Numerical dose-compensated in vitro fertilization inseminations yield high fertilization and pregnancy rates.
OBJECTIVE
To evaluate in cases with morphologically abnormal sperm whether fertilization and pregnancy rates are increased by normalizing the number of sperm inseminated and whether biomarkers can identify cases of reduced or failed fertilization.


METHODS
Prospective studies of sperm morphology and function.


METHODS
University hospital assisted human reproduction program.


METHODS
Partners of 308 women undergoing IVF.


METHODS
Motile sperm populations were assessed for sperm head morphology, for surface receptors for mannose and progesterone binding, and the ability to undergo a free mannose-induced acrosome reaction. Zinc in seminal plasma was determined by atomic absorption spectroscopy.


METHODS
Sperm morphology was associated with fertilization and clinical pregnancy rates. Biomarker analyses were correlated with fertilization rates using Kruskal-Wallis tests, chi2 tests, and Spearman rank order correlations.


RESULTS
Fertilization and pregnancy rates after numerical dose compensation inseminations were indistinguishable between men with differing percentages of normal sperm. Biomarker deficits were identified irrespective of sperm head morphology in 96% of cases of reduced or failed fertilization.


CONCLUSIONS
Fertilization and pregnancy rates in cases of abnormal morphology are optimized by inseminating at least 25,000 sperm/mL with normal acrosomes. Reduced or failed fertilization can be predicted by testing for molecular deficits in mannose receptor expression and mannose-stimulated acrosome loss.
Benoff
S
S
Department of Obstetrics and Gynecology, North Shore University Hospital-New York University School of Medicne, Manhasset 11030, USA. sbenoff@nshs.edu
Cooper
G W
GW
Paine
T
T
Hurley
I R
IR
Napolitano
B
B
Jacob
A
A
Scholl
G M
GM
Hershlag
A
A
D015415:Biomarkers / Q000032:analysis; D002462:Cell Membrane / Q000737:chemistry; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D007248:Infertility, Male / Q000628:therapy*; D037181:Lectins, C-Type; D008297:Male; D000090323:Mannose Receptor; D037241:Mannose-Binding Lectins; D011247:Pregnancy; D011446:Prospective Studies; D011956:Receptors, Cell Surface / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis; D012661:Semen / Q000737:chemistry; D013076:Sperm Count; D013094:Spermatozoa / Q000002:abnormalities* / Q000737:chemistry / Q000502:physiology; D013997:Time Factors; D015032:Zinc / Q000032:analysis
D015415:Biomarkers; D037181:Lectins, C-Type; D000090323:Mannose Receptor; D037241:Mannose-Binding Lectins; D011956:Receptors, Cell Surface; D011980:Receptors, Progesterone; D015032:Zinc