title: Male partner screening before in vitro fertilization: preselecting patients who require intracytoplasmic sperm injection with the sperm penetration assay.
abstract: OBJECTIVE
  To determine the diagnostic accuracy of the sperm penetration assay (SPA) and standard semen parameters for subsequent fertilization in in vitro fertilization-embryo transfer (IVF-ET).
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Andrology Laboratory, and university research laboratory.
  
  
  METHODS
  Two hundred sixteen couples undergoing male-partner screening before IVF-ET (265 cycles).
  
  
  METHODS
  Male-partner screening (semen analyses [SA] and SPA), standard IVF-ET procedures, follow-up of fertilization in IVF-ET.
  
  
  METHODS
  Diagnostic accuracy of SA and SPA for prediction of fertilization in IVF-ET.
  
  
  RESULTS
  The SPA predicted IVF fertilization with high negative (84%) and positive (98%) predictive rates, and correct prediction in 88% of cycles. In contrast, sperm concentration, motility, morphology, and complete SA showed poor diagnostic accuracy, with correct prediction of IVF fertilization in 64%, 65%, 45%, and 68% of cycles, respectively.
  
  
  CONCLUSIONS
  Very low sperm concentration and/or motility were good predictors of poor IVF fertilization, however, low to normal semen parameters were not predictive of successful IVF fertilization. The SPA is a useful screening tool that predicts IVF fertilization with high diagnostic accuracy. The SPA may be useful to discriminate between those couples with a high probability of normal fertilization in IVF and those with a low probability of normal fertilization that may benefit from assisted fertilization by intracytoplasmic sperm injection (ICSI).
authors.affiliation: Nashville Fertility Center, Nashville, Tennessee 37203, USA. mfreeman@nashvillefertility.com
authors.forename: M R
authors.initials: MR
authors.lastname: Freeman
authors.forename: A E
authors.initials: AE
authors.lastname: Archibong
authors.forename: J J
authors.initials: JJ
authors.lastname: Mrotek
authors.forename: C M
authors.initials: CM
authors.lastname: Whitworth
authors.forename: G A
authors.initials: GA
authors.lastname: Weitzman
authors.forename: G A
authors.initials: GA
authors.lastname: Hill
mesh_terms: D000818:Animals; D006224:Cricetinae; D004624:Embryo Transfer; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D005306:Fertilization / Q000502:physiology; D006801:Humans; D008297:Male; D008647:Mesocricetus; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D013076:Sperm Count; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D013081:Sperm Motility; D013084:Sperm-Ovum Interactions / Q000502:physiology*