A PROSPECTIVE ANALYSIS OF THE ACCURACY OF THE TEST-YOLK BUFFER ENHANCED HAMSTER EGG PENETRATION TEST AND ACROSIN

The aim of this study, based on a prospective analysis, was to evaluat e the accuracy of the TEST-yolk buffer enhanced hamster egg penetratio n test (HEPT) and acrosin activity in discriminating fertile from infe rtile males as compared with the conventional semen profile. The incid ence of spontaneous pregnancies was monitored during a followup period ranging between 18-24 months in 62 couples without untreatable female infertility, The diagnostic accuracy of the HEPT was significantly hi gher than that of the conventional semen profile, as evaluated with fi tted ROC curves. The best discriminatory ability was exhibited by a pe netration index (penetrations/oocyte) of 2 as cut-off value. In our se ries it gave a positive predictive value of 77.8% and a negative predi ctive value of 92.3%, Acrosin activity did not show a discriminating p ower significantly higher than the conventional semen profile, but an acrosin activity <20 mu IU/10(6) spermatozoa was found only among pati ents who did not achieve a pregnancy. In conclusion, this prospective analysis indicates that the TEST-yolk buffer enhanced HEPT constitutes a significant improvement over the conventional semen profile in disc riminating fertile from infertile males, Acrosin activity could provid e a useful adjunctive test because of the high negative predictive val ue of its poor results.