increases the capacity of human sperm to penetrate hamster eggs in vitro

The effect of a two-hour, room temperature incubation of human spermatozoa in TEST-yolk buffer on the rate of fertilization in vitro

PURPOSE

To reassess the use of TEST-yolk buffer (TYB) in an in vitro fertilization (IVF) program by comparing fertilization rates achieved in a glucose-free cleavage medium by the standard IVF preparation of sperm versus a 2-h, room temperature incubation of sperm in TYB.

METHODS

Oocytes collected for IVF were randomly split into two groups and inseminated with either TYB-treated sperm or IVF-prepared sperm.

SETTING

Stanford Reproductive Endocrinology and Infertility Center.

PATIENTS

Fifty couples undergoing IVF with at least 10 mature oocytes.

MAIN OUTCOME MEASURES

Fertilization rates in vitro.

RESULTS

Fertilization rates were significantly higher (p = 0.015) with TYB treatment. The average 2PN fertilization rate was 49.6% (188/379) for the IVF group and 57.4% (221/385) in the IVF with TYB group.

CONCLUSIONS

A 2-h, room temperature incubation of sperm in TYB produces significantly higher 2PN fertilization rates as compared to standard IVF preparation of sperm in a current generation cleavage medium.

Association between freezing agent and acrosome damage of human spermatozoa from subnormal and normal semen

This experimental study compares the effects of human sperm preservation medium (HSPM) with TEST-yolk buffer (TYB) as cryoprotectants of human spermatozoa with respect to the integrity of the acrosome after the freeze-thawing procedure. Fifty-six semen samples were included in this study; 18 were subnormal (G1) and 38 were normal (G2) based on World Health Organization criteria, except for morphology, which was evaluated according to strict criteria. Each semen sample was divided into two parts: the first part was prepared for cryopreservation by the addition of HSPM (1:1) and the second by addition of TYB (1:1). Freezing was performed in liquid nitrogen vapour. Smears were made before freezing and after the thawing process for evaluation of acrosome integrity using fluorescent-lectin labelling. The mean percentage of spermatozoa with intact acrosomes in the subnormal group was 77.0 +/- 7.2% before freezing and decreased significantly (P < 0.001) after thawing: to 63.7 +/- 8.2% with the use of HSPM and 66.8 +/- 8.7% with the use of TYB. The corresponding values in the normal semen samples were 83.4 +/- 9.2%, 76.0 +/- 8.8% and 77.9 +/- 9.2%, respectively. It is obvious that the decrease in the mean percentage of spermatozoa with intact acrosome was significantly higher when using HSPM in comparison with TYB, not only for G1 (-14.9 +/- 1.9% versus -11.8 +/- 1.4%) but also for G2 samples (-13.8 +/- 1.5% versus -11.9 +/- 1.3%). In conclusion, TYB should be recommended for freeze-thawing of human spermatozoa as the first-choice cryoprotectant, for normal as well as subnormal semen samples, in order to protect the sperm acrosome from the deleterious effects of the freeze-thawing procedure.

Analysis of TEST (TES and Tris) yolk buffer effects on human sperm

OBJECTIVE

To assess different parameters of TEST (TES and Tris) yolk buffer (TYB) treatment of human sperm that may contribute to the biologic effects of TYB on sperm function.

DESIGN

The influence of TYB treatment on occurrence of acrosome reactions was studied, as was the influence of the concentration of acrosome-reacted sperm reacted by TYB or Biggers-Whitten-Whittingham medium (BWW) incubation on penetration levels in the sperm penetration assay (SPA). The necessity for the TYB to achieve enhanced SPA performance as well as the effect of heat shock on sperm also were studied.

SETTING

Andrology laboratory of a university hospital.

PATIENTS

Sperm donors.

MAIN OUTCOME MEASURES

Sperm penetration levels in the SPA and acrosomal loss as evaluated by a fluorescent lectin staining technique.

RESULTS

Sperm incubated in TYB for 42 to 46 hours at 4 degrees C demonstrated a higher rate of acrosomal loss than did sperm capacitated in BWW media for 20 to 22 hours. The difference was not significant. When insemination concentrations were normalized to identical concentrations of acrosome-reacted sperm, TYB treated specimens demonstrated much higher penetration levels compared with BWW specimens. Samples incubated in BWW versus TYB for 42 to 46 hours at 4 degrees C before heat shock had identical penetration levels. Samples washed with 37 degrees C BWW (positive heat shock) had significantly higher penetration levels than did samples washed with 4 degrees C BWW (negative heat shock).

