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• W2014691494 abstract "Conventional semen analysis is not a good predictor of successful outcome of in vivo insemination, intrauterine insemination (IUI) or hysteroscopic intra-tubal insemination (HIT), or a predictor of complete fertilization failure (CFF) in conventional IVF (IVF). We investigated whether calcium ionophore induced acrosome reaction provides an additional indicator of pregnancy among various assisted reproduction modalities as well as an indicator of complete fertilization failure in IVF, independent of conventional semen parameters, sperm concentration and motility. prospective study Subjects included infertile couples with no female infertility factors (n=478) and women with tubal obstruction (n=32). Procedures included conventional IVF (IVF): n=148, ICSI: n=72, HIT: n=245, IUI: n=61. They all underwent a standard protocol of history-taking, physical examination and investigations including conventional semen analysis as well as a test of the sperm acrosome reaction following ionophore challenge. Every patient gave an informed consent prior to participating in this study, which was approved by the local Institutional Review Board, Faculty of Medicine. Calcium ionophore induced acrosomal reactivity was assessed in spermatozoa selected by swim-up. Spermatozoa on the slide were subjected to staining with fluorescent isothiocyanate-conjugated pisum sativum agglutinin (FITC-PSA) and with Hoescht 33258. Spermatozoa were considered viable when their heads were unstained or stained only lightly with Hoechst 33258. When the equatorial segment strongly stained with FITC-PSA, the spermatozoon was considered to have reacted. The percentage of acrosome-reacted spermatozoa to viable spermatozoa (%AR) was calculated. At least 300 spermatozoa per sample were examined to determine the %AR. We excluded abnormal or deformed spermatozoa, as well as unclassifiable fluorescence patterns. Multiple logistic regression analysis and receiver-operator characteristic (ROC) curve analysis were performed to determine the best predictive variables and cut-off values in the prediction of fertilization rate and pregnancy in each modality. χ-square analysis was used to compare the different fertilization and pregnancy rates. P<0.05 was considered significant. Cut-off value of %AR for IVF was 21% and the value was independent from the parameters of conventional semen analysis in predicting fertilization rate and pregnancy. Fertilization rate on IVF was higher for those with %AR over 21% compared to that of those with a lower percentage (63.6% vs. 35.4%; p<0.01). The pregnancy rate was also higher (43.1% vs. 18.9%; p<0.01). CFF was lower for those with %AR over 21% (24.5% vs. 4.2%,p<0.01). Fertilization rate, pregnancy rate, and CFF on ICSI did not differ for those with %AR over 21%. Pregnancy rates were higher for those with %AR over 21% than for those with a lower percentage on IUI (28.0% vs. 5.6%, p<0.05) and on HIT (23.9% vs. 6.2%, p<0.01). These data shows that %AR may be a novel parameter independent of conventional semen parameters in choosing assisted reproduction modalities. Thus, patients with acrosomal reactivity below 21% could not achieve pregnancy by IUI, HIT, or IVF with high rates. With reactivity below 21%, a low fertilization rate for initial IVF, ICSI or split fertilization is indicated." @default.
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• W2014691494 date "2004-09-01" @default.
• W2014691494 modified "2023-10-14" @default.
• W2014691494 title "Prediction of outcomes of assisted reproductive technology treatment by calcium ionophore-induced acrosome reaction" @default.
• W2014691494 doi "https://doi.org/10.1016/j.fertnstert.2004.07.547" @default.
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