Are sperm DNA fragmentation hyperactivation and hyaluronan binding ability predictive for fertilization and embryo development in in vitro fertilization and intracytoplasmic sperm injection

Capsule:
Because DNA fragmentation, hyaluronan-binding ability, and induced hyperactivity of spermatozoa correlate with the fertilization rate after in vitro fertilization, blastocyst formation can be predicted by the sperm DNA fragmentation rate.

Authors:
Barbara Pregl Breznik, B.Sc., Borut Kovačič, Ph.D., Veljko Vlaisavljević, Ph.D., M.D.

Volume 99, Issue 5, Pages 1233-1241, April 2013

Abstract:

Objective:
To determine the diagnostic value of the following sperm function tests in predicting the fertilizing ability of spermatozoa in conventional IVF and ICSI: hyaluronan binding assay (HBA), DNA fragmentation (Halosperm) and hyperactivity.

Design:
Prospective study.

Setting:
University Medical Centre.

Patients:
One hundred thirty-three couples undergoing infertility treatment with IVF/ICSI.

Interventions:
Analysis of sperm DNA fragmentation, hyaluronan binding ability and hyperactivation on washed semen samples used for the insemination of oocytes.

Main outcome measure(s):
Correlation between the results of sperm function tests and the fertilization rate (FR) or embryo quality (EQ) after IVF and ICSI. Comparison of the sperm DNA fragmentation, hyperactivation and hyaluronan binding ability between cycles with less than 50% (Group 1) and more than 50% (Group 2) of oocytes fertilized after IVF.

Results:
Both FR and EQ in IVF cycles negatively correlated with sperm DNA fragmentation. Furthermore, a positive correlation was observed between FR and hyaluronan binding ability or induced hyperactivity. The semen samples from the IVF cycles with low FR (Group 1) were characterized by significantly higher sperm DNA fragmentation and lower hyaluronan binding ability in comparison with semen samples from the group with high levels of fertilization (Group 2). In ICSI cycles, no relationship was found between sperm function tests and FR or EQ.

Conclusions:
The Halosperm test, the HBA test and induced hyperactivity are useful in predicting the ability of spermatozoa to fertilize oocytes in IVF and are helpful in distinguishing semen samples suitable for IVF or ICSI.

  • Ki

    This is a very interesting study. Characterization of the predictive power of assays beyond the standard semen analysis is critically necessary if we are to improve our diagnostic capabilities. While your scatter plots are helpful in illustrating clinical correlates, I would love to see receiver operator characteristic curves to better understand the sensitivity and specificity of the various measures you evaluated. Did you perform any analyses to establish clinically relevant cutoffs using your datasets?

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