Andrological methods of predicting the pregnancy outcome of an in vitro fertilization program.

摘要

urrent advances in fertility treatment emphasize extracorporeal procedures, such as in vitro fertilization (IVF)/embryo transfer. IVF is now used to treat several types of infertility, including male factor and idiopathic infertility. However, IVF is time consuming, costly, unpredictable, and often yields a low pregnancy rate. Thus, it would be valuable to devise laboratory procedures for better prediction of IVF outcome.;The male infertility rate can be as high as 50%. Since sperm count and percent of motility alone do not appear to be strong predictors of IVF outcome especially when these parameters are not severely abnormal, a multivariable analysis of other parameters was made. In addition, because many IVF centers use swim-up preparations of semen samples for insemination, whole semen and swim-up samples obtained for IVF were analyzed. Major sperm motion characteristics (such as sperm mean velocity and linearity), adenosine triphosphate (ATP), creatine kinase (CK) activity in whole semen and sperm, hypoosmotic swelling test (HOST), and sperm morphology were evaluated.;A total of 138 patients from Norfolk IVF series 27 and 30 were studied. To minimize bias, only semen samples with normal count (;Analysis of sperm motion characteristics in the group with the highest pregnancy rate indicated that sperm in swim-up samples of this group had significantly (p