Prediction of outcomes of assisted reproduction treatment using the calcium ionophore-induced acrosome reaction.
BACKGROUND
Sperm concentration and motility are poor predictors of the outcome of intrauterine insemination (IUI), hysteroscopic intratubal insemination (HIT), or complete fertilization failure (CFF) in conventional IVF. We investigated whether the calcium ionophore-induced acrosome reaction (AR) constitutes an additional indicator of CFF and pregnancy that is independent of these semen parameters.


METHODS
Infertile couples with no female factor (n=388) and women with tubal obstruction (n=32) were studied: IVF (n=133), ICSI (n=72), HIT (n=245) and IUI (n=61). The percentage of acrosome-reacted sperm in relation to viable sperm was calculated. Receiver operating characteristic curve and multiple logistic regression analyses were used to determine threshold values and the best predictor for CFF and pregnancy.


RESULTS
Threshold values of AR for predicting CFF in IVF and pregnancy in IVF and HIT + IUI were 21, 26 and 22% respectively. These values were independent of the conventional semen analysis parameters. CFF was lower (2 versus 20%; P<0.01) and the pregnancy rate was higher (46 versus 24% P<0.05) for those with AR >21% in IVF. CFF and pregnancy rate in ICSI did not differ according to AR. Pregnancy rate was higher for those with an AR >22% for HIT + IUI (23 versus 11% P<0.01).


CONCLUSIONS
Ionophore-induced AR appears to be a useful indicator in addition to routine semen analysis for selection of patients for treatment with appropriate assisted reproduction procedure.
Katsuki
Takafumi
T
Department of Obstetrics and Gynecology, Infectious Disease Control and Prevention, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
Hara
Tetsuaki
T
Ueda
Katsunori
K
Tanaka
Junko
J
Ohama
Koso
K
D020101:Acrosome Reaction; D002118:Calcium / Q000378:metabolism*; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis*; D007248:Infertility, Male / Q000175:diagnosis*; D007476:Ionophores; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D012372:ROC Curve; D027724:Reproductive Techniques, Assisted; D013081:Sperm Motility
D007476:Ionophores; D002118:Calcium