Relationship between human spermatozoa-hyaluronan-binding assay, conventional semen parameters and fertilisation rates in intracytoplasmic spermatozoa injection

Abstract

Selecting the best spermatozoa for intracytoplasmic spermatozoa injection (ICSI) has recently been a topic of great interest among embryologists. The study aimed to evaluate the relationship between the spermatozoa-hyaluronan-binding assay (HBA), routine semen analysis results and fertilisation rates as recorded during conventional ICSI therapy. Ninety-one patients undergoing conventional ICSI treatment in the Medfem Fertility Clinic in Johannesburg (South Africa) were included in the study. A total of 797 oocytes were injected of which 457 oocytes fertilised (57.3%, range 0-100%). None of the semen parameters correlated with the fertilisation rates (Table 2). HBA scores, however, revealed a highly significant association (p ≤ 0.0001) with the fertilisation rates. The HBA scores also correlated significantly with the biochemical pregnancy values (Spearman r = 0.24, P = 0.02, 95% CI 0.039-0.43); however, the HBA scores did not correlate with the clinical pregnancy rates (Spearman r = 0.14, P = 0.16, 95% CI -0.06 to 0.34). No correlation was recorded between HBA and the standard semen parameters. The study showed that HBA is significantly associated with fertilisation in conventional ICSI. The HBA scores were also significantly associated with the fertilisation rates and biochemical pregnancies.

Evaluation of spermatozoal function—useful tools or just science

“…In human, HBA represents a convenient and reproducible laboratory test for identifying candidates and assigning them for IVF or ICSI (Cayli et al., ; Huszar et al., ). HBA values in pregnant women were numerically higher than those in the non‐pregnant group, although not statistically significant (Esterhuizen et al., ). HBA does not predict the IUI outcome in couples with unexplained infertility or mild male factor infertility, as well as it cannot replace sperm penetration assays, but it can be used together with other semen parameters to verify sperm quality (Lazarevic et al., ; Yildirim, Duvan, Pekel, Ayrim, & Kafali, ).…”

The Efficacy of Hyaluronic Acid Binding (HAB) in the Treatment of Male Infertility: A Systematic Review of the Literature

“…All studies were considered of undetermined quality given that exclusion criteria were either illdefined or included pathologies which may impact later outcomes, e.g., endometriosis. [26,31,[44][45][46][47][48].…”

“…Six of the included studies reported fertilisation rates [31,[44][45][46][47][48]. Esterhuizen et al calculated the HAB score of raw semen samples in 91 couples undergoing conventional ICSI, reporting a significant positive correlation between HAB score and fertilisation rates (R = 0.60, p = 0.0001) [44].…”

“…Six of the included studies reported fertilisation rates [31,[44][45][46][47][48]. Esterhuizen et al calculated the HAB score of raw semen samples in 91 couples undergoing conventional ICSI, reporting a significant positive correlation between HAB score and fertilisation rates (R = 0.60, p = 0.0001) [44]. Breznik et al reported similar results in a prospective, controlled study of 133 couples diagnosed with male factor or unexplained infertility, where HAbinding assessments were carried out on density gradient centrifugation (DGC)-prepared sperm used in IVF cycles only [47].…”

“…Seven of the included studies reported clinical pregnancy rates [19,26,31,[44][45][46]48]. Three studies reported no statistically significant correlations between HAB score and clinical pregnancy rates [44,45,48].…”