Abstract
Purpose: To investigate if including evaluation of acrosome index (AI) in the semen analysis of teratozoospermic samples could help to predict for which patients intracytoplasmic sperm injection (ICSI) is necessary.
Methods: The fertilization rate, pregnancy rate, and percentage of good quality embryos were compared after performing conventional in vitro fertilization (IVF) and ICSI, respectively, using sibling oocytes. The role of AI was evaluated by dividing patients into two groups; Group A (AI < 7%) and Group B (AI ≥ 7%).
Results: A significant difference in fertilization rate was observed between Group A and B after conventional IVF. In Group A, the fertilization rate, embryo transfer rate, and percentage of good quality embryos were higher after ICSI than after IVF. In Group B, the fertilization and pregnancy rates were numerically but not significantly higher after IVF compared to ICSI.
Conclusion: Evaluation of acrosome index will not accurately predict fertilization, although this study shows that a sperm sample with less than 5% normal forms and an AI greater than 7% may achieve a mean fertilization rate >70% after conventional IVF.
Keywords: acrosome index, fertilization, ICSI, IVF, sibling oocytes, teratozoospermia
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REFERENCES
- 1.Kruger TF, Menkveld R, Stander FSH, Lombard CJ, Van der Merwe JP, van Zyl JA, Smith K. Sperm morphologic features as a prognostic factor in in vitro fertilization. Fertil Steril. 1986;46:1118–1123. doi: 10.1016/s0015-0282(16)49891-2. [DOI] [PubMed] [Google Scholar]
- 2.Enginsu ME, Dumoulin JCM, Pieters MHEC, Bras M, Evers JLH, Geraedts JPM. Evaluation of human sperm morphology using strict criteria after Diff-Quik staining: Correlation ofmorphology with fertilization in vitro. Hum Reprod. 1991;6:854–858. doi: 10.1093/oxfordjournals.humrep.a137440. [DOI] [PubMed] [Google Scholar]
- 3.Grow DR, Swanson RJ, Oehninger S, Kruger TF, Seltman HJ, Muasher SJ, Toner JP. Spermmorphology 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]
- 4.Ombelet W, Fourie FL, Vandeput H, Bosmans E, Cox A, Janssen M, Kruger T. Teratozoospermia and in-vitro fertilization: A randomized prospective study. Hum Reprod. 1994;9:1479–1484. doi: 10.1093/oxfordjournals.humrep.a138734. [DOI] [PubMed] [Google Scholar]
- 5.Vawda AI, Gunby J, Younglai EV. Semen parameters as predictors of in-vitro fertilization: The importance of strict criteria sperm morphology. Hum Reprod. 1996;11:1445–1450. doi: 10.1093/oxfordjournals.humrep.a019417. [DOI] [PubMed] [Google Scholar]
- 6.Küpker W, Al-Hasani S, Schulze W, Kühnel W, Schill T, Felberbaum R, Diedrich K. Morphology in intracytoplasmic sperm injection: Preliminary results. J Assist Reprod Genet. 1995;12:620–626. doi: 10.1007/BF02212586. [DOI] [PubMed] [Google Scholar]
- 7.Nagy ZP, Liu J, Joris H, Verheyen G, Tournaye H, Camus M, Derde M-P, Devroey P, Van Steirteghem AC. The result of intracytoplasmic sperm injection is not related to any of the basic sperm parameters. Hum Reprod. 1995;10:1123–1129. doi: 10.1093/oxfordjournals.humrep.a136104. [DOI] [PubMed] [Google Scholar]
- 8.Svalander P, Jakobsson A-H, Forsberg A-S, Bengtsson A-K, Wikland M. The outcome of intracytoplasmic sperm injection is unrelated to 'strict criteria' sperm morphology. Hum reprod. 1996;11:1019–1022. doi: 10.1093/oxfordjournals.humrep.a019289. [DOI] [PubMed] [Google Scholar]
- 9.Lundin K, Söderlund B, Hamberger L. The relationship between sperm morphology and rates of fertilization, pregnancy and spontaneous abortion in an in-vitro fertilization/ intracytoplasmic injection programme. Hum Reprod. 1997;12:2676–2681. doi: 10.1093/humrep/12.12.2676. [DOI] [PubMed] [Google Scholar]
