Z. T. Homonnai

The hemizona assay is of good prognostic value for the ability of sperm to fertilize oocytes in vitro

OBJECTIVESnTo assess the prognostic value of hemizona assay (HZA) in predicting the success of IVF.nnnDESIGNnSamples from 133 patients, who were referred for semen evaluation, were tested by HZA. Thirty samples were tested twice to assess interassay variation. Seventy couples were also referred for IVF. Results of HZA were compared with standard parameters of sperm quality, fertilization rates, and pregnancies.nnnRESULTSnThe intra-assay and interassay coefficient of variation were 8% and 14%, respectively. Hemizona assay results had the highest correlation with sperm morphology (r = 0.60). Of all parameters evaluated, fertilization rates were best predicted by hemizona index (HZI) (r = 0.75). The assay was found to have high sensitivity and specificity rates, at a threshold HZI of 23%.nnnCONCLUSIONSnThe HZA is a valuable prognostic test for IVF. With a threshold HZI of 23%, it has a good predictive value for fertilization rates in IVF, and may thus be used for patient preselection before IVF.

Improved fertilization rate in an in vitro fertilization program by egg yolk-treated sperm.

High fertilization and PRs have been achieved by using thawed donor sperm cryopreserved with medium containing EY. The aim of our study was to examine the possible effect of EY on the fertilizing capacity of fresh sperm in an IVF program. Preincubation of spermatozoa in EY for 2 hours at room temperature significantly improved fertilization (P less than 0.001) in couples who had low fertilization rates in previous cycles, whereas no effect was found concerning couples with high fertilization rates.

Pentoxifylline improves sperm binding to the zona pellucida in the hemizona assay

OBJECTIVEnTo evaluate the effect of pentoxifylline on sperm binding capacity to zona pellucida (ZP) using the hemizona assay (HZA).nnnDESIGNnThe fertility potential of 82 men was evaluated by routine semen analysis. Each ejaculate was incubated with or without pentoxifylline (3 mM) in Hams F-10 medium (Flow Laboratories, Irvine, Scotland) before the HZA. The effect of the pentoxifylline treatment on sperm-binding capacity to ZP was assessed by the hemizona index.nnnRESULTSnThe mean hemizona indexes with medium or pentoxifylline treatment were 23% +/- 2.1% (mean +/- SE) and 41% +/- 3.4%, respectively. Taking into consideration a significant change of the hemizona index on rising above the intra-assay coefficient of variation (+/- 8%) after pentoxifylline treatment, 73.1% of specimens improved, 19.5% deteriorated, and 7.4% remained unchanged. Using a threshold hemizona index of 23% as a discriminator between fertile and infertile specimens, 43.5% of the pentoxifylline-improved samples ascended to the fertile zone (> 23%). No correlations were found between sperm variables in the raw semen and the effect of pentoxifylline on sperm binding capacity.nnnCONCLUSIONnPentoxifylline may improve the binding capacity of human spermatozoa. However, this effect is confined to a selected group of patients and cannot be predicted by the basic sperm variables. Thus, to avoid uncertain or damaging effects of pentoxifylline while preparing sperm suspension for assisted reproductive techniques, it is recommended that its effect be tested by the HZA system before its use.

The predictive fertilization value of the hypoosmotic swelling test (HOST) for fresh and cryopreserved sperm.

BackgroundThe hypoosmotic swelling test (HOST) was recommended as a predictive test for in vitro fertilization (IVF) outcome. These results, however, were controversial and the results for thawed semen were insufficient. The present study was conducted in order to clarify the predictive value of the HOST for IVF in fresh and thawed sperm.Methods:The hypoosmotic swelling test was performed in three groups: husbands fresh semen “subfertile” group, donors thawed semen group, and donors fresh semen “fertile” group.ResultsNo correlation was found between HOST values and sperm characteristics in fresh or thawed sperm. Fresh sperm HOST values correlated with IVF fertilizations. No such correlations were found when thawed sperm was used. HOST values were significantly higher in the fresh fertile donor group than in the fresh subfertile group (P <0.001). Following the freezing and thawing process, HOST values decreased dramatically. Nevertheless, the fertilization rate was still higher compared to that of the fresh subfertile group (P <0.001). There were significantly more IVF cycles with no fertilizations when HOST values were below 45%.ConclusionThe HOST has a predictive value for fertilization of oocytes in IVF cycles when fresh semen, but not thawed sperm, is used. The freezing—thawing process affects the outer membrane of the spermatozoon and changes its characteristics, leading to a decrease in HOST values. Sperm characteristics that play a role in the fertilization process are not expressed directly by HOST values.

