Hemizona Assay and Sperm Penetration Assay in the Prediction of IVF Outcome: A Systematic Review

Abstract

The limited predictive value of semen analysis in achieving natural conception or in IVF outcome confirms the need for sperm function tests to determine optimal management. We reviewed HZA and SPA predictive power in IVF outcome, with statistical significance of diagnostic power of the assays. HZA was readily efficient in predicting IVF outcome, while evident inconsistency among the studies analysed framed the SPA's role in male fertility evaluation. Considerable variation was noted in the diagnostic accuracy values of SPA with wide sensitivity (52–100%), specificity (0–100%), and PPV (18–100%) and NPV (0–100%) together with fluctuation and notable differentiation in methodology and cutoff values employed by each group. HZA methodology was overall consistent with minor variation in cutoff values and oocyte source, while data analysis reported strong correlation between HZA results with IVF outcome, high sensitivity (75–100%), good specificity (57–100%), and high PPV (79–100%) and NPV (68–100%). HZA correlated well with IVF outcome and demonstrated better sensitivity/specificity and positive/negative predictive power. Males with normal or slightly abnormal semen profiles could benefit by this intervention and could be evaluated prior to referral to assisted reproduction. HZA should be used in a sequential fashion with semen analysis and potentially other bioassays in an IVF setting.

Sperm function tests in clinical practice

“…SPA measures the capacitation ability of spermatozoa, acrosome reaction, fusion and penetration through the oolemma and decondensation within the cytoplasm of hamster oocytes. [8] Vogiatzi et al [9] reported higher sensitivity (52%-100%), specificity (0-100%) and positive predictive value (PPV; 18%-100%) and negative predictive value (NPV; 0-100%) in terms of the diagnostic accuracy of SPA. The standardization and reproducibility of this assay is low.…”

“…Vogiatzi et al [9] 2013 To review SPA's predictive power in IVF Considerable variation was noted in the diagnostic outcomes, together with statistical significance accuracy rates of SPA with higher sensitivity of diagnostic power of the assay (52-100%), specificity (0-100%), and PPV (18-100%) and NPV (0-100%) rates together with fluctuation and notable differentiation in methodology and cut-off values employed by each group…”

“…Vogiatzi et al [9] 2013 To review predictive power of HZA in IVF HZA should be used in a sequential fashion with semen outcomes, with statistical significance of analysis and potentially other bioassays in an IVF setting. diagnostic power of the assay Oehninger et al [8] 2000 To examine the predictive value of sperm-zona Results demonstrated a high predictive power of the pellucida binding assay for IVF outcomes sperm-zona pellucida binding and the induced-acrosome reaction assays for fertilization outcomes Said et al [44] 2008 To investigate whether the MACS technology Integrating MACS as a part of sperm preparation could be used to improve ART outcomes techniques will improve semen quality and cryosurvival rates by eliminating apoptotic sperm Said et al [45] 2011 To systematically review the literature describing Fertilization and pregnancy rates showed improvement these advanced sperm selection methods focusing following some of the advanced sperm selection on their anticipated benefits on sperm quality techniques such as MACS and ART outcomes Chan et al [47] 2006 To develop a simple zeta potential method for sperm The zeta method improved sperm parameters associated isolation, and to analyze the sperm maturity, with increased fertilization and pregnancy rates after morphology, kinematic, and DNA parameters.…”

Evaluation of spermatozoal function—useful tools or just science

“…It was confirmed in human that these functional assays allow prediction of the fertilizing ability of spermatozoa in vitro and in vivo with accuracy. The fact of crucial importance from a clinical point of view is that functional tests are well correlated with IVF outcome in humans (Vogiatzi et al., ). In human medicine, the clinical significance of these tests is high, in spite of the fact that their role has been undermined to some extent by the introduction of intracytoplasmic sperm injection (ICSI) as a treatment method of male infertility.…”

Sperm değerlendirme testleri: dünden bugüne

“…Bu nedenle, hyalüronik asit sperm seçim tekniğinin rutin kullanımı için kesin bir klinik kılavuz denilemez. Bu konu hakkında daha fazla araştırma yapılması gerekir(13).…”