CONCLUSION

Although TYB treatment does increase the occurrence of acrosome reactions, this alone does not account for the dramatic increase in penetration levels in SPA seen with these samples. TEST yolk buffer is not required for enhancement of penetration, and the heat shock step of the procedure seems to be most important for enhancement of sperm fusion ability in the SPA.

Enhanced quality of capacitated spermatozoa from oligoasthenozoospermic men after incubation in test yolk medium

To improve artificially the quality of poor sperm samples to be used in assisted procreation procedures, Test Yolk Buffer (TYB) incubation effect was investigated. After adding the TYB procedure to the standard swim-up technique, a significant (P < 0.001) increase in spermatozoa velocity was observed, while the other seminal parameters were not affected. Three of 11 couples who had not had success after three intraperitoneal inseminations (IPI) with sperm prepared by the usual swim-up technique obtained pregnancies after IPI with TYB-incubated spermatozoa. These preliminary results suggest that TYB incubation for capacitated spermatozoa be employed in the assisted procreation strategies applied for male infertility.

A prospective controlled evaluation of TEST-yolk buffer in the preparation of sperm for human in vitro fertilization in suspected cases of male infertility

OBJECTIVE

To evaluate sperm preincubation in tes and tris (TEST)-yolk buffer as a potential enhancing agent of fertilizing capacity of sperm during human in vitro fertilization (IVF).

DESIGN

Oocytes obtained during IVF were divided into two groups: one group fertilized with TEST-yolk buffer-treated sperm and the other group with standard-prepared sperm.

SETTING

The University of Southern California IVF Program.

PATIENTS

Thirty-nine couples with suspected male factor infertility undergoing IVF.

INTERVENTIONS

Preinsemination incubation of sperm in TEST-yolk buffer for 24 hours.

MAIN OUTCOME MEASURES

Fertilization rates in vitro.

RESULTS

TEST-yolk buffer-treated sperm fertilized 140 of 241 oocytes (58%), whereas control sperm fertilized 108 of 251 oocytes (43%). Of four couples who had previously failed to fertilize during IVF, one fertilized with both specimens and three fertilized with TEST-yolk buffer-treated sperm only.

CONCLUSIONS

TEST-yolk buffer pretreatment of sperm for 24 hours results in higher fertilization rates during IVF among suspected male factor patients.

The effect of egg yolk medium on human sperm binding in the hemizona assay

OBJECTIVE

To evaluate, using the hemizona assay (HZA), whether egg yolk treatment of human sperm enhances binding to the human zona pellucida in vitro and to determine whether such a treatment is as efficient as the standard swim-up procedure for promoting sperm binding ability.

DESIGN

Ejaculates were divided into aliquots and half incubated at 37 degrees C for 21 hours in standard culture medium or combined with buffered medium containing chicken egg yolk and stored at 4 degrees C for 21 hours. A second set of ejaculates were split and processed by a standard 1-hour rise alone or treated with egg yolk medium.

SETTING

University teaching hospital.

PARTICIPANTS

Two healthy sperm donors.

MAIN OUTCOME MEASURE

The number of sperm tightly bound to the hemizona were measured and compared between the groups.

RESULTS

A significant increase (P less than 0.0001) in hemizona binding (n = 46) for egg yolk treatment (90.1 +/- 9.8; range 7 to 258) as compared with standard culture medium (53.0 +/- 8.8; range 0 to 228) was observed. Similarly, a significant increase (P less than 0.0001) in binding (n = 37) for egg yolk treatment (74.9 +/- 8.2; range 7 to 219) as compared with samples obtained with a sperm rise (37.1 +/- 5.7; range 2 to 122).

CONCLUSIONS

Treatment of human spermatozoa with an egg yolk medium at 4 degrees C overnight significantly increases sperm binding in the HZA.

Comparative study on the use of human follicular fluid or egg yolk medium to enhance the performance of human sperm in the zona-free hamster oocyte penetration assay

A prospective study was conducted on 61 unselected semen samples from infertile patients to compare the efficacy of human follicular fluid (hFF) or TEST-egg yolk medium treatment in enhancing sperm performance in the zona-free hamster oocyte penetration (HOP) test. Both hFF and TEST-egg yolk enhanced penetration scores significantly in the HOP test in comparison with the control swim-up sperm preparation. The TEST-egg yolk medium treatment, however, exhibited the highest penetration scores, and there were higher percentages of preparations passing the 10 or 20% penetration rate cut-off point with sperm exposed to the TEST-egg yolk medium than those exposed to hFF. These results indicate that modification of the original HOP-test protocol by incorporation of TEST-egg yolk medium gives a greatly increased penetration rate when compared to the addition of hFF in such a system.

