Human Reproduction, Vol. 16, No. 9, 1885-1892,
September 2001
© 2001 European Society of Human Reproduction and Embryology
The acrosome index, radical buffer capacity and number of isolated progressively motile spermatozoa predict IVF results*
1 IVF Centre, Department of Reproductive Medicine, 2 Department of Clinical Chemistry, Academic Hospital Vrije Universiteit, de Boelelaan 1117, 1081 HV, Amsterdam, 3 Department of Clinical Epidemiology and Biostatistics, University Medical Centre, University of Amsterdam, Amsterdam, The Netherlands, 4 Andrology Laboratory E3, Reproductive Biology Unit, Department of Obstetrics and Gynaecology, Tygerberg Hospital and University of Stellenbosch, Tygerberg 7505, and 5 Biostatistics, MRC, Cape Town, South Africa
BACKGROUND: The accuracy by which a number of newly described semen variables can predict either total fertilization failure (TFF) or pregnancy outcome in IVF, has not previously been investigated. The study aim was, therefore, to determine prospectively the predictive value of these variables. METHODS: The semen variables investigated were the post-wash total progressively motile sperm cell count (TPMCpost-wash), the acrosome index (AI), `cytoplasmic residues' and normal sperm morphology, evaluated according to the strict criteria (`strict criteria'), as well as the fast and slow total radical trapping antioxidant potential (`fast TRAP' and `slow TRAP' respectively). RESULTS: The study group (n = 87) showed a mean (± SD) number of 10.2 ± SD retrieved oocytes, 12.6% TFF, a mean fertilization rate of 59.7% and a pregnancy rate of 19.5% (17/87). TFF was significantly predicted by TPMCpost-wash, `strict criteria', AI and `cytoplasmic residues' (all P < 0.05). The outcome after embryo transfer was significantly predicted by AI and `fast TRAP'. Semen samples with an AI <5% and a `fast TRAP' <1.14 mmol/l in particular did not result in any pregnancies after IVF-embryo transfer. CONCLUSIONS: Of all the measured and calculated semen variables, TPMCpost-wash was the best predictor of TFF, whilst AI and `fast TRAP' were the best predictors of pregnancy after IVF.
Key words: fertilization failure/IVF/pregnancy/spermatozoa/TRAP
* Presented in part at the 56th Annual Meeting of the American Society for Reproductive Medicine, October 22–25, 2000, San Diego, California, USA
6 Present address: Department of Obstetrics and Gynaecology, Bronovo Hospital, Bronovolaan 5, 2597 AX, The Hague, The Netherlands
7 To whom correspondence should be addressed. E-mail: j.vermeiden{at}azvu.nl