Research questions

Can a previously defined relationship between sperm capacitation and the probability of a man generating pregnancy within three cycles, prospectively predict male fertility in diverse clinical settings? A second study asked, what is the prevalence of impaired sperm fertilizing ability in men questioning their fertility (MQF), and does this relate to traditional semen analysis metrics?

Design

In the multicentric, prospective observational study, data (n = 128; six clinics) were analysed to test a published relationship between the percentage of fertilization-competent, capacitated spermatozoa (Cap-Score) and probability of generating pregnancy (PGP) within three cycles of intrauterine insemination. Logistic regression of total pregnancy outcomes (n = 252) assessed fit. In the cohort comparison, Cap-Scores of MQF (n = 2155; 22 clinics) were compared with those of 76 fertile men.

Results

New outcomes (n = 128) were rank-ordered by Cap-Score and divided into quintiles (25–26 per group); chi-squared testing revealed no difference between predicted and observed pregnancies (P = 0.809). Total outcomes (n = 252; 128 new + 124 previous) were pooled and the model recalculated, yielding an improved fit (P < 0.001). Applying the Akaike information criterion found that the optimal model used Cap-Score alone. Cap-Scores were performed on 2155 men (with semen analysis data available for 1948). To compare fertilizing ability, men were binned by PGP (≤19%, 20–29%, 30–39%, 40–49%, 50–59%, ≥60%). Distributions of PGP and the corresponding