Induction of the acrosome reaction in sperm by exposure to low temperature increases their rate of fusion with zona-free hamster oocytes

The fusion rate of human sperm with zona-free hamster ova was investigated after induction of the acrosome reaction by exposure to a low temperature (4 degrees C). Sperm were collected from 14 patients, and selected by the 'swim-up' method. The sperm were incubated for 24 h at either room temperature (control group) or at 4 degrees C (low temperature group), followed by additional incubation at 37 degrees C for 3 h. The mean sperm penetration rate, number of swollen sperm heads as well as the number of sperm attached to the oocyte increased significantly after exposing sperm to low temperature. The sperm penetration rate showed a significant correlation (Spearman test, r = 0.572, n = 28, P less than 0.0035) with the acrosome reaction in the low temperature group. These results were associated with an increase in the rate of penetration of hamster ova observed in this study, presumably due to the increase in induction of the acrosome reaction by low temperature. Incubation of sperm at low temperature might be useful in the evaluation of so-called false negative results in the zona-free hamster test.

Fertilization failure and dysfunctions as possible causes for human idiopathic infertility

Consideration of the most common currently practiced laboratory assays for human spermatozoal fertility are discussed, with reference to the relevance of such assays to success or failure in human in vitro fertilization (IVF). Such IVF therapy should be the definitive challenge for human spermatozoal fertilization ability. However, when fertilization fails, is polyspermic, or is suboptimal, then questions concerning the step or steps in the process of fertilization which are dysfunctional remain unanswered. Quite possibly new assays need to be devised to address these problems, while in the meantime our present laboratory assay systems need to be improved to discern those defects in fertilization which operate in many cases of human idiopathic infertility.

Comparison of characteristics of human spermatozoa selected by the multiple-tube swim-up and simple discontinuous Percoll gradient centrifugation

The multiple-tube swim-up (MT-SU) and simple, discontinuous Percoll gradient centrifugation are two recent methods for the processing of human spermatozoa for assisted reproductive technologies. The present study was undertaken to compare the effects of these two methods on various parameters of spermatozoal qualities of normospermic semen samples. Both methods were found to select spermatozoa of better percentage motility, percentage normal morphology, viability, functional integrity of plasma membrane, movement characteristics including the curvilinear velocity, linearity of movement and head beat frequency, and in vitro fertilizing capacity with comparable degree of efficacy. It is concluded that both methods are effective for the separation of spermatozoa from normospermic semen samples for use in infertility treatment.

The diagnostic value of seminal adenosine triphosphate (ATP) in an in vitro fertilization (IVF) program

The level of adenosine triphosphate (ATP) was quantitated in semen samples used for in vitro fertilization of human oocytes. Seminal ATP level correlated with the concentration and percentage motility of spermatozoa but not with the in vitro fertilization rate of human oocytes. Seminal ATP measurement appears to have little diagnostic value in predicting the fertilizing capacity of spermatozoa as evaluated by the multivariate stepwise discriminant analysis.

Establishment of TEST-yolk buffer enhanced sperm penetration assay limits for fertile males

TEST-yolk buffer has been shown to enhance sperm penetration of zona-free hamster eggs. Review of sperm penetration assay (SPA) data from a fertile population was undertaken to determine a normal range for SPA with TEST-yolk buffer enhancement. Thirty-eight intrauterine insemination patients and 4 artificial insemination donors who had successfully initiated a pregnancy within 18 months of SPA analysis were examined. All 42 enhanced SPAs demonstrated penetration of greater than 10%, and 37 of these (88%) yielded SPA values of greater than or equal to 20%. Thirty-three percent (14/42) of these individuals achieved 0% penetration in the SPA without TEST-yolk buffer. The SPA performed with the TEST-yolk modification has fewer false negatives than the assay done with the original methodology.

