Low Hypo-osmotic Swelling Test Scores Research Articles

Males with highly positive antisperm antibodies (ASA) on their sperm do not have a greater frequency of low hypo-osmotic swelling test scores

Males with highly positive antisperm antibodies (ASA) on their sperm do not have a greater frequency of low hypo-osmotic swelling test scores

Sperm with an abnormal hypo-osmotic swelling test – normal fertilization, normal embryo development, but implantation failure

Purpose: To review the clinical importance of including the hypo-osmotic swelling (HOS) test in routine male fertility testing which in general is not evaluated by most physicians dealing with infertility. Materials and Methods: Pregnancy rates were evaluated in patients with low HOS test scores. A low HOS test was specifically defined as having less than 50% of sperm exhibiting the normal physiologic response of tail swelling, when subjected to a hypo-osmolar solution. Pregnancy rates of patients with low HOS test were examined after intercourse, intrauterine insemination (IUI), conventional oocyte insemination, and in vitro fertilization (IVF). Patients with a low HOS test were also treated with a protein digestive enzyme chymotrypsin. Patients receiving intervention then underwent IUI, IVF with conventional oocyte insemination, or IVF with intracytoplasmic sperm injection (ICSI). Pregnancy rates of the cohort receiving intervention were then examined for comparison. Results: The HOS test abnormality leads to normal fertilization but almost invariably negatively effects embryo implantation. Treatment with chymotrypsin, or performing IVF with ICSI, can overcome the toxic protein causing the embryo implantation defect. This toxic protein may be cryolabile and freezing sperm or embryos may prove to be another mode of therapy. Conclusions: The HOS abnormality may be the most reliable semen abnormality predicting failure to conceive even with IVF unless the defect is negated. Therapy is very effective. Unfortunately this test is rarely evaluated by most infertility specialists but it should be. The frequency increases with age.

Intracytoplasmic Sperm Injection Allows Normal Pregnancy Rates for Males ≥ 40 With Low Hypo-osmotic Swelling Test Scores Even When Complicated by Very Low Motility Percentage

BACKGROUND: Males with sperm with subnormal hypo-osmotic swelling (HOS) tests (<50%) are generally infertile. Interestingly, the abnormality does not prevent fertilization or the production of morphologically normal embryos. Instead the defect has been clearly demonstrated to inhibit embryo implantation. The defect seems to be related to a toxic factor that causes an impairment to the functional integrity of the sperm membrane which forms the basis of the test to detect this abnormality (impairment of the sperm membrane to allow normal osmosis).

P-590: A comparison of the efficacy of treating sperm with low hypo-osmotic swelling test scores with chymotrypsin followed by intrauterine insemination vs. in vitro fertilization with intracytoplasmic sperm injection

Males with hypo-osmotic swelling (HOS) test scores <50% almost never achieve successful pregnancies either following intercourse, intrauterine insemination (IUI) or in vitro fertilization (IVF) with conventional insemination. Treatment of sperm with low HOS test scores with chymotrypsin-galactose (CG) can improve scores ≥50%. The objective of the present study was to compare the efficacy of IUI with CG treated sperm with HOS test scores <50% (but improve to ≥50% following CG exposure) vs. IVF with intracytoplasmic sperm injection (ICSI).

P-586: Intracytoplasmic sperm injection completely negates the implantation problem associated with conventional fertilization with sperm with low hypo-osmotic swelling test scores as evidenced by evaluating donor-recipient pairs

P-586: Intracytoplasmic sperm injection completely negates the implantation problem associated with conventional fertilization with sperm with low hypo-osmotic swelling test scores as evidenced by evaluating donor-recipient pairs

Effect of treating sperm with low hypo-osmotic swelling test scores with chymotrypsin on pregnancy rates after conventional in vitro fertilization–embryo transfer

The embryos formed from fertilizing oocytes with sperm with subnormal hypo-osmotic swelling tests with conventional insemination rather than intracytoplasmic sperm injection are very unlikely to implant. The toxic factor transferred to the zona pellucida by such sperm can be negated by pretreating the sperm with the protein digestive enzyme chymotrypsin, resulting in markedly improved implantation rates.

An evaluation of the efficacy of in vitro fertilization with intracytoplasmic sperm injection for sperm with low hypoosmotic swelling test scores and poor morphology.

To corroborate or refute a previous study demonstrating that in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) is an effective therapy for infertility related to males with subnormal hypoosmotic swelling tests (HOST). The study would also determine if the copresence of poor morphology has any adverse effect on outcome. Clinical and viable pregnancy rates and implantation rates were evaluated in a second series of patients. The data were further stratified according to whether the semen specimen demonstrated morphology using strict criteria < 4% normal vs > or = 4%. Clinical and viable pregnancy rates and implantation rates were 49.1, 45.3, and 23.4% for those with subnormal HOST scores and subnormal morphology vs 38.0, 34.3, and 22.5% for those with low HOST and strict morphology > or = 4% (p = NS, chi-square analysis). In vitro fertilization with ICSI is an effective therapy for infertility related to subnormal HOST scores. Poor morphology does not adversely affect the outcome.

Evidence that fragmentation of embryo blastomeres may be caused by the sperm rather than the oocyte

A high percentage of fragmentation of embryo blastomeres may be associated with reduced fecundity following embryo transfer (ET). Some scientists think that this phenomenon may be related to an oocyte mitochondrial defect, and this problem has been treated by donor oocyte cytoplasm injection. However, the following observation strongly suggests that at least in some circumstances fragmentation may be related to a sperm rather than egg factor. A 35 year old woman with a 4 year history of primary infertility was treated with in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) because of her male partner’s semen analysis demonstrating the presence of antisperm antibodies (82% IgG, 77% IgA) and subnormal hypo-osmotic swelling test (HOST) score (47%). For financial reasons the woman elected to share oocytes with a recipient (24 for patient, 25 for recipient). Seventeen oocytes were fertilized by ICSI and all were cryopreserved because of risk of ovarian hyperstimulation syndrome. Thirteen embryos were thawed and transferred over 3 cycles (4 were discarded). Nine of the 13 embryos had 25% or more fragmentation and 4 had 50% fragmentation and no pregnancies were achieved. Three fresh embryos were transferred to a recipient and one had 25% fragmentation but one had no fragmentation and the other <25% fragmentation. She conceived a normal male. The other frozen embryos were donated to another woman who thawed 8 frozen embryos and had only 1 with >25% fragmentation and 1 had no fragmentation. Three embryos were transferred, 3 re-frozen and 2 discarded (low cleavage) but she did not conceive. These data suggest that the sperm in some instances may be responsible for fragmentation. The possibility exists that the presence of antisperm antibodies and or low HOST scores were somehow responsible for this phenomenon despite ICSI. Alternatively, since the recipient had conventional insemination, perhaps fertilization of some oocytes by ICSI can lead to fragmentation.

Treatment of sperm with subnormal host scores with chymotrypsin/viable pregnancy after IUI.

Men with low hypoosmotic swelling test (HOST) scores (<50%) rarely achieve a pregnancy with intercourse or conventional intrauterine insemination (IUI) or even IVF. The defect seems to be related to a toxic factor attached to the sperm that can be transferred to the zona pellucida, which ultimately interferes with implantation. A small case series showed optimistic pregnancy outcome with treatment of the sperm with low HOST scores with chymotrypsin. However, the live pregnancy rate in 90 subsequent IUI cycles in men whose low HOST scores were improved by chymotrypsin was only 3.3%. IVF with ICSI remains the only highly effective treatment of this disorder.

R-029. Effect of low hypo-osmotic swelling test scores on fertilization and pregnancy rates after IVF and embryo transfer

R-029. Effect of low hypo-osmotic swelling test scores on fertilization and pregnancy rates after IVF and embryo transfer

Transfer of cryopreserved embryos improved pregnancy rates in patients with damage to the functional integrity of the sperm membrane as measured by the hypo-osmotic swelling test

To compare the pregnancy rates (PRs) after transfer of cryopreserved embryos in patients who have damage to the functional integrity of the sperm membrane as measured by the hypo-osmotic swelling test to those without this defect. Prospective clinical study. University-associated IVF center. Fifty-four patients enrolled in a matched prospective study to evaluate the effects of low HOS scores (<50%) on PRs after IVF-ET were followed to determine the PR after transfer of cryopreserved embryos. Clinical PRs and implantation rates. Fourteen patients with low hypo-osmotic swelling test scores underwent 21 frozen ET cycles, achieved for clinical pregnancies for a PR per cycle of 19.0% and an implantation rate of 7.1%. Twelve patients with normal hypo-osmotic swelling test scores underwent 21 frozen ET cycles, achieved five preganancies for a clinical PR per cycle of 23.8% and an implantation rate of 9.3%. Previous studies have demonstrated an adverse effect of low hypo-osmotic swelling test scores on PRs after IVF-ET despite normal fertilization. This adverse effect was not found in the transfer of cryopreserved embryos from males with hypo-osmotic swelling test scores. Further investigation is required to determine how cryopreservation improves the chances of implantation of these embryos.

The transfer of frozen but not freshly derived embryos from fertilization of oocytes with sperm with low hypo-osmotic swelling test scores results in a normal pregnancy rate.

The transfer of frozen but not freshly derived embryos from fertilization of oocytes with sperm with low hypo-osmotic swelling test scores results in a normal pregnancy rate.