Enginsu M E, Pieters M H, Dumoulin J C, Evers J L, Geraedts J P
Department of Molecular Cell Biology/Genetics, University of Limburg (3X-Gebouw), Maastricht, The Netherlands.
Hum Reprod. 1992 Sep;7(8):1136-40. doi: 10.1093/oxfordjournals.humrep.a137808.
The effect of different semen parameters was evaluated in 200 consecutive couples in an in-vitro fertilization (IVF) programme. All semen analyses were performed on the native aliquot of semen which was subsequently prepared and used for in-vitro insemination. Morphology evaluation using strict criteria (kappa 0.46 and r = 0.565) was compared with progressive motile sperm density (kappa 0.37 and r = 0.333) and the conventional World Health Organisation (WHO) evaluation of morphology (kappa 0.31 and r = 0.378). Results show that morphology evaluation using strict criteria is the best predictor of IVF and density of progressively motile spermatozoa can be an optional method. The combined results of strict morphology and motile concentration progressively showed that if both parameters were below the cut-off points of 5% and 3 x 10(6)/ml respectively, the fertilization rate per oocyte was very low (18%). No pregnancies were achieved in this group. When both parameters were above the cut-off points, the fertilization rate per oocyte was high (72%) (P less than 0.005) and the pregnancy rate per embryo transfer was 27%. Predictive values indicate that morphology evaluation using strict criteria and the number of progressive motile spermatozoa can be used as patient selection criteria for infertility clinics.
在一项体外受精（IVF）计划中，对200对连续的夫妇评估了不同精液参数的影响。所有精液分析均在精液的原始等分试样上进行，随后制备该等分试样并用于体外受精。将使用严格标准的形态学评估（kappa值为0.46，r = 0.565）与进行性活动精子密度（kappa值为0.37，r = 0.333）以及世界卫生组织（WHO）传统的形态学评估（kappa值为0.31，r = 0.378）进行比较。结果表明，使用严格标准的形态学评估是体外受精的最佳预测指标，进行性活动精子的密度可以作为一种可选方法。严格形态学和活动浓度的综合结果逐渐表明，如果这两个参数分别低于5%和3×10⁶/ml的临界值，则每个卵母细胞的受精率非常低（18%）。该组未实现妊娠。当两个参数均高于临界值时，每个卵母细胞的受精率很高（72%）（P<0.005），每次胚胎移植的妊娠率为27%。预测值表明，使用严格标准的形态学评估和进行性活动精子的数量可作为不孕不育诊所的患者选择标准。
