The Sperm Acrosome Reaction Response to Progesterone: Associates with Sperm DNA Damage and Has a Better Predicting Value for IVF Than That Response to the Ionophore.
Presenter: Jianyuan Jin
OBJECTIVE: To evidence the correlation between progesterone (P4) or A23187 induced sperm acrosome reaction (AR) and sperm DNA fragmentation (SDF) and to determine the predictive value of P4-induced AR for in vitro fertilization (IVF). view more
OBJECTIVE: To evidence the correlation between progesterone (P4) or A23187 induced sperm acrosome reaction (AR) and sperm DNA fragmentation (SDF) and to determine the predictive value of P4-induced AR for in vitro fertilization (IVF).
DESIGN: The spontaneous or induced (response to P4 or A23187) sperm AR were assessed in 129 patients or in a subgroup of 47 patients who underwent IVF treatment (female paternal with or without simple tubal factors, male patient with a semen concentration ≥10×106/ml and sperm progressive motility ≥20%). Correlations to semen parameters and the SDF were analyzed. Correlations with the fertilization rate of IVF were analyzed.
MATERIALS AND METHODS: Conventional semen analysis was performed using SCA software or according to the WHO laboratory manual. Sperm AR was evaluated by using fluorescein-conjugated Pisum sativum agglutinin (FITC-PSA). SDF was analyzed by the SCSA assay. The multivariate linear regressions were performed to detect the correlations between P4-induced AR and sperm motility, normal morphology, SDF and the fertilization rate of IVF. Receiver operating characteristic (ROC) curve analysis was used to determine the prognostic accuracy of P4-induced AR as well as the cutoff point for predicting “50% fertilization rate”. With the univariate and multivariate linear regressions analysis, the adjusted β value and 95% CI was calculated to present the effect of the threshold value. Statistically significant difference was set at p<.05.
RESULTS: (1) Sperm AR response to P4 and A23187 were correlated significantly to the percentage of SDF, with the negative correlation -9.05(-17.25-(-0.84), p<.05, n=47) and -0.453(-0.858-(-0.048), p<.05, n=47), respectively. While the spontaneous AR rate had a positive correlation with SDF (0.182 (0.05-0.314), p<.01, n=129) and a negative correlation with sperm progressive motility (-0.211(-0.362-(-0.061), p<.05, n=129)). (2) P4-induced AR, as well as SDF was significant correlated to the fertilization rate in IVF, while the correlation between spontaneous, A23187 induced AR and fertilization rate were not significant. (3) The receiver operator characteristics (ROC) curve analyses indicated that P4-induced AR was a better prognostic predictor for the fertilization rate compared with the SDF, with the areas under the curve 0.729 (0.580-0.849), p<.01 and 0.637 (0.484-0.772), p=.16, respectively. And a cutoff value for P4-induced AR to predict “50% fertilization rate” was 23.4% with sensitivity and specificity of 63.3% and 88.2%, respectively. When the percentage of P4-induced AR<23.4%, the adjusted β (95% CI) was 0.135 (0.014-0.257, P<.05).
CONCLUSIONS: Induced sperm AR is negatively correlated with sperm DNA damage, . The assessment of P4-induced AR of capacitated sperm may be a more sensitive indicator for fertilization rate in vitro compared with A23187-induced AR.