Effect of abnormal hypo-osmotic swelling test on fertilization rate and pregnancy outcome in in vitro fertilization cycles.
OBJECTIVE
To assess the value of the hypo-osmotic swelling test in predicting fertilization, pregnancy, implantation, miscarriage, and live birth rates in IVF-ET cycles.


METHODS
Prospective study.


METHODS
Academic tertiary referral center for fertility treatment.


METHODS
Three hundred twenty-six couples having IVF-ET for tubal damage or male factor infertility with the female partner < 38 years of age.


METHODS
Each male had a hypo-osmotic swelling test performed between 4 and 8 weeks before IVF-ET.


METHODS
Fertilization, implantation, miscarriage, and live birth rates.


RESULTS
Eighty of 326 men had abnormal hypo-osmotic swelling tests. An abnormal test was not associated with lower fertilization rates (odds ratio [OR] = 1.14; 95% confidence interval [CI] = 0.97 to 1.14) or pregnancy rate (OR = 0.98; CI = 0.50 to 1.96). However, although couples with a normal test had a miscarriage rate of 26.9% (14/52), in the group with an abnormal test the miscarriage rate was 50.0% (7/14) (OR = 0.37; CI = 0.09 to 1.49). This resulted in a reduction in the live birth rate from 14.1% in the group with a normal test to 11.8% in patients with an abnormal test (OR = 1.23; CI = 0.45 to 3.87).


CONCLUSIONS
The hypo-osmotic swelling test has little value in predicting fertilization in IVF-ET procedures. However, an abnormal test may help predict adverse outcome if pregnancy is achieved.
Biljan
M M
MM
Department of Obstetrics and Gynaecology, University of Liverpool. marinko@rvhob2.lan.mcgill.ca
Buckett
W M
WM
Taylor
C T
CT
Luckas
M
M
Aird
I
I
Kingsland
C R
CR
Lewis-Jones
D I
DI
D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D002462:Cell Membrane / Q000502:physiology / Q000648:ultrastructure; D005260:Female; D005306:Fertilization / Q000502:physiology*; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D015994:Incidence; D007248:Infertility, Male / Q000209:etiology / Q000503:physiopathology; D008297:Male; D009997:Osmotic Pressure; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011446:Prospective Studies; D013081:Sperm Motility / Q000502:physiology; D013094:Spermatozoa / Q000166:cytology / Q000502:physiology* / Q000648:ultrastructure