Yonsei Med J.  2009 Jun;50(3):352-357. 10.3349/ymj.2009.50.3.352.

Correlation of Post Swim-Up Acrosome Index with in-vitro Fertilization Outcomes

• Ozguner M
• Evirgen O
• Oral B

• KMID: 1758562
• DOI: http://doi.org/10.3349/ymj.2009.50.3.352

Abstract

PURPOSE: A prospective study was planned to determine the relationship between post swim-up acrosome index (AI) evaluation and fertilization outcomes in an in vitro fertilization (IVF) program.
MATERIALS AND METHODS
Infertile couples who have applied to IVF were admitted into this study when the male partner's sperm concentration was > 20x106/mL and motility > 30%. Pre- and post swim-up semen quality parameters including concentration, motility, sperm morphology and AI were evaluated in a prospective, randomized and blinded fashion. The couples were divided prospectively into 2 groups. In group I (25 couples) 50 000 sperm per oocyte were used for insemination considering post swim-up acrosome index, and in group II (25 couples) 50 000 sperm per oocyte were used for insemination without considering post swim-up acrosome index.
RESULTS
Pre- and post swim-up AI were 30.8 +/- 3.4 and 17.8 +/- 4.5 in group I, and 31.4 +/- 3.6 and 16.3 +/- 4.7 in group II (p > 0.05) respectively. The significant improvement in morphology and motility after double wash swim-up procedure has been observed. However, double wash swim-up procedure could not eliminate head and especially acrosomal defects which would directly effect fertilization capacity in conventional IVF program. In group I, 85.3% of oocytes were fertilized, with a 48% pregnancy rate; in group II, 71.0% of oocytes were fertilized, with a pregnancy rate of 20%. Fertilization and pregnancy rates were significantly different (p < 0.05) between the two groups.
CONCLUSION
We have concluded that it could be useful to consider post swim-up AI of sperm inseminated in conventional IVF cycles, which correlates with high fertilization and pregnancy rates.

Keyword

Sperm analysis; acrosome index; double wash swim-up procedure

MeSH Terms

*Acrosome
Adult
Female
Fertilization in Vitro/*methods
Humans
Male
Pregnancy
Prospective Studies
*Semen Analysis
Sperm Count
Treatment Outcome

Figure

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  Fig. 1 The mean sperm concentrations (χ106/mL) before and after double wash swim-up procedure revealed statistically significant difference (p < 0.001).

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  Fig. 2 Comparison of the mean percentage (MP) of motility double wash swim-up procedure was statistically significant (p < 0.001). MP of progressively rapide motile sperm (PRMS), MP of progressively slow motile sperm (PSMS) highly increased whereas MP of locally motile sperm (LMS) and MP of immotile sperm (IS) dramatically decreased after swim-up procedure.

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  Fig. 3 Comparison of the changes in the mean percentage (MP) of morphology were highly significant (p < 0.001). Comparison of MP of midpiece and tail abnormalities revealed decrease after double wash swim-up procedure whereas comparison of MP of head/acrosome abnormalities and cytoplasmic residues revealed increase after the procedure.

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