מתוך medicontext.co.il
By Steven Reinberg
NEW YORK (Reuters Health) – Compared with complete sperm analysis, the sperm penetration assay (SPA) more accurately predicts the success of in vitro fertilization (IVF). As such, it may be useful in identifying couples with a high probability of normal in vitro fertilization and those who may need to resort to intracytoplasmic sperm injection.
"We found that patients who had a low value in the SPA test did not obtain normal fertilization in IVF cycles," Dr. Melanie R. Freeman from the Nashville Fertility Center, Tennessee, told Reuters Health. "Using the SPA test we have almost eliminated failed cycles," she added.
Dr. Freeman and colleagues studied 216 couples undergoing male partner screening before IVF. Men underwent both standard sperm analysis and SPA, according to the report in the December issue of Fertility and Sterility.
The negative predictive rate for IVF for SPA was 84% and the positive predictive rate was 98%. SPA also correctly predicted the outcome of IVF in 88% of 265 IVF embryo transfer cycles, Dr. Freeman's team found.
But, sperm concentration correctly predicted IVF fertilization in only 64% of the cycles, sperm motility was correct in 65% of the cycles, morphology was predictive in 45% of the cycles and complete sperm analysis correctly predicted IVF outcomes in only 68% of the cycles, the researchers report.
SPA used to be commonly performed, but it has decreased in popularity because it is expensive and the results can vary depending on the procedure. However, if procedures are established to set constant cutoff values, SPA is a very good test, Dr. Freeman said. SPA is certainly less expensive than a failed IVF cycle, she noted.
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