Acrobeads test as a predictor of fertilization in vitro.
OBJECTIVE
To determine whether the results of the Acrobeads test, which measures the expression of the complement regulator molecule CD46 on the inner acrosomal membrane following the acrosome reaction, accurately identifies semen specimens that will exhibit reduced or failed fertilization following conventional IVF insemination.


METHODS
The Acrobeads test was performed on semen specimens from 97 consecutive patients preparing to undergo an IVF cycle utilizing a standardized insemination protocol. Motile sperm populations were examined at 6 h and 24 h post-isolation for sperm-bead agglutination. Results of the Acrobeads test were compared to that of TRITC-PSA staining in matched specimens to directly measure the spontaneous loss of acrosome content. The percentages of TRITC-PSA-negative sperm were determined in freshly isolated motile populations and in duplicate aliquots incubated 18 to 20 h under sperm capacitating conditions. The relationship between the results of both analyses estimating spontaneous acrosome reactions and the rate of fertilization of metaphase II oocytes was examined.


RESULTS
The Acrobeads score did not correlate significantly with the rate of fertilization by insemination at 6 h or at 24 h. The negative predictive value of this test was 21.4%. There was no correlation between the Acrobeads score and the percentage of sperm undergoing a spontaneous acrosome reaction as detected by TRITC-PSA labeling. In contrast, the increment increase in the percentage of spontaneous acrosome reactions as quantified by TRITC-PSA staining was correlated with the fertilization rate.


CONCLUSIONS
Contrary to previous reports, our prospective, double-blinded study failed to demonstrate that the Acrobeads test can accurately predict fertilization outcome in IVF. Therefore, the routine use of this test to screen patients prior to an IVF cycle in order to select appropriate treatment (i.e., ICSI) cannot be recommended.
Hershlag
A
A
Department of Obstetrics and Gynecology, North Shore University Hospital-New York University School of Medicine, Manhasset 11030, USA.
Paine
T
T
Scholl
G M
GM
Rosenfeld
D L
DL
Mandel
F S
FS
Zhu
J Z
JZ
Guhring
P
P
Mecerod
D
D
Benoff
S
S
D000177:Acrosome / Q000276:immunology; D000372:Agglutination Tests; D004311:Double-Blind Method; D005307:Fertilization in Vitro; D005456:Fluorescent Dyes; D006801:Humans; D007248:Infertility, Male / Q000175:diagnosis / Q000276:immunology*; D037102:Lectins / Q000276:immunology; D008297:Male; D008863:Microspheres; D018532:Pisum sativum / Q000276:immunology; D037121:Plant Lectins; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012235:Rhodamines; D013073:Sperm Agglutination / Q000276:immunology
D005456:Fluorescent Dyes; D037102:Lectins; D037121:Plant Lectins; D012235:Rhodamines; C009434:tetramethylrhodamine isothiocyanate