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Hum. Reprod. Advance Access originally published online on March 21, 2009
Human Reproduction 2009 24(7):1569-1574; doi:10.1093/humrep/dep068
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© The Author 2009. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Evaluation of male fertility potential by Toluidine Blue test for sperm chromatin structure assessment

I. Tsarev1, M. Bungum2, A. Giwercman2, J. Erenpreisa3, T. Ebessen4, E. Ernst4 and J. Erenpreiss1,5

1 Andrology Laboratory, Riga Stradins University, Riga LV 1007, Latvia 2 Reproductive Medicine Centre, Malmo University Hospital, Lund University, Malmo, Sweden 3 Biomedicine Research and Study Centre, Riga, Latvia 4 Cryos International Sperm Bank, Åarhus, Denmark

5 Correspondence address. E-mail: jerenpreiss{at}gmail.com

BACKGROUND: We have previously suggested that the Toluidine Blue (TB) test can be used for sperm chromatin structure assessment. In this study, we wished to evaluate the clinical applicability of the TB test in assessing male fertility potential using well-defined groups of fertile and infertile men.

METHODS: Sixty-three fertile and 79 infertile men were tested. Infertility thresholds for the proportion of sperm with abnormal [TB dark cells (TBDCs)] and normal [TB light cells (TBLCs)] chromatin structure were set by the ROC curve analysis.

RESULTS: Thresholds of 45% TBDC and 20% TBLC were highly predictive for infertility (specificity of the test: 92 and 90%, respectively), but they were poor predictors of the fertility (sensitivity of the test: 42 and 32%, respectively). Odds ratio for infertility was 7.5 [95% confidence interval (CI): 2.7–20.8] when the 45% TBDC threshold was used and 4.4 (95% CI: 1.7–11.6) when the 20% TBLC threshold was used.

CONCLUSIONS: The TB test can be suggested for clinical use as a complementary test for standard semen analysis to diagnose male infertility.

Key words: Toluidine Blue/sperm chromatin/male infertility/diagnostic test

Submitted on May 31, 2008; resubmitted on January 7, 2009; accepted on February 24, 2009.


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