Genk Institute for Fertility Technology (GIFT), Ziekenhuis Oost Limburg, Genk, Belgium.
Reprod Biomed Online. 2009 Nov;19(5):671-84. doi: 10.1016/j.rbmo.2009.07.002.
Functional sperm tests such as the sperm chromatin structure assay (SCSA), chromomycin A3 staining (CMA(3)) and hyaluronic acid binding assay (HBA) have been suggested as predictive tests of fertility in vitro. This study aimed to define the clinical role of these functional parameters in assisted reproduction in a prospective cohort study. Conventional sperm diagnosis (motility, morphology and concentration) as well as SCSA, CMA(3) and HBA tests were performed on 205 semen samples [74 IVF, 94 ICSI and 37 combined IVF/intracytoplasmic sperm injection (ICSI)]. Main outcome parameters were fertilization rate, clinical pregnancy rate and take-home baby rate. The study showed that each of the three functional sperm tests was related to one or more conventional and one or more functional sperm tests, indicating that spermatozoa from patients with abnormal conventional semen parameters have a higher likelihood for multiple functional abnormalities. Only SCSA and CMA(3) staining were shown to have a limited predictive value when IVF or combined IVF/ICSI was applied. The proposed threshold value of <or=15% for predicting good fertilization rates and obtaining a pregnancy in IVF could only be confirmed for percent HDS (high DNA stainability in SCSA). ICSI outcome was not influenced by any of the conventional or functional sperm parameters.
功能精子测试，如精子染色质结构分析（SCSA）、色霉素 A3 染色（CMA(3)) 和透明质酸结合试验（HBA），被认为是体外生育能力的预测性测试。本研究旨在通过前瞻性队列研究确定这些功能参数在辅助生殖中的临床作用。对 205 份精液样本[74 份 IVF、94 份 ICSI 和 37 份 IVF/胞浆内精子注射（ICSI）]进行了常规精子诊断（活力、形态和浓度）以及 SCSA、CMA(3)和 HBA 测试。主要结局参数是受精率、临床妊娠率和抱婴回家率。研究表明，三种功能精子测试中的每一种都与一种或多种常规精子测试和一种或多种功能精子测试相关，这表明常规精液参数异常的患者的精子更有可能存在多种功能异常。只有 SCSA 和 CMA(3)染色显示在应用 IVF 或联合 IVF/ICSI 时有一定的预测价值。<or=15%的 SCSA 中 HDS（高 DNA 染色性）值被提议作为预测良好受精率和获得 IVF 妊娠的阈值，仅能得到确认。ICSI 结局不受任何常规或功能精子参数的影响。
