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PubMedDate not supplied

Hemizona index (HZI) demonstrates excellent predictability when evaluating sperm fertilizing capacity in in vitro fertilization patients.

The objective of this work was to assess the power of the hemizona assay to predict in vitro fertilization (IVF) results using receiving operating characteristics (ROC) analysis. In a tertiary medical center setting, 94 couples undergoing IVF were included in the study comparing their fertilization results to sperm function during the hemizona assay. Using ROC analysis, fertilization in IVF (mature oocytes only) was compared to performance of the sperm in the sperm-zona pellucida binding test as expressed by hemizona index (HZI; [number of test sperm bound/number of control sperm bound] x 100). The IVF results were as follows: 32 patients had no fertilization (0%), 55 patients fertilized all of the oocytes (100%), and 7 patients fertilized between 14% and 85% of the oocytes. Modified ROC analysis was used to determine the best threshold for fertilization success or failure, depending upon how the data are viewed. A HZI of 40-43 separated the 100% fertilization group from the other groups, with a true positive rate of 87% and a true negative of 83%. Conversely, a HZI of 4-5 separated the 0% fertilization versus partial or total fertilization, with a true positive rate of 100% and true negative rate of 71%. Sperm performance in the hemizona assay as measured by the HZI reflects performance in IVF and benefits couple evaluation and counseling.

Female↗
PubMed2000

Rescue intracytoplasmic sperm injection (ICSI)-salvaging in vitro fertilization (IVF) cycles after total or near-total fertilization failure.

OBJECTIVE: To evaluate the effectiveness of delayed oocyte reinsemination by ICSI (rescue ICSI) after total or near-total fertilization failure (</=25%) in IVF. DESIGN: A retrospective clinical study. SETTING: Non-hospital-based IVF program. PATIENT(S): Thirty IVF cycles with total fertilization failure and two cycles with </=25% initial fertilization. MAIN OUTCOME MEASURE(S): Fertilization and pregnancy rates after rescue ICSI. INTERVENTION(S): Rescue ICSI 19-22 hours after initial oocyte insemination. RESULT(S): A fertilization rate of 60.2% was achieved with rescue ICSI (141 of 234 oocytes, 29 of 32 patients). Of 30 patients with total fertilization failure, 27 had fresh transfers with rescue ICSI embryos. Two additional patients with </=25% initial fertilization had subsequent replacement of frozen-thawed rescue ICSI embryos. Six pregnancies resulted, including three singleton, one twin, one missed abortion, and one ectopic pregnancy (20.7%). One of the singleton pregnancies resulted from replacement of four frozen-thawed embryos and is the first known pregnancy achieved from cryopreserved rescue ICSI embryos. CONCLUSION(S): Rescue ICSI should be considered in the presence of total or near-total fertilization failure in IVF. Early application of rescue ICSI (19-22 hours after insemination) may be critical for establishing fertilization within an optimal window and producing viable embryos and pregnancies.

Adult↗
PubMed1996

Evaluation of a cut-off value for normal sperm morphology using strict criteria to predict fertilization after conventional in-vitro fertilization and embryo transfer in asthenozoospermia.

The predictive value of sperm morphology evaluation using strict criteria (MEUSC) on fertilization and pregnancy rates was evaluated in 60 couples undergoing in-vitro fertilization (IVF) and embryo transfer. In all, 47 of the male partners had a progressive sperm motility < 50% with a density > 20 x 10(6)/ml (asthenozoospermia) and 13 had normozoospermia. MEUSC was performed on the same semen sample that was used for IVF on at least 100 spermatozoa after Papanicolaou staining at x 1250 magnification. Defects in the head, mid-piece and tail were counted separately, borderline forms were classified as abnormal and the teratozoospermia index was calculated for each sample. Of the spermatozoa in the asthenozoospermic group, 13.0% were judged as normal on MEUSC versus 19.8% in normozoospermia (P = 0.0013). The number of normal spermatozoa on MEUSC correlated with the progressive motility in asthenozoospermia (rho = 0.41, P = 0.0043). Defects in the mid-piece (P = 0.0004) and tail (P = 0.025) were more common, and the teratozoospermia index (P = 0.015) was higher in asthenozoospermic than normozoospermic samples. The parameters of MEUSC did not correlate with the fertilization rate. In asthenozoospermia, differences in fertilization rates were calculated for each cut-off value between 4 and 10% normal spermatozoa on MEUSC. A cut-off value of 6% gave the best statistical power. If > 6% of spermatozoa were normal, a median of 66.7% of ova were fertilized, compared with a median fertilization rate of 35.4% if < or = 6% of spermatozoa were normal (P = 0.022). The highest cut-off value still giving significant discrimination was 8% (normal MEUSC > 8%, median fertilization rate 66.7%; < or = 8%, median fertilization rate 35.7%, P = 0.028), and this may be used as the critical value for normal morphology in asthenozoospermia. It is concluded that despite a significant linear relationship between morphology using strict criteria and progressive motility, MEUSC is still useful as a predictor for fertilization in asthenozoospermia. In cases of asthenozoospermia with < or = 8% normal spermatozoa on MEUSC, micromanipulation should be considered.

Adult↗
PubMed2002

In vitro fertilization of in vitro-matured equine oocytes: effect of maturation medium, duration of maturation, and sperm calcium ionophore treatment, and comparison with rates of fertilization in vivo after oviductal transfer.

Three experiments were conducted to evaluate the effect of oocyte and sperm treatments on rates of in vitro fertilization (IVF) in the horse and to determine the capacity of in vitro-matured horse oocytes to be fertilized in vivo. There was no effect of duration of oocyte maturation (24 vs. 42 h) or calcium ionophore concentration during sperm capacitation (3 microM vs. 7.14 microM) on in vitro fertilization rates. Oocytes matured in 100% follicular fluid had significantly higher fertilization (13% to 24%) than did oocytes matured in maturation medium or in 20% follicular fluid (0% to 12%; P < 0.05). There was no significant difference in fertilization rate among 3 sperm treatments utilizing 7.14 microM calcium ionophore (12% to 21%). Of in vitro-matured oocytes recovered 40-44 h after transfer to the oviducts of inseminated mares, 77% showed normal fertilization (2 pronuclei to normal cleavage). Cleavage to 2 or more cells was seen in 22% of oocytes matured in follicular fluid and 63% of oocytes matured in maturation medium; this difference was significant (P < 0.05). We conclude that in vitro-matured horse oocytes are capable of being fertilized at high rates in the appropriate environment and that in vitro maturation of oocytes in follicular fluid increases fertilization rate in vitro but reduces embryo development after fertilization in vivo. Further work is needed to determine the optimum environment for sperm capacitation and IVF in the horse.

Animals↗
PubMed2003

[Fertilization rate analysis as a predictive variable for an in-vitro fertilization program success].

OBJECTIVE: Determining if fertilization rates can be used as a predictive factor for pregnancy induction in ETIVF-ICSI programs. TYPE OF STUDY: Retrospective, observational and descriptive. MATERIALS AND METHODS: Six hundred and seventy nine cycles of the in vitro fertilization program, using long protocol hypophyseal suppression, stop, or antagonsits, were included. Ovarian stimulation was carried out with menotropines or recombinant FSH. Those patients whose cycle was stopped due to the lack of follicular development were excluded. Variables under study were: age, fertilization percentage, pregnancy rate, pre-ovulatory estradiol levels, number and quality of captured oocytes, transferred embrios and endometrial thickness on the day of transference and the presence of pregnancy. The Pearson P Test with a 95% confidence interval and the Student T Test used to establish differences with a 95% confidence interval statistical analyses were applied. RESULTS: Six hundred and seventy nine cycles were studied, 487 of which used the conventional fertilization method, and 192 used the ICSI method. Mean age among patients was 34 +/- 1.1 years old, with pre-ovulatory estradiol levels of 4,023 +/- 1,134 pg/mL, the average quantity of captured oocytes was 11.7 +/- 3.2 with a capture rate of 69.6%. Mean fertilization rates averaged 54% with a 20.7% pregnancy rates using the transference method. After analyzing the fertilization rate in each group, a statistically significant linear correlation was observed (P = 0.547, CI 95%) with the pregnancy rate. After assigning patients to two different groups: conventional IVF and ICSI, a higher positive correlation was observed (P = 0.827, CI 99%) in the first group. No significant differences were observed in the remaining parameters between both groups, excepting oocyte maturity, where greater prophase I and metaphase II percentages were observed in the ICSI group. When 50% fertilization was taken as the cutting point, a 78.19% negative predictive value was determined, with a 25% positive predictive value, 77.5% sensitivity, and 25.6% specificity. CONCLUSIONS: A fertilization percentage greater than 50% can be used as a pregnancy predicting factor in in vitro fertilization programs.

Adult↗
PubMedDate not supplied

Evaluation of human sperm fertility by interspecific (human spermatozoa-hamster oocytes) in vitro fertilization.

The fertilizing capacity of 1) Males with unproven fertility to be admitted to an IVF/RE programme; 2) Probably infertile subjects and of 3) Males with idiopathic infertility, has been evaluated using the humster (HUMan-hamSTER) test. Sixty-seven percent of normal sperms from the IVF-Re couples were capable of fertilizing hamster oocytes, with an average fertilization rate of 52%. In one of the suspect male infertility group sperms were able to fertilize hamster oocytes and in the idiopathic infertility group forty-eight percent of sperms fertilize, but the average fertilization rate is clearly lower. It is surprising that 26% of normal sperms have a negative humster test and fertilize the human oocytes at the same rates (86%) as those having a positive humster test. It means that if statistically and over large populations this test undoubtedly gives good results, when the individual cases are taken into consideration this test does not provide final proof of the patient's infertility. Nevertheless the authors stress that the test may provide a new criterion for determining sperm quality and in the future it might become a complementary examination of the spermogram and postcoital test and supply fundamental data on the mechanism of fertilization (capacitation, acrosome reaction, spermatozoa-oocyte fusion and pronuclei formation).

Animals↗
PubMed1996

The CUE Fertility Monitor compared to ultrasound and LH peak measurements for fertile time ovulation detection.

A prospective study of the reliability of the CUE Fertility Monitor to identify the fertile time of the menstrual cycle was conducted. The device provides a digital measurement of the electrical resistance of saliva (SER) and vaginal secretions (VL). The readings of the device were compared with the fertile time detected by ultrasonography of the growing follicle and estimation of the LH surge to detect ovulation. Thirteen women participated in the study. Sixteen cycles contained both signals (SER, VL) for the beginning and the end of the fertile period. In 2 cycles a CUE signal could not be found by the device. Using a computerized algorithm for evaluation of the CUE signals, the beginning of the fertile period was accurately detected in 14 cycles; in 2 cycles the signal was found less than five days prior to ovulation. The last day of fertility was identified correctly by the CUE Fertility Monitor in 10 cycles; in 6 it was incorrectly identified during the time when the woman was still fertile. This suggests that the CUE Fertility Monitor utilizing the algorithm on which it currently is based cannot be recommended for natural family planning. However, we think that the algorithm for evaluation should be improved as useful signals in the menstrual cycle are detected.

Adult↗
PubMed1993

Complete failure of fertilization in couples with unexplained infertility: implications for subsequent in vitro fertilization cycles.

OBJECTIVE: To determine whether complete failure of fertilization of oocytes in couples with unexplained infertility persists during subsequent in vitro fertilization (IVF) cycles. DESIGN: A retrospective study of 120 cycles of IVF in 44 couples with unexplained infertility and complete failure of fertilization during their first IVF trial. SETTING: In vitro fertilization unit of the Sheba Medical Center. PATIENTS: Forty-four couples undergoing IVF for unexplained infertility. MAIN OUTCOME MEASURE(S): Fertilization rate of retrieved oocytes and pregnancy rate. RESULTS: Of the initial 44 couples, 37 underwent additional IVF cycles and 30 (81.1%) achieved fertilization. Seven patients conceived during the study period as a result of IVF and two conceived spontaneously. CONCLUSIONS: Complete failure of fertilization does not necessarily persist during subsequent IVF cycles. Therefore, at least two more IVF cycles should be attempted before reverting to other therapeutic options. However, although fertilization can be achieved in most couples, the mean oocyte fertilization rate during subsequent cycles in this group is low. This suggests an underlying undiagnosed pathology of oocyte/sperm interaction in some of these patients.

Female↗
PubMed1995

The effect of serum from infertile women with endometriosis on fertilization and early embryonic development in a murine in vitro fertilization model.

OBJECTIVE: To evaluate the effect of serum from infertile women with endometriosis on fertilization and embryonic development in a murine IVF model. DESIGN: Pretreatment and post-treatment comparison of murine oocyte fertilization and early embryonic development with the addition of serum supplements from infertile women with endometriosis. SETTING: Tertiary care academic medical center. PATIENTS: Sera from 10 fertile women without endometriosis and 28 infertile women with endometriosis both before and after laser laparoscopy. RESULTS: When compared with serum from fertile women, serum from infertile women with endometriosis inhibited fertilization rates (51% versus 81%) and subsequent embryonic development rates (46% versus 79%). The inhibitory effect was greater as the stage of endometriosis increased. Treatment of endometriosis by laser laparoscopy improved both fertilization (51% versus 56%) and early embryonic development rates (46% versus 58%). CONCLUSIONS: Serum from infertile women with endometriosis inhibits both fertilization and early embryonic development in the murine IVF model. Inhibition of fertilization and early embryonic development rates increases as the stage of endometriosis increases. Improved fertilization and early embryonic development rates are observed after treatment of endometriosis by laser laparoscopy.

Adolescent↗
PubMed1994

Acrosome reaction inducibility predicts fertilization success at in-vitro fertilization.

We prospectively studied the ability of acrosome reaction (AR) inducibility to predict fertilization success in a group of 232 infertile patients presenting sequentially for in-vitro fertilization (IVF). The median percentage of eggs fertilized for the overall patient population was 25% (interquartile range 5-58%), with one to 29 oocytes available for insemination (median, five oocytes). The median percentage of eggs fertilized at IVF increased as the percentage of spermatozoa able to undergo AR became greater: spermatozoa with a failed AR (< or = 5%) fertilized only 12% of eggs, while spermatozoa with AR values > 9% fertilized 50% of eggs. The assay had a specificity of 0.75, a sensitivity of 0.55 and an odds ratio of 2.9; thus, AR-positive patients are 2.9 times more likely to achieve fertilization than patients with a failed AR. Receiver operator characteristic (ROC) curves were constructed for AR, sperm concentration and percentage of normal forms in semen. All three parameters proved to be potentially useful in predicting the occurrence of fertilization, although AR and morphology appeared to be better than sperm concentration by ROC analysis. Patients were divided into four clearly defined subgroups according to their traditional semen characteristics, including morphology. The median percentage of eggs fertilized decreased as traditional semen characteristics deteriorated, from a median of 46% for patients with excellent sperm concentration, motility and morphology, to a median of 29% for patients with suboptimal semen quality and a median of 0% for patients with severely impaired semen.(ABSTRACT TRUNCATED AT 250 WORDS)

Acrosome↗
PubMed1996

Analysis of poultry fertility data. 3. Analysis of the duration of fertility in naturally mating Japanese quail.

The purpose of the present study was to test the appropriateness of iterative least squares regression for the evaluation of fertility data in naturally mating quail. In each of four trials, 20 male and 200 female randombred Japanese quail were housed in stacked breeder cages. Paired females were exposed to their assigned male for a single 48-h period. Eggs were collected for 2 wk following removal of the male, incubated, and fertility determined by visual inspection at egg breakout. In Trials 1 and 3, sexually experienced males were placed with experienced and inexperienced females, respectively. In Trials 2 and 4, inexperienced males were placed with experienced and inexperienced females, respectively. Duration of fertility, by male, was analyzed by iterative least squares, using the model y(x) = gamma/(1 + e beta(tau - x)). Overall fertility was analyzed with a log odds model following transformation to logits. Iterative least squares provided estimates of fertility duration of 3.75 to 9.18 d, with significant (P < 0.05) differences in the duration of fertility observed between individual males as well as between the trials. Differences (P < 0.05) in overall fertility (17.7 to 58.3%) were also observed, with inexperienced males paired with experienced females exhibiting the lowest overall means. Taken together, these results suggest that iterative least squares may be used to evaluate fertility in naturally mating populations and that reproductive experience can have a profound effect on the interpretation of fertility in naturally mating quail.

Animals↗
PubMed1988

[Problems in evaluating male fertility: valuable factors in evaluating male fertility and normal values of seminal parameters].

To determine the valuable factor for evaluating male fertility, a comparative study was done as to various seminal parameters between fertile and infertile groups. The fertile group consists of 57 proven fertile males and the infertile group consists of randomly chosen 67 infertile patients. Seminal parameters assessed were sperm concentration, motility, mean velocity, total sperm output, total motile sperm output, sperm morphology, acrosin activity and sperm penetration rate on zona-free hamster egg penetration assay (SPA). The infertile group was significantly different from the fertile group in every parameter except acrosin activity. However, the range of each parameter in the two groups overlapped each other. The diagnostic rate of each parameter, which is the percentage of an infertile male correctly diagnosed as infertile, was calculated by using 95% specificity threshold value of fertile males. The 95% specificity threshold values of sperm concentration, motility and % normal shaped sperm were 24.9 x 10(6)/ml, 34.9% and 55%, respectively, and they could be acceptable for the normal limit of seminal parameters. The diagnostic rate was highest in penetration rate (72.4%). In other words, penetration rate is the most valuable factor in various parameters for making a distinction between fertile and infertile males. Sperm motility and mean velocity showed the next highest diagnostic rate. On the other hand, sperm concentration showed a poor diagnostic rate (36.8%). In addition, there was no significant correlation between penetration rate and any other seminal parameters. These results suggest that the SPA will be an essential test for evaluating male fertility and penetration rate may be a marker of male fertility in the treatment of male infertility.

Adult↗
PubMedDate not supplied

Fertilizing capacity of rat spermatozoa is correlated with decline in straight-line velocity measured by continuous computer-aided sperm analysis: epididymal rat spermatozoa from the proximal cauda have a greater fertilizing capacity in vitro than those from the distal cauda or vas deferens.

Rat spermatozoa recovered from different regions of the excurrent ducts of 10 adult males (proximal cauda epididymidis [PC], distal cauda epididymidis [DC], and vas deferens [VD]) were assessed by in vitro fertilization (LVF) using limited sperm numbers, and by continuous evaluation of motility parameters during 5 hours of incubation in vitro with automated computer-aided sperm analysis (CASA). Spermatozoa from the PC region fertilized (68 +/- 6%) a significantly greater (P < or = 0.005) number of oocytes than those from the DC (44 + 5%) or VD (47 +/- 7%). For pooled samples from all three regions, the mean fertilization rate (51 +/- 14%) was less tan for spermatozoa from the PC (P < 0.05) but was not significantly different from spermatozoa from the DC or VD. For each time point and sample, 1,592 +/- 428 sperm tracks were analyzed. CASA was verified by comparison with manual still-frame analysis of video recordings, by repeated analysis of the same or different samples of spermatozoa, and by examination of computer tracks. The coefficients of variation for various motion parameters suggested that the CASA obtained a high degree of precision. There were no significant differences in motility parameters for spermatozoa recovered from equivalent regions of the left or right tract or in motility parameters for spermatozoa from different regions of the tract immediately after recovery. However, during incubation in vitro, spermatozoa from the DC or VD regions exhibited a marked decline in straight-line velocity (VSL) compared with spermatozoa from the PC region. The reduction in VSL (combined values from right and left tract) for DC or VD spermatozoa compared with PC spermatozoa was significant at 2.5 hours of incubation (P < or = 0.05) and highly significant (P < or = 0.005) by the end of the incubation period. Differences in average path velocity (VAP) were also apparent after 4 hours (p < or = 0.05), but no significant differences were observed for measurements of curvilinear velocity (VCL) or lateral bead displacement (ALH). Overall, the decline in VSL over 5 hours was highly correlated (P < or = 0.001) with the outcome of fertilization in vitro. In contrast, initial VSL and changes in VCL of spermatozoa were not correlated with fertilization rate. These results indicate that the in vitro fertilizing capacity of rat spermatozoa is correlated with 1) the decline in straight-line velocity (VSL) as measured by repeated CASA during incubation in vitro and 2) with the site of recovery of mature rat spermatozoa from the distal excurrent duct. It is suggested that the deterioration of the quality of rat spermatozoa in the distal epididymidis and vas deferens during storage may occur sooner than previously realized, and therefore care must be taken when recovering samples for fertility assessment. In keeping with findings in other species, immediate "snapshot" analysis of rat motility was a poor predictor of sperm fertility. In contrast, continuous CASA provided significant information for determining sperm fertilizing capacity and will be a useful technique for reproductive toxicology.

Animals↗
PubMed1997

Fertility and schizophrenia: evidence for increased fertility in the relatives of schizophrenic patients.

Fertility has been observed to be reduced in patients with schizophrenia, although the disorder was seen to occur at a steady rate in the general population. The hypothesis of increased fertility in the healthy relatives of the patients, which maintained the genetic contribution to the disorder has been proposed but has not received much support. The present study reports the fertility rate in 100 schizophrenic patients and their relatives (grandparents, parents, uncles, aunts and siblings). The fertility of the different family members was compared, taking into account the completion of age of maximum reproductivity, i.e. up to 50 years of age. The trends in fertility rates over three generations of patients' families were compared with those in the general population of India over a corresponding period from 1950 to 2000 AD. The patients were observed to be hypofertile, but their parents showed a higher fertility than all other relatives, as well as the general population. The siblings of the patients also tended to have higher fertility rates than the general population. This increased fertility in parents and sibs, who are the probable carriers of the abnormal gene, could compensate for the reduction in genetic contribution to morbid risk for schizophrenia due to reduced reproductivity of the patients themselves.

Adult↗