EFFECT OF ABNORMAL HYPOOSMOTIC SWELLING TEST ON FERTILIZATION RATE AND PREGNANCY OUTCOME IN IN-VITRO FERTILIZATION CYCLES

Objective: To assess the value of the hypo-osmotic swelling test in pr edicting fertilization, pregnancy, implantation, miscarriage, and live birth rates in IVF-ET cycles. Design: Prospective study. Setting: Aca demic tertiary referral center for fertility treatment. Patients: Thre e hundred twenty-six couples having IVF-ET for tubal damage or male fa ctor infertility with the female partner <38 years of age. Interventio ns: Each male had a hypo-osmotic smelling test performed between 4 and 8 weeks before IVF-ET. Main Outcome Measures: Fertilization, implanta tion, miscarriage, and live birth rates. Results: Eighty of 326 men ha d abnormal hypo-osmotic swelling tests. An abnormal test was not assoc iated with lower fertilization rates (odds ratio [OR] = 1.14; 95% conf idence interval [CI] = 0.97 to 1.14) or pregnancy rate (OR = 0.98; CI = 0.50 to 1.96). However, although couples with a normal test had a mi scarriage rate of 26.9% (14/52), in the group with an abnormal test th e miscarriage rate was 50.0% (7/14) (OR = 0.37; CI = 0.09 to 1.49). Th is resulted in a reduction in the live birth rate from 14.1% in the gr oup with a normal test to 11.8% in patients with an abnormal test (OR = 1.23; CI = 0.45 to 3.87). Conclusions: The hypo-osmotic swelling tes t has little value in predicting fertilization in IVF-ET procedures. H owever, an abnormal test may help predict adverse outcome if pregnancy is achieved.