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Prediction of in vitro fertilization outcome by sperm penetration assay with TEST-yolk buffer preincubation
1Department of Obstetrics and Gynecology, Tel Aviv University, Sackler School of Medicine, Assaf Harofe Medical Center, Zerifin, Israel.
Objective:
To evaluate sperm penetration assay (SPA) value as a screening tool before in vitro fertilization (IVF).
Design:
Follow-up study comparing sperm variables and IVF outcome.
Setting:
Infertile couples in an academic research environment.
Patients, Participants:
Two hundred forty-one infertile couples scheduled for IVF.
Interventions:
Sperm penetrating assay with cold Tes-TRIS (TEST) Yolk buffer semen preincubation and IVF.
Main Outcome Measures:
Percent of egg penetration recoded into poor and good category (0% to 20%, 21% to 100%) and compared with fertilization, embryo transfer, and pregnancy rate (PR) in IVF, as well as sperm count motility and morphology.
Results:
Sperm penetrating assay predicted fertilization with a high negative (74%) and positive (82%) predictive rate and good specificity value (0.96). One of 31 patients in the poor SPA category (3%) fertilized less than 50% of eggs; no pregnancy occurred. In the good SPA category, 87 of 210 patients (41%) fertilized greater than or equal to 50% of eggs with 34.3% PR. Sperm penetrating assay correlated better with fertilization rate than did sperm count and motility but not morphology.
Conclusions:
Sperm penetrating assay is a useful screening assay before IVF together with sperm morphology.