The acrosome index, radical buffer capacity and number of isolated progressively motile spermatozoa predict IVF results

BACKGROUND: The accuracy by which a number of newly described semen variabl es can predict either total fertilization failure (TIFF) or pregnancy outco me in IVF, has not previously been investigated. The study aim was, therefo re, to determine prospectively the predictive value of these variables. MET HODS: The semen variables investigated were the post-wash total progressive ly motile sperm cell count (TPMCpost-wash) the acrosome index (Al), 'cytopl asmic residues' and normal sperm morphology, evaluated according to the str ict criteria ('strict criteria'), as well as the fast and slow total radica l trapping antioxidant potential ('fast TRAP' and 'slow TRAP' respectively) . RESULTS: The study group (n = 87) showed a mean (+/- SD) number of 10.2 /- SD retrieved oocytes, 12.6% TIFF, a mean fertilization rate of 59.7% and a pregnancy rate of 19.5% (17/87). TIFF was significantly predicted by TPM Cpost-wash, 'strict criteria', Al and 'cytoplasmic residues' (all P < 0.05) . The outcome after embryo transfer was significantly predicted by Al and ' fast TRAP'. Semen samples with an Al <5% and a 'fast TRAP' <1.14 mmol/l in particular did not result in any pregnancies after IVF-embryo transfer. CON CLUSIONS: Of all the measured and calculated semen variables, TPMCpost-wash was the best predictor of TIFF, whilst Al and 'fast TRAP' were the best pr edictors of pregnancy after IVF.