Franken D R, Acosta A A, Kruger T F, Lombard C J, Oehninger S, Hodgen G D
Department of Obstetrics and Gynaecology, University of Stellenbosch, Tygerberg Hospital, South Africa.
Fertil Steril. 1993 May;59(5):1075-80. doi: 10.1016/s0015-0282(16)55931-7.
To identify male factor infertility among a group of patients in an assisted reproductive program (phase 1) and to evaluate the hemizona assay (HZA) in the diagnosis and prognosis of such a program (phase 2).
The IVF performance of normal gametes in the Tygerberg program were critically evaluated. Female patients were classified as pure tubal factor infertility, having a normal FSH:LH ratio on day 3 of the menstrual cycle. All participating women produced three or more preovulatory oocytes at retrieval and were inseminated with sperm considered normal by all present diagnostic criteria. The total and normal fertilization rate thresholds were defined in that group. Using those thresholds, couples tested for sperm binding in the HZA (n = 48) were used and divided into two groups according to their fertilization rates, namely group 1, low fertilization (< 55%) and group 2, normal fertilization (> 55%).
University-based tertiary care center.
Ninety-nine couples (589 oocytes) with pure tubal factor infertility and normal male factor were used in phase 1. Forty-eight couples with normal and abnormal male factors that had both HZA performed and IVF treatment were included in phase 2.
Investigation of the performance of normal gametes in 99 couples (589 oocytes) revealed the total fertilization rate (total number of oocytes fertilized/total number of oocytes inseminated) was (mean +/- SD) 88.6% +/- 16.8% and the normal fertilization rate (total number of oocytes with normal fertilization/total number of oocytes inseminated) was 81.3% +/- 22%. The minimum total fertilization rate that can be considered normal in the Tygerberg program using mean--2 SD is therefore 55% and for normal fertilization rate is 37%. The group with low fertilization rate (< 55%) showed a mean hemizona index (HZI) significantly lower; nevertheless, the distribution overlapping indicates a low discriminating power of the HZA. A sensitivity of 75% and a specificity of 75% were found; the positive and negative predictive values were 81% and 68%, respectively.
The results indicated the HZA and HZI contribute important information and can serve in conjunction with other semen characteristics as useful tools during the diagnosis of the male factor in assisted reproduction.
在一个辅助生殖项目中识别一组患者中的男性因素不育症（第一阶段），并评估半透明带试验（HZA）在该项目诊断和预后中的作用（第二阶段）。
对泰格堡项目中正常配子的体外受精表现进行严格评估。女性患者被归类为单纯输卵管因素不育症，月经周期第3天促卵泡生成素：促黄体生成素比值正常。所有参与的女性在取卵时产生三个或更多排卵前卵母细胞，并用所有现有诊断标准认定为正常的精子进行授精。在该组中定义了总受精率和正常受精率阈值。使用这些阈值，对进行HZA精子结合测试的夫妇（n = 48）进行研究，并根据其受精率分为两组，即第1组，低受精率（< 55%）和第2组，正常受精率（> 55%）。
大学附属三级医疗中心。
第一阶段使用了99对（589个卵母细胞）患有单纯输卵管因素不育症且男性因素正常的夫妇。第二阶段纳入了48对进行了HZA和体外受精治疗、男性因素正常和异常的夫妇。
对99对夫妇（589个卵母细胞）中正常配子表现的研究表明，总受精率（受精的卵母细胞总数/授精的卵母细胞总数）为（平均值±标准差）88.6%±16.8%，正常受精率（正常受精的卵母细胞总数/授精的卵母细胞总数）为81.3%±22%。因此，在泰格堡项目中使用平均值减2个标准差可认为正常的最低总受精率为55%，正常受精率为37%。低受精率组（< 55%）的平均半透明带指数（HZI）显著较低；然而，分布重叠表明HZA的鉴别能力较低。发现敏感性为75%，特异性为75%；阳性和阴性预测值分别为81%和68%。
结果表明，HZA和HZI提供了重要信息，可与其他精液特征一起作为辅助生殖中男性因素诊断的有用工具。
