Evaluation of quantitative motility and zona pellucida binding of human spermatozoa in an assisted reproductive programme
Male factor disorders affect more than 30% of infertile couples. Thus, it has become important to perform a andrological consultation and a basic semen evaluation in all male partners of couples consulting for infertility. The advent and development of assisted reproductive technologies has not only improved clinical results but also enhanced our basic understanding of the physiology of sperm and sperm preparation methods. Assisted reproduction has become among the more successful therapeutic modalities for a wide variety of sperm function disorders e.g. artificial insemination and in vitro fertilization (IVF) (Acosta et al. 1989). It is clear from recent experience that patients with male infertility showing oligozoospermia, asthenozoospermia, teratozoospermia (sometimes in combination), male immunological factor (antisperm antibodies) or ejaculatory problems as well as congenital abnormalities, can be successfully treated with IVF and embryo transfer. Prerequisite pre-fertilization changes by sperm, termed "capacitation" (Austin 1952) provides sperm with the capacity to fertilize eggs. These processes are generally regarded as encompassing all pre-fertilization changes occurring in sperm up 'to, but not including, loss of the acrosome (Bedford 1970). The endpoints of capacitation are often described as the acrosomal loss as well as changes in the motion characteristics. Capacitation alters the pattern of motility exhibited by freely swimming sperm, changing from a fairly rigid flagellar beat pattern to one of extreme flexure, often associated with increased thrust (Johnson et al. 1981) , which is referred to as hyperactivated motility (Yanagimachi 1981). without the transition to hyperactivated motility, sperm are unable to penetrate the zona pellucida (Fraser 1981), and possibly unable to fertilize eggs. Hyperactivation per se is marked by increased curvature in swimming trajectories and/or increased lateral displacement of the sperm head along their path (Burkman 1984). However, the physiological role of this change in motility is not clearly understood because almost all relevant data have been obtained under in vitro conditions. The association of specific seminal characteristics (sperm concentration, percentage motile cells and percentage normal sperm morphology) with the success rate of assisted particular has been The analysis of 1984; the reproductive techniques and IVF in under great scrutiny (Mahadevan and Trounson relationships between conventional semen parameters and fertilization rates in vitro has shown that sperm motility, concentration and morphology must be considered in estimating opportunities for successful intervention, as in the case of IVF and gamete intrafallopian transfer (GIFT) (Oehninger and Hodgen 1991). A reduction in the percentage of progressive motility alone does not seem to have a significant impact on IVF results unless it is below a threshold value of 10%. The semen sample should have an acceptable sperm concentration and morphology and/or that at least 1.5 X 106 motile spermatozoa can be recovered after swim-up separation (Acosta et al. 1989).