Abstract
Purpose: To corroborate or refute a previous study demonstrating that in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) is an effective therapy for infertility related to males with subnormal hypoosmotic swelling tests (HOST). The study would also determine if the copresence of poor morphology has any adverse effect on outcome.
Methods: Clinical and viable pregnancy rates and implantation rates were evaluated in a second series of patients. The data were further stratified according to whether the semen specimen demonstrated morphology using strict criteria <4% normal vs ≥4%.
Results: Clinical and viable pregnancy rates and implantation rates were 49.1, 45.3, and 23.4% for those with subnormal HOST scores and subnormal morphology vs 38.0, 34.3, and 22.5% for those with low HOST and strict morphology ≥4% (p = NS, chi-square analysis).
Conclusions: In vitro fertilization with ICSI is an effective therapy for infertility related to subnormal HOST scores. Poor morphology does not adversely affect the outcome.
Keywords: Hypoosmotic swelling test, intracytoplasmic sperm injection, sperm morphology, strict criteria
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References
- 1.JeyendranRS, Van d. V., Perez-PalaezM, CraboBG, ZaneveldLJD Development of an assay to assess the functional integrity of the human sperm membrane and its relationship to other semen characteristics. J Reprod Fertil. 1984;70:219–228. doi: 10.1530/jrf.0.0700219. [DOI] [PubMed] [Google Scholar]
- 2.CheckJH, EpsteinR, NowrooziK, ShanisBS, WuCH, BollendorfA The hypoosmotic swelling test as a useful adjunct to the semen analysis to predict fertility potential. Fertil Steril. 1989;52:159–161. doi: 10.1016/s0015-0282(16)60808-7. [DOI] [PubMed] [Google Scholar]
- 3.BarrattCLR, OsbornJC, HarrisonPE, MonksN, DunphyBC, LentonEA, CookeID The hypoosmotic swelling test and the sperm mucus penetration test in determining fertilization of the human oocyte. Hum Reprod. 1989;4:430–434. doi: 10.1093/oxfordjournals.humrep.a136922. [DOI] [PubMed] [Google Scholar]
- 4.SjoblumP, CocciaE On the diagnostic value of the hypoosmotic sperm swelling test in an in vitro fertilization program. J In Vitro Fertil Embryo Transfer. 1989;6:41–43. doi: 10.1007/BF01134580. [DOI] [PubMed] [Google Scholar]
- 5.AveryS, BoltonUM, MasonBA An evaluation of the hypoosmotic sperm swelling test as a predictor of fertilizing capacity in vitro. Int J Androl. 1990;13:93–99. doi: 10.1111/j.1365-2605.1990.tb00966.x. [DOI] [PubMed] [Google Scholar]
- 6.EnginsuME, DumoulinJCM, PietersMHEC, BergersM, EversJLH, GeraedtsJPM Comparison between the hypoosmotic swelling test and morphology evaluation using strict criteria in predicting in vitro fertilization (IVF) J Assist Reprod Genet. 1992;9:259–264. doi: 10.1007/BF01203825. [DOI] [PubMed] [Google Scholar]
- 7.ChanSYW, WangC, ChanSTH, HoPC Differential evaluation of human sperm hypoosmotic swelling test and its relationship with the outcome of in-vitro fertilization of human oocytes. Hum Reprod. 1990;5:84–88. doi: 10.1093/oxfordjournals.humrep.a137047. [DOI] [PubMed] [Google Scholar]
- 8.CheckJH, StumpoL, LurieD, BenferK, CallanC A comparative prospective study using matched samples to determine the influence of subnormal hypo-osmotic test scores of spermatozoa on subsequent fertilization and pregnancy rates following in-vitro fertilization. Hum Reprod. 1995;10:1197–1200. doi: 10.1093/oxfordjournals.humrep.a136118. [DOI] [PubMed] [Google Scholar]
- 9.KatsoffD, CheckML, CheckJH Evidence that sperm with low hypoosmotic swelling test scores cause embryo implantation defects. Arch Androl. 2000;44:227–230. doi: 10.1080/014850100262218. [DOI] [PubMed] [Google Scholar]
- 10.CheckJH, KatsoffD, CheckML Some semen abnormalities may cause infertility by impairing implantation rather than fertilization. Med Hypoth. 2001;56:653–657. doi: 10.1054/mehy.2000.1166. [DOI] [PubMed] [Google Scholar]
- 11.KrugerTF, AcostAA, SimmonsKF, SwansonRJ, MattaJF, OehningerS Predictive value of abnormal sperm morphology in in vitro fertilization. Fertil Steril. 1988;49:112–117. doi: 10.1016/s0015-0282(16)59660-5. [DOI] [PubMed] [Google Scholar]
- 12.OehningerS, SwansonRJ, AcostaAA, SimmonsKF, MorsttediM, RosenwaksZ, VeeckL Corrective measures and pregnancy outcome in in vitro fertilization in patients with severe sperm morphology abnormalities. Fertil Steril. 1988;50:283–287. doi: 10.1016/s0015-0282(16)60074-2. [DOI] [PubMed] [Google Scholar]
- 13.RogersBJ, BentwoodH, Van C., HelmbrechtD, SoderdahlD, HaleRW Sperm morphology assessment as an indicator of human fertilizing capacity. J Androl. 1983;4:119–125. doi: 10.1002/j.1939-4640.1983.tb00735.x. [DOI] [PubMed] [Google Scholar]
- 14.CheckJH, AdelsonHG, SchubertBR, BollendorfA Evaluation of sperm morphology using Kruger's strict criteria. Arch Androl. 1992;28:15–17. doi: 10.3109/01485019208987674. [DOI] [PubMed] [Google Scholar]
- 15.CheckML, BollendorfA, CheckJH, KatsoffD Reevaluation of the clinical importance of evaluating sperm morphology using strict criteria. Arch Androl. 2002;48:1–3. doi: 10.1080/014850102753385134. [DOI] [PubMed] [Google Scholar]
- 16.KieferD, CheckJH, KatsoffD The value of motile density, strict morphology, and the hypoosmotic swelling test in in vitro fertilization-embryo transfer. Arch Androl. 1996;37:57–60. doi: 10.3109/01485019608988502. [DOI] [PubMed] [Google Scholar]
- 17.CheckJH, KatsoffD, CheckML, ChoeJK, SwensonK In vitro fertilization with intracytoplasmic sperm injection is an effective therapy for male factor infertility related to subnormal hypo-osmotic swelling test scores. J Androl. 2001;22:261–265. [PubMed] [Google Scholar]
- 18.KrugerTF, AcostaAA, SimmonsKF, SwansonRJ, MattaJF, VeeckLL, MorshedimM, BrugoS A new method of evaluating sperm morphology with with predictive value for in vitro fertilization. Urology. 1987;30:248. doi: 10.1016/0090-4295(87)90246-9. [DOI] [PubMed] [Google Scholar]
- 19.GrowD, OehningerS, SeltmanH, TonerJ, SwansonRJ, DrugerT, MuasherSJ Sperm morphology as diagnosed by strict criteria probing the impact of teratozoospermia on fertilization rate and pregnancy outcome in a large in vitro fertilization population. Fertil Steril. 1994;62:559–567. doi: 10.1016/s0015-0282(16)56946-5. [DOI] [PubMed] [Google Scholar]
- 20.HammittDG, WalkerDL, SyropCH, MillerTM, BennettMR Treatment of severe male factor infertility with high concentrations of motile sperm by microinsemination in embryo cryopreservation straws. J In Vitro Fertil Embryo Transf. 1991;8:101–110. doi: 10.1007/BF01138663. [DOI] [PubMed] [Google Scholar]
- 21.OehningerS, KrugerTF, SimonT, JonesD, MayerJ, LanzendorfS, TonerJP, MuasherSJ A comparative analysis of embryo implantation potential in patients with severe teratozoospermia undergoing in-vitro fertilization with a high insemination concentration or intracytoplasmic sperm injection. Hum Reprod. 1996;11:1086–1089. doi: 10.1093/oxfordjournals.humrep.a019302. [DOI] [PubMed] [Google Scholar]