OBJECTIVE: Established andrology assays assist in directing the clinician towards the selection of the optimal ART for each couple facing infertility. The HBA assay assesses the ability of the seminal population to bind to an immobilized substrate of hyaluronan. H-bound (HB) sperm carry reduced levels of chromosomal aberrations and enhanced levels of developmental maturity. This relationship led to the current study examining sperm binding potential, descriptive parameters of the male and female partners and their individual contribution to IVF outcome. The study sought to explore the potential association between the HBA index, morphology (M), total number of motile sperm (MS), ART treatment, age, follicle stimulating hormone (FSH) level, number of dominant follicles (DF) and the likelihood of CP.DESIGN: A retrospective analysis of 253 infertility couples examined each parameter as to its contribution to a positive CP. Data collection followed an IRB-approved protocol. The sample consisted of patients requiring intracytoplasmic sperm injection (ICSI) (n=84), IVF (n=93) and intrauterine insemination (IUI) (n=76).MATERIALS AND METHODS: The HBA score, M, MS, ART treatment, age, FSH and DF were the independent variables (IV) recorded for each patient. The HBA score was calculated as # bound MS/# total MS. With CP as the dependent variable, all IV were entered into a logistic regression model (LRM). Descriptive analyses included ANOVA and Pearson's χ 2 (chi square) using SPSS 15.0.RESULTS: Overall, 11.8% of IUI, 68% of IVF and 72.6% of ICSI patients demonstrated a CP. There was a statistically significant difference in mean HBA scores of IUI and IVF patients (79.87, 78.58, respectively (resp.)) as compared to ICSI patients (62.26, p<0.001). The LRM showed that the HBA score, female age and ART method had a statistically significant role in contributing to CP (p=.003, p=.001, p<.001, resp.). Male age, MS, M and FSH level showed no statistical significance (p>0.05) in contributing to CP.CONCLUSIONS: The use of the HBA index in the evaluation of the infertile couple merits strong consideration in the selection of the most appropriate ART to achieve a CP. The statistically significant value of the HBA index in predicting CP suggests the influence HB-sperm exert on preimplantation embryogenesis. Use of refined criteria for the HBA index may better direct the ART technologies selected for infertile patients thus optimizing CP and improving patient care. OBJECTIVE: Established andrology assays assist in directing the clinician towards the selection of the optimal ART for each couple facing infertility. The HBA assay assesses the ability of the seminal population to bind to an immobilized substrate of hyaluronan. H-bound (HB) sperm carry reduced levels of chromosomal aberrations and enhanced levels of developmental maturity. This relationship led to the current study examining sperm binding potential, descriptive parameters of the male and female partners and their individual contribution to IVF outcome. The study sought to explore the potential association between the HBA index, morphology (M), total number of motile sperm (MS), ART treatment, age, follicle stimulating hormone (FSH) level, number of dominant follicles (DF) and the likelihood of CP. DESIGN: A retrospective analysis of 253 infertility couples examined each parameter as to its contribution to a positive CP. Data collection followed an IRB-approved protocol. The sample consisted of patients requiring intracytoplasmic sperm injection (ICSI) (n=84), IVF (n=93) and intrauterine insemination (IUI) (n=76). MATERIALS AND METHODS: The HBA score, M, MS, ART treatment, age, FSH and DF were the independent variables (IV) recorded for each patient. The HBA score was calculated as # bound MS/# total MS. With CP as the dependent variable, all IV were entered into a logistic regression model (LRM). Descriptive analyses included ANOVA and Pearson's χ 2 (chi square) using SPSS 15.0. RESULTS: Overall, 11.8% of IUI, 68% of IVF and 72.6% of ICSI patients demonstrated a CP. There was a statistically significant difference in mean HBA scores of IUI and IVF patients (79.87, 78.58, respectively (resp.)) as compared to ICSI patients (62.26, p<0.001). The LRM showed that the HBA score, female age and ART method had a statistically significant role in contributing to CP (p=.003, p=.001, p<.001, resp.). Male age, MS, M and FSH level showed no statistical significance (p>0.05) in contributing to CP. CONCLUSIONS: The use of the HBA index in the evaluation of the infertile couple merits strong consideration in the selection of the most appropriate ART to achieve a CP. The statistically significant value of the HBA index in predicting CP suggests the influence HB-sperm exert on preimplantation embryogenesis. Use of refined criteria for the HBA index may better direct the ART technologies selected for infertile patients thus optimizing CP and improving patient care.
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