Advanced methods for evaluation of sperm quality

Summary Routine semen analysis includes measurements of sperm concentration, motility, and morphology. In our study, three additional tests were evaluated in relation to fertilization rate in an in vitro fertilization program: the freezing and hypo‐osmotic swelling tests that evaluate the functional integrity and stability of the sperm membrane under extreme osmotic conditions, and migration sedimentation test that isolates high‐quality motile sperm cells. The study was performed on semen delivered by men of couples treated at the In Vitro Fertilization Unit, and men who served as semen donors (fresh or cryopreserved semen). No correlation was found between the sperm fertilization rate, and the decrease in motility percent following the freezing‐thawing process. Thus, the freezing test cannot be used to predict semen fertilization capacity. The hypo‐osmotic swelling test was applied on semen given by a similar population of men. While the hypo‐osmotic swelling test values carried out with fresh semen was found to have good correlation with fertilization, no correlation was found when frozen thawed semen was used. Post‐migration sedimentation test sperm characteristics, and especially the recovery rate of the motile sperm, were significantly better in in vitro fertilization cycles with fertilizations. Both the hypo‐osmotic swelling test and migration sedimentation test can assist in evaluating semen quality, judged by the fertilization rate in an in vitro fertilization program.

The efficiency of cryopreserved semen versus fresh semen for in vitro fertilization/embryo transfer

The efficiency of cryopreserved donor semen versus fresh donor semen in an in vitro fertilization/embryo transfer programme was evaluated. Thirty-nine in vitro fertilization/embryo transfer cycles were performed using fresh donor semen (group A) and 74 cycles were carried out using cryopreserved semen (group B). All patients anderwent a uniform controlled ovarian hyperstimulation using high doses of human menopausal gonadotropins. Oocytes were retrieved transvaginally under ultrasound imaging. Semen (fresh or frozen-thawed) were prepared for insemination by a washing technique. Each ovum was inseminated with 500,000–600,000 motile spermatozoa. No significant difference was noted between the two groups regarding female age, duration of infertility, and number of ova retrieved per aspiration. Even though the fertilization rate in group B was significantly lower than in group A (55.5±3.8 vs 70.4±3.5,P=0,008); pregnancy rates per embryo transfer were similar-39.3 and 38.5%, respecitively.

Separation of sperm cells by sedimentation technique is not suitable for in vitro fertilization purposes

Summary. Two methods of sperm preparation for in vitro fertilization were compared: the swim‐up technique vs. the migration‐sedimentation technique. The study comprised fresh semen samples obtained from 25 couples treated in the In Vitro Fertilization Unit. Oocytes aspirated in a single cycle were divided into two groups, each inseminated by sperm prepared by one of these techniques. Motility, degree of motility, and normal morphology were improved by both methods. The improvement was greater when the migration‐sedimentation technique was applied. However, fertilization rate was significantly higher after the swim‐up technique. In order to clarify this contradiction, an additional group of 26 semen samples was divided and then prepared by the swim‐up or migration‐sedimentation techniques. Sperm quality was examined up to 72 h after separation. Compared with the swim‐up technique, sperm characteristics were better after separation by the migration‐sedimentation technique. However, this difference abated after 24 h. The better results of the swim‐up technique in the ‘survival experiment’ may explain its improved performance in in vitro fertilization, despite lower separation capacity. Thus, the migration‐sedimentation technique is not recommended for sperm preparation in in vitro fertilization.

The Effect of Massage Treatment of Prostatic Congestion on the Prostatic Size and Secretion of Citric Acid

Auswjrkung der Prostatamassage auf Prostatagröße und Zitronensäure‐Sekretion