The acrosome index, radical buffer capacity and number of isolated progressively motile spermatozoa predict IVF results.
BACKGROUND
The accuracy by which a number of newly described semen variables can predict either total fertilization failure (TFF) or pregnancy outcome in IVF, has not previously been investigated. The study aim was, therefore, to determine prospectively the predictive value of these variables.


METHODS
The semen variables investigated were the post-wash total progressively motile sperm cell count (TPMC(post-wash)), the acrosome index (AI), 'cytoplasmic residues' and normal sperm morphology, evaluated according to the strict criteria ('strict criteria'), as well as the fast and slow total radical trapping antioxidant potential ('fast TRAP' and 'slow TRAP' respectively).


RESULTS
The study group (n = 87) showed a mean (+/- SD) number of 10.2 +/- SD retrieved oocytes, 12.6% TFF, a mean fertilization rate of 59.7% and a pregnancy rate of 19.5% (17/87). TFF was significantly predicted by TPMC(post-wash), 'strict criteria', AI and 'cytoplasmic residues' (all P < 0.05). The outcome after embryo transfer was significantly predicted by AI and 'fast TRAP'. Semen samples with an AI <5% and a 'fast TRAP' <1.14 mmol/l in particular did not result in any pregnancies after IVF-embryo transfer.


CONCLUSIONS
Of all the measured and calculated semen variables, TPMC(post-wash) was the best predictor of TFF, whilst AI and 'fast TRAP' were the best predictors of pregnancy after IVF.
Rhemrev
J P
JP
IVF Centre, Department of Reproductive Medicine, Academic Hospital Vrije Universiteit, de Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
Menkveld
R
R
Roseboom
T J
TJ
van Overveld
F W
FW
Teerlink
T
T
Lombard
C
C
Vermeiden
J P
JP
D020101:Acrosome Reaction; D000328:Adult; D002021:Buffers; D005260:Female; D005306:Fertilization; D005307:Fertilization in Vitro; D005544:Forecasting; D006801:Humans; D008297:Male; D009865:Oocytes; D011237:Predictive Value of Tests; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D013048:Specimen Handling; D013076:Sperm Count; D013081:Sperm Motility; D017211:Treatment Failure; D016896:Treatment Outcome
D002021:Buffers