Identification of the capacitating agent for bovine sperm in egg yolk-TEST semen extender

Bovine sperm can be capacitated in egg yolk-TEST buffer. To determine what constituent of the buffer was responsible, ejaculated semen was diluted 1:10 at 37 degrees C with the following 20% egg yolk (vol/vol)-containing buffers: TES-Tris, TES-tetramethylammonium hydroxide, taurine-Tris, citric acid-Tris, citrate, egg yolk salts, egg yolk proteins Tris, and citrate-taurine. Buffers were pH 7.6 and 321 to 325 mOsmol/kg. Extended semen was cooled slowly to 4 degrees C and stored 8 h. Sperm taken at 0 and 8 h were washed in pH 7.6 bovine serum albumin-saline and assessed for motility and capacitation using zona-free hamster eggs. Sperm motilities at 0 and 8 h were similar (60 to 73%) in all extenders except citric acid-Tris (54%) and egg yolk proteins Tris (15%). Bull sperm, stored 8 h in egg yolk-TEST, became capacitated. Because sperm storage in egg yolk-citrate did not result in penetration, both egg yolk and citrate were ruled out as capacitating agents. Capacitating activity resided in the TES and Tris molecules. The TES molecule contains a Tris component and this capacitated bull sperm. The TES molecule also contains a taurine component. However, taurine was not a capacitating agent for bull sperm. In conclusion, both TES- and Tris-containing buffers, alone or together (TEST), were equally effective in capacitating bull sperm.

Induction of bovine sperm capacitation by TEST-yolk semen extender

Ejaculated bull semen was diluted 1:10 in the TEST-yolk buffer, cooled slowly to 4 degrees C, and stored for up to 48 h. Aliquots were taken at 0, 4, 8, 16, 24, and 48 h and washed once or three times in bovine serum albumin-saline and the sperm pellets resuspended in this saline. Fertilization of zona-free hamster oocytes was used to assess sperm capacitation. Motility differed between samples washed once or three times (53.7 vs. 21.7%). Motility was highest at 4 h storage but did not differ between 16, 24, or 48 h of storage. More sperm without intact acrosomes were found at 4 h than at 0 h, but the percentage did not change further until after 24 h. Penetration of oocytes was not different between sperm washed once or three times (28.5 vs. 26.9%). No penetration occurred at 0 h, and highest penetration rates occurred at 4 and 8 h of storage (32.1 and 33.4%). Penetration rates at 16, 24, and 48 h were not different (25.3, 25.2, 22.5%). In conclusion, storage of bull sperm in TEST-yolk buffer for 4 to 48 h resulted in capacitation. Even though capacitation was induced by 4 h, at least 71% of the sperm population had not undergone an acrosome reaction by 48 h of storage. This may explain why penetrability was maintained over this period.

Preincubation of human spermatozoa in test-yolk medium: effect on penetration of zona-free hamster oocytes and correlation with other semen characteristics

Penetration of zona-free hamster oocytes by human spermatozoa after preincubation with BWW medium (standard technique) or a buffer system containing egg yolk (TESTY) was compared by applying both treatments to aliquots of 60 ejaculates from 34 patients. The TESTY-treated spermatozoa penetrated the oocytes much more successfully than the spermatozoa treated by the standard technique. Although the penetration levels achieved by the two methods were significantly correlated, the correlation coefficient was too low to predict the penetration outcome from one technique to the other. More consistent results were obtained when different ejaculates from the same donor were treated by TESTY than by the standard technique. Spermatozoan penetrating ability was more strongly correlated with sperm concentration, motility, and morphology after treatment by the standard technique than after TESTY treatment. Much larger differences in penetration were present between normal and abnormal ejaculates when the standard technique was used than TESTY.

Evaluation of computerized analysis of sperm movement characteristics and differential sperm tail swelling patterns in predicting human sperm in vitro fertilizing capacity

Multivariate discriminant analysis was used to evaluate the usefulness of computer image analysis of sperm movement characteristics and differential patterns of sperm tail swelling after hypoosmotic treatment for predicting the human sperm in vitro fertilizing capacity assessed by the zona-free hamster egg penetration assay. Fifty-five semen samples, mostly normospermic, from untreated infertility clinic patients were analyzed. The % normal sperm morphology, linearity of seminal sperm movement, seminal sperm head beat frequency, mean and maximum amplitudes of lateral head displacement, and hypoosmotic sperm tail swelling patterns c, d and f were selected by multivariate discriminant analysis to be capable of discriminating the samples exhibiting the presence or the absence of sperm in vitro fertilizing capacity. The % total sperm tail swelling did not give additional information about in vitro fertilizing capacity. These preliminary data suggest that computer image analysis of sperm movement characteristics and differential evaluation of hypoosmotic sperm tail swelling might be useful for the prediction of human sperm fertility. Further prospective studies are necessary to validate their predictive functions.