Human Reproduction, Vol. 16, No. 6, 1185-1190,
June 2001
© 2001 European Society of Human Reproduction and Embryology
Frequency of disordered zona pellucida (ZP)-induced acrosome reaction in infertile men with normal semen analysis and normal spermatozoa–ZP binding
1 University of Melbourne Department of Obstetrics and Gynaecology, 2 Reproductive Services, 3 Andrology Laboratory, Royal Women's Hospital and 4 Melbourne IVF, Victoria 3053, Australia
Results of zona pellucida (ZP)-induced acrosome reaction (AR) are reported for 186 normospermic men with unexplained infertility and compared with 34 normal fertile men and 54 patients with disordered ZP-induced AR (DZPIAR) diagnosed after failure of standard IVF. For each ZP-induced AR test, four oocytes that failed to fertilize in IVF were incubated for 2 h with 2x106/ml motile spermatozoa. Spermatozoa tightly bound to the ZP were recovered by aspirating the oocytes with a pipette and the AR assessed using pisum sativum agglutinin labelled with fluorescein. The standard deviation of the difference was 5.2% for repeated tests for ZP-induced AR on different ejaculates from 54 men. The ranges for the ZP-induced AR were 3–98% for normospermic infertile men, 24–95% for fertile men and 0–16% for DZPIAR patients. In the normospermic group, there was a significant correlation between ZP-induced AR and sperm concentration (Spearman r = 0.238, P < 0.001). Using ZP-induced AR 
16% as the threshold for diagnosis of DZPIAR, the frequency of this condition in normospermic infertile men would be 25%. Thus DZPIAR is common with normospermic idiopathic infertility and this condition should be diagnosed before assisted reproductive technology since it requires intracytoplasmic sperm injection.
Key words: disordered ZP-induced AR/male infertility/semen analysis
5 To whom correspondence should be addressed. Email: dyl{at}unimelb.edu.au
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