- 10.Pisarska MD, Casson PR, Cisneros PL, Lamb DJ, Lipshultz LI, Buster JE, Carson SA. Fertilization after standard in vitro fertilization versus intracytoplasmic sperm injection in subfertile males using sibling oocytes. Fertil Steril. 1999;71:627–632. doi: 10.1016/s0015-0282(98)00538-x. [DOI] [PubMed] [Google Scholar]
- 11.Menkveld R, Rhemrev JPT, Franken DR, Vermeiden J, Kruger TF. Acrosomal morphology as a novel criterion for male fertility diagnosis: Relation with acrosin activity, morphology (strict criteria), and fertilization in vitro. Fertil Steril. 1996;65:637–644. doi: 10.1016/s0015-0282(16)58167-9. [DOI] [PubMed] [Google Scholar]
- 12.Menkveld R, Stander FSH, Kruger TF.Comparison between acrosome index and teratozoospermia index as additional criteria to sperm morphology in the prediction of expected in-vitro fertilization outcome Hum Reprod 1998131049512238 [Google Scholar]
- 13.Liu DY, Baker HW. The proportion of human sperm with poor morphology but normal intact acrosomes detected with Pisum sativum agglutinin correlates with fertilization in vitro. Fertil Steril. 1988;50:288–293. doi: 10.1016/s0015-0282(16)60075-4. [DOI] [PubMed] [Google Scholar]
- 14.Liu D, Baker H. Test of human sperm function and fertilization in vitro. Fertil Steril. 1992;58:465–483. doi: 10.1016/s0015-0282(16)55247-9. [DOI] [PubMed] [Google Scholar]
- 15.WHO Laboratory Manual for the Examination of Human Semen and Sperm-Cervical Mucus Interaction. Cambridge: Cambridge University Press; 1992. [Google Scholar]
- 16.Menkveld R, Oettlé EE, Kruger TF, Swanson RJ, Acosta AA, Oehninger S. Atlas of Human Sperm Morphology. Baltimore, MD: Williams & Wilkins; 1991. [Google Scholar]
- 17.Kruger TF, Swanson RJ, Acosta AA, Matta JF, Simmons KF, Oehninger S. 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]
- 18.Liu DY, Bourne H, Baker HW. Fertilization and pregnancy with acrosome intact sperm by intracytoplasmic sperm injection in patients with disordered zona pellucida-induced acrosome reaction. Fertil Steril. 1995;64:116–121. [PubMed] [Google Scholar]
- 19.Kruger TF, Matta JF, Acosta AA, Veeck LL, Simmons K, Swanson RJ, Brugo S. A new method of evaluating sperm morphology with predictive value for human in vitro fertilization. Urology. 1987;30:248–251. doi: 10.1016/0090-4295(87)90246-9. [DOI] [PubMed] [Google Scholar]
- 20.Robinson JN, Lockwood GM, Dokras A, Egan DM, Nicholson SC, Ross C, Barlow H. Does isolated teratozoospermia affect performance in in-vitro fertilization and embryo transfer. Hum Reprod. 1994;9:870–874. doi: 10.1093/oxfordjournals.humrep.a138608. [DOI] [PubMed] [Google Scholar]
- 21.Coetzee K, Kruger TF, Lombard CJ. Predictive value of normal sperm morphology: A structured literature review. Hum Reprod Update. 1998;4:73–82. doi: 10.1093/humupd/4.1.73. [DOI] [PubMed] [Google Scholar]
- 22.Höst E, Lindenberg S, Ernst E, Christensen F. Sperm morphology and IVF: Embryo quality in relation to sperm morphology following the WHO and Kruger's strict criteria. Acta Obstet Gynecol Scand. 1999;78:526–529. [PubMed] [Google Scholar]
- 23.Ron-el R, Nachum H, Herman A, Golan A, Caspi E, Soffer Y. Delayed fertilization and poor embryonic development associated with impaired semen quality. Fertil Steril. 1991;55:338–344. doi: 10.1016/s0015-0282(16)54127-2. [DOI] [PubMed] [Google Scholar]
- 24.Parinaud J, Mieusset R, Vieitez G, Labal B, Richoilley G. Influence of sperm parameters on embryo quality. Fertil Steril. 1993;60:888–892. doi: 10.1016/s0015-0282(16)56292-x. [DOI] [PubMed] [Google Scholar]
- 25.Oehninger S, Kruger TF, Simon T, Jones D, Mayer J, Lanzendorf S, Toner JP, Muasher SJ. 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]
- 26.Benoff S, Cooper GW, Paine T, Hurley IR, Napolitano B, Jacob A, Scholl GM, Hershlag A. Numerical dosecompensated in vitro fertilization inseminations yield high fertilization and pregnancy rates. Fertil Steril. 1999;71:1019–1028. doi: 10.1016/s0015-0282(99)00136-3. [DOI] [PubMed] [Google Scholar]
