Abstract
BackgroundTraditional semen parameters have shown little to none predictive value for fertilization and blastocyst viability for a successful pregnancy. Therefore, the purpose of this study was to explore the usefulness of incorporating the acrosome reaction (AR) and chromatin integrity to conventional semen analysis to individually predict the fertile potential of sperm samples.MethodsA cross-sectional study was conducted in 69 participants undergoing IVF using oocyte donation. Semen samples were collected and evaluated for: AR [spontaneous (sAR) and induced (iAR)] by flow cytometry using anti-CD46-FITC, Acrosome Response to an Ionophore Challenge (ARIC), chromatin integrity by Sperm Chromatin Structure Assay (DNA Fragmentation Index-%DFI and High DNA Stainability-%HDS), WHO semen analysis, fertilization and blastocyst rates.ResultsThe participant age was 40.0 ± 6.1 years (66% were normozoospermic). Sperm morphology, sAR, iAR, and ARIC were associated with the fertilization (β = 3.56, R2 = 0.054; β = − 5.92, R2 = 0.276; β = 1.83, R2 = 0.150; and β = 2.10, R2 = 0.270, respectively, p < 0.05). A logit model was developed to calculate the probability of fertilization (≥ 60%) for each participant, using the sperm morphology and ARIC as independent variables, followed by ROC analysis to determine a cutoff probability of 0.65 (specificity = 80.6%, sensitivity = 63.2%). %DFI was inversely associated with the viable blastocyst rate (β = − 1.77, R2 = 0.057, p = 0.003), by the logit model and ROC analysis, a cutoff probability of 0.70 (specificity = 80.6%, sensitivity = 72.3%) was obtained to predict blastocyst viability (≥ 40%). There was no difference in the results with normozoospermic samples (n = 46).ConclusionsThe incorporation of ARIC and %DFI allowed to obtain predictive models for high fertilization and blastocyst rates in an individualized way, being promising tools to improve the diagnosis of male fertility potential for research or assisted reproduction, even in men with unknown infertility.
Highlights
Traditional semen parameters have shown little to none predictive value for fertilization and blastocyst viability for a successful pregnancy
A total of 170 men were invited, and 153 accepted to participate; 84 participants were not included because their semen samples were not enough to provide an aliquot for the analyses or their in vitro fertilization (IVF) cycles were canceled; the final samples came from 69 participants
Lineal regression analysis was performed to determine the association between the acrosome reaction (AR), Structure Assay (SCSA) or WHO parameters and the IVF outcomes
Summary
Traditional semen parameters have shown little to none predictive value for fertilization and blastocyst viability for a successful pregnancy. Due that semen quality assessed by WHO criteria does not fully predict male fertility [8], new methodologies have been developed to determine sperm quality and function, including proteomic analysis [9, 10], apoptotic markers [11], oxidative status [12, 13], DNA adducts [14], and DNA methylation status [15], obtaining good associations with male fertility These techniques are expensive and difficult to include in the operational process in andrology laboratories, and have not had continuity. It has been reported that some environmental-related factors, such as diet, physical activity, and exposure to environmental contaminants like pesticides and metals alter the AR and the sperm function [30,31,32]
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