The Exploring Of Correlationship Between Human Spermatozoa Spontaneous Acrosome Reaction Rate And ART Pregnancy Outcome

OBJECTIVE:At present, the correlationship between human spermatozoa spontaneous acrosome reaction rate and ART pregnancy outcome has not been systematacially reported. In this study, the spontaneous acrosome reaction rate of human spermatozoa was detected. And the prospective study of the correlationship between spermatozoa spontaneous acrosome reaction rate and ART pregnancy outcome including AI (husband IUI pregnancy rate, donor ICI pregnancy rate) or (huaband IVF fertility rate, donor IVF fertility rate) was also discussed. This study was designed to confirm the clinical predictive potential of spontaneous acrosome reaction rate, and establish standard procedure of detecting spontaneous acrosome reaction by which the accuracy of perdicting sample fertility can be improved and the appropriate therapeutic schedule for couples under ART treatment can be determined.METHODS:The patient couples under husband ART (husband IUI, huaband IVF) and donor ART (donor ICI, donor IVF) were selected sequentially. Subsequently according to clinical data of patient couples respectively conforming to therapeutics indication of husband IUI, husband IVF, donor IVF, donor ICI and inclusion criteria patient couples were selected.The statistical software SPSS16.0was responsible for the correlationship analysis of the correlationship between human spermatozoa spontaneous acrosome reaction rate and sperm parameters or ART clinical outcome,optimal threshold was assured by the ROC anaysis to establish a set of reference system.This study has declared ethical review and was approved by ethics committees, the ratification No. LL-SC-SG-2013-014.RESULTS:(1)For the patient couples under husband IUI, spontaneous acrosome reaction rate of husband spermatozoa positively correlated with sperm density before and after preparation, C and D grade spem count before and after preparation, and negatively correlated with sperm viability rate before and after preparation.(2)For the patient couples under husband IVF, the best threshold value of spontaneous acrosome reaction ratediagnosing low fertility rate was4.4%by ROC curve analysis.(Low IVF Fertilization rate was defined lower than50%fertilization rate.) The spontaneous acrosome reaction rate of husband spermatozoa negatively correlated with IVF ovum fertilization rate, and negatively correlated with sperm paramaters including sperm density before preparation, sperm viability rate before preparation, forward movement sperm rate before preparation, A grade sperm percentage before and after preparation, B grade sperm percentage before preparation.(3)For the patient couples under donor IVF, the spontaneous acrosome reaction rate of donor spermatozoa after preparation, the best threshold value of spontaneous acrosome reaction rate diagnosing low fertility rate was17.62%by ROC curve analysis. The spontaneous acrosome reaction rate by density gradient centrifugation negatively correlated with IVF ovum fertilization rate, sperm density after preparation; for the spontaneous acrosome reaction rate of donor spermatozoa after preparation by microscale density gradient centrifugation, the best threshold value diagnosing low fertility rate was25.36%by ROC curve analysis. The spontaneous acrosome reaction rate was grouped in two groups(<25.36%,≥25.36%), there existed significant difference between groups.(4) For the patient couples under donor ICI, the spontaneous acrosome reaction rate positively correlated with the cryo-survial rate.(5)The spontaneous acrosome reaction rate of spermatozoa prepared by upstream method was significantly lower than that after being prepared by density gradient centrifrigation.CONCLUSION:(1) For the patient couples under husband IUI and donor ICI, the prediction value of spontaneous acrosome reaction rate for clinical pregnancy needed further research.(2) For the patient couples under husband IVF and donor IVF, though the ROC analysis could give the cut-off point, its guiding significance for deciding the selection of therapeutic schedule was little because both of the two groups of IVF fertility rate were greater than70%.(3) The different methods of sperm preparation and the damage of cryopreservation effected on spontaneous acrosome reaction rate.