PERFORMANCE OF THE SPERM QUALITY ANALYZER IN PREDICTING THE OUTCOME OF ASSISTED REPRODUCTION

The present study was undertaken to assess the relationship between th e results of conventional semen analysis and the sperm motility index (SMI) as measured by the sperm quality analyser (SQA), and to evaluate these in relation to the fertilization and/or pregnancy outcome of as sisted reproduction. SMI determinations and conventional semen analyse s were performed on 223 samples hom subfertile men in two laboratories in Leuven (n = 136) and Antwerp (n = 87), and on spermatozoa prepared on a Percoll gradient (n = 136) used for treatment of male factor inf ertility in 57 cycles of intrauterine insemination (IUI), 44 attempts at in vitro fertilization (IVF) and 31 attempts at intracytoplasmic sp erm injection (ICSI). SMI values for native semen correlated significa ntly with sperm concentration, motility and morphology. Multiple regre ssion analysis revealed sperm concentration after preparation, and the concentration of motile spermatozoa with normal morphology and SMI (b efore preparation:) to be the independent determinants for SMI after p reparation. SMI values were significantly higher after, than before, p reparation (p < 0.0001). In regular IVF (n = 44) the percentage of fer tilized oocytes correlated significantly (p < 0.05) with sperm motilit y (A + B%, r = 0.33), with die percentage of spermatozoa with normal m orphology (r = 0.46) before preparation, with the values of SMI both b efore and after preparation (r = 0.54, r = 0.48), with sperm concentra tion (r = 0.34) and with the motile sperm concentration (r = 0.29) aft er preparation. For the occurrence of pregnancy (all treatment methods ), comparison of areas under ROC curves (AURC) indicated motile sperm concentration after preparation, as well as SMI both before and after preparation, to have the highest AURC, with no significant difference between these values as far as predictive power was concerned. These r esults indicate that the SQA allows for rapid evaluation of sperm char acteristics and of the effectiveness of sperm preparation techniques. However, it is not superior to conventional semen analysis ill predict ing the outcome of assisted reproduction.