Objective: To assess different parameters of TEST (TES and Tris) yolk
buffer (TYB) treatment of human sperm that may contribute to the biolo
gic effects of TYB on sperm function. Design: The influence of TYB tre
atment on occurrence of acrosome reactions was studied, as was the inf
luence of the concentration of acrosome-reacted sperm reacted by TYB o
r Biggers-Whitten-Whittingham medium (BWW) incubation on penetration l
evels in the sperm penetration assay (SPA). The necessity for the TYB
to achieve enhanced SPA performance as well as the effect of heat shoc
k on sperm also were studied. Setting: Andrology laboratory of a unive
rsity hospital. Patients: Sperm donors. Main Outcome Measures: Sperm p
enetration levels in the SPA and acrosomal loss as evaluated by a fluo
rescent lectin staining technique. Results: Sperm incubated in TYB for
42 to 46 hours at 4 degrees C demonstrated a higher rate of acrosomal
loss than did sperm capacitated in BWW media for 20 to 22 hours. The
difference was not significant. When insemination concentrations were
normalized to identical concentrations of acrosome-reacted sperm, TYB
treated specimens demonstrated much higher penetration levels compared
with BWW specimens. Samples incubated in BWW versus TYB for 42 to 46
hours at 4 degrees C before heat shock had identical penetration level
s. Samples washed with 37 degrees C BWW (positive heat shock) had sign
ificantly higher penetration levels than did samples washed with 4 deg
rees C BWW (negative heat shock). Conclusion: Although TYB treatment d
oes increase the occurrence of acrosome reactions, this alone does not
account for the dramatic increase in penetration levels in SPA seen w
ith these samples. TEST yolk buffer is not required for enhancement of
penetration, and the heat shock step of the procedure seems to be mos
t important for enhancement of sperm fusion ability in the SPA.