Sperm-preparation techniques for men with normal and abnormal semen analysis - A comparison

OBJECTIVE: To compare two commonly used sperm preparation techniques, densi ty gradient centrifugation and swim-up procedures, with respect to thier ef fects on acrosome reaction (AR), hypoosmotic swelling (HOS) and nuclear mat urity in men with abnormal and normal semen analyses. STUDY DESIGN: In accordance with Would Health Organization criteria, 23 men with abnormal (group I) and 20 men with normal (group II) semen analyses w ere included in a prospective, controlled study. Each semen specimen was di vided into aliquots in order to assess AX, HOS and nuclear maturity, determ ined with acridine orange staining, in both raw and processed semen samples using the density gradient centrifugation and swim-up techniques. RESULTS: Initial semen samples in group I revealed diminished AR, HOS and n uclear maturity rates in comparison to those ill group II. IIE group I, den sity gradient centrifugation improved AR, HOS and nuclear maturity rates mo ve than did swim up. However, in group II it improved only the AX; HOS rate s weve better than with swim-up, There was a significant positive correlati on be between sperm concentration and HOS rate in raw semen samples from gr oup I. In the samples from group, motility and morphology correlated with t he nuclear maturity nlte but not with AR and HOS rates. Semen samples with between motility (>20%) or morphology (>25%) skewed better nuclear maturity rates (>50%) in men with abnormal semen anlyses. Motility and a sensitivit y of 77% and specificity of 90% in predicting nuclear maturity. Morphology had similar sensitivity bur lower specificity (70%).