Journal of Andrology
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Journal of Andrology, Vol 14, Issue 1 53-59, Copyright © 1993 by The American Society of Andrology

JOURNAL ARTICLE

Importance of total motile oval count in interpreting the hamster ovum sperm penetration assay

V. T. Brandeis
Brandeis Fertility Center, New York, New York.

A prospective study relating computer-assisted semen analysis (CASA) and technician-determined morphology to sperm penetration assay (SPA) outcome in patients with unexplained infertility or male factor was undertaken on 190 males aged 28-45 to determine the value of total motile oval count (TMO), compared to concentration, motility, and morphology considered independently, in predicting the outcome of the SPA. Prewash sperm count ranged 20-1,328 x 10(6), motility 0-93%, morphology 25-78% oval (%OVAL), and SPA scores 0-100%. Multiple regression analysis yielded two statistical models that identified significant predictors for % penetration (%P). Only TMO in one model and %OVAL in an independent effects model showed statistically significant correlation (P < 0.0001) to %P for all subjects. Discriminant function analysis showed the TMO model 85.4% accurate in classifying %P both in the abnormal range (< 20%P) and in the normal range (> or = 20%P). The independent effects model correctly classified 93% in the abnormal group, but projected 72 false negatives in the 101 subjects with %P > or = 20%, correctly classifying only 28.7%. Relative risk analysis showed TMO as a stronger risk factor affecting SPA outcome than %OVAL. It is concluded from this study that below 20%P, both TMO and %OVAL appeared to be comparable as predictive factors. Additionally, the TMO model was equally predictive for SPA > or = 20%P, where the independent effects model showed only 28.7% accuracy. SPA outcome appeared to be more profoundly affected by a decrease in TMO than by a decrease in %OVAL alone.




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Copyright © 1993 by The American Society of Andrology.