Human sperm acrosome function assays are predictive of fertilization rate in vitro: a retrospective cohort study and meta-analysis

Abstract

ObjectiveTo determine whether acrosome function scoring—including acrosomal enzyme (AE) levels and acrosome reaction (AR) results—can predict fertilization rate in vitro.MethodsWe examined the predictive value of acrosomal enzymes (AE) determined by spectrophotometry/N-α-benzoyl-dl-arginine-p-nitroanilide for fertilization rate (FR) in vitro in a retrospective cohort study of 737 infertile couples undergoing IVF therapy. Additionally, a meta-analysis was done for prospective cohort or case-control studies; the following summary measures were reported to expand upon the findings: pooled spearman correlation coefficient (Rs), standardized mean difference (SMD), sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic score (DS), diagnostic odds ratio (DOR), and area under the summary receiver operating characteristic curve (AUC).ResultsLower AE levels determined by spectrophotometry with a cut-off value of <25μIU/106 spermatozoa were predictive of total fertilization failure (TFF) with moderate SEN (88.23%) and low SPE (16.50%). On meta-analysis, a total of 44 unique articles were selected, but given the multiple techniques described there was a total of 67 total datasets extracted from these 44 articles, comprising 5356 infertile couples undergoing IVF therapy. The AE levels or induced AR% was positively correlated with FR (Rs = 0.38, SMD = 0.79; Rs = 0.40, SMD = 0.86, respectively). Lower AE levels or induced AR% was predictive of lower fertilization rate with moderate accuracy (AUC = 0.78, AUC = 0.84, respectively); this was accompanied by low SEN/moderate SPE (0.57/0.85), moderate SEN/moderate SPE (0.79/0.87), respectively. For AE assay, the diagnostic performance in Asia (Rs = 0.24, SMD = 0.50) was inferior to that in North America (Rs = 0.54, SMD = 0.81) and Europe (Rs = 0.46, SMD = 0.92). Cryopreserved spermatozoa (SMD = 0.20, P = 0.204) were inferior to fresh spermatozoa (SMD = 0.89, P < 0.001). Sperm preparation yielded inferior results as compared to no preparation; spermatozoa after swim up were weak relevant (Rs = 0.27, P = 0.044); and there was no correlation for spermatozoa after a discontinuous gradient (SMD = 1.07, P > 0.05). Lower AE levels determined by fluorometry or substrate assay were used for predicting lower FR with low sensitivity and high specificity; the spectrophotometry assay had an uncertain predictive value. For induced AR assay, the diagnostic performance in the other areas was inferior to that in Africa (Rs = 0.65, SMD = 1.86). No preparation or double preparation yielded inferior results as compared to one preparation (Rs = 0.41); discontinuous gradient (Rs = 0.17, SMD = 0.47) was inferior to swim up (Rs =0.65, SMD = 1.51). Nonphysiological triggers (SMD = 0.81) did not differ from physiological triggers (SMD = 0.95) in general; ZP (Rs = 0.63) or mannose (Rs = 0.59) was superior to other physiological or nonphysiological triggers; and there was no correlation for human follicle fluid, progesterone, cyclic adenosine 3′-5′-p...

Acute effects on human sperm exposed in vitro to cadmium chloride and diisobutyl phthalate

“…Wilcoxon test: † P < 0.05, P-stimulated vs basal condition in CTRL samples; *P < 0.05 vs CTRL; § P < 0.05 vs 100 µM DIBP. In particular, progesterone-induced acrosome reaction is highly related to fertilization ability of spermatozoa as demonstrated by numerous studies (Xu et al 2018a).…”

The expression of human testis‐specific actin capping protein predicts in vitro fertilization outcomes: A novel biomarker of sperm function for assisted reproductive technology

“…3 While there have been some reports indicating that the results of these tests are associated with fertilization rates, [4][5][6] they have proven to be inadequate as markers for predicting the fertilization rate of assisted reproductive approaches such as IVF. [6][7][8][9] As such, there is a need to develop new methods to measure sperm function as it relates to fertilization potential.…”

Evaluación funcional de espermatozoides posterior a la separación por columnas magnéticas

“…Los reportes sugieren que la reacción acrosomal inducida por la N-acetil glucosamina y por la zona pelúcida comparten muchas características. La participación de los residuos de N-acetil glucosamina de la zona pelúcida en la interacción espermatozoide-ovocito en humanos podría ser sustentada en ensayos donde se trataron los ovocitos con Nacetilglucosaminidasas y se bloqueó la capacidad de unión de los espermatozoides, lo que sugiere la presencia de sitios de unión de N-acetil glucosamina en el espermatozoide 181 .…”

“…Con base en lo reportado, la detección de la función del acrosoma proporciona información sobre la capacidad de fertilización de los espermatozoides, y por lo tanto se considera una herramienta de diagnóstico útil para la infertilidad masculina 181 .…”

“…En cuanto a la proporción de espermatozoides que no sufrieron reacción acrosomal nos habla de espermatozoides que no tenían una integridad acrosomal, es decir que, probablemente presentaron defectos estructurales y funcionales en el acrosoma, los cuales no son eliminados por la técnica de separación con MACS 181 .…”