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Human Reproduction, Vol. 18, No. 3, 534-539, March 2003
© 2003 European Society of Human Reproduction and Embryology

The significance of the ionophore-challenged acrosome reaction in the prediction of successful outcome of controlled ovarian stimulation and intrauterine insemination

Guneet Makkar, Ernest Hung Yu Ng1, William Shu Biu Yeung and Pak Chung Ho

Department of Obstetrics & Gynecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of China

1 To whom correspondence should be addressed at: Department of Obstetrics & Gynecology, The University of Hong Kong, 6/F, Professorial Block, Queen Mary Hospital, Pokfulam Road, Hong Kong. e-mail: nghye{at}hkucc.hku.hk

BACKGROUND: This prospective study compared the acrosome reaction following ionophore challenge (ARIC) versus conventional sperm parameters and sperm velocities in predicting successful outcome following ovarian stimulation and intrauterine insemination. METHODS: All patients were offered a maximum of three treatment cycles. Conventional semen analysis was performed and sperm velocities were measured using computer-aided sperm analysis. Acrosome-reacted sperm were stained using chlortetracycline after ionophore challenge. Multiple logistic regression analysis and the receiver–operator characteristic curve analysis were applied to determine the best predictive variables and their cut-off values. RESULTS: ARIC score was the most significant variable in predicting pregnancy, followed by the percentage of induced acrosome-reacted sperm, serum estradiol levels on the day of hCG and sperm morphology by strict criteria. Higher spontaneous acrosome reaction had a negative relationship with pregnancy. ARIC score of 10% had a sensitivity of 85.3% and a specificity of 85.5%. The positive and negative predictive values were 64.2 and 96.6% respectively and the false positive and negative rates were 14.7 and 14.5% respectively. CONCLUSION: ARIC score was a better predictor of pregnancy than conventional sperm parameters and sperm velocities.

Key words: acrosome reaction/ARIC/calcium ionophore/intrauterine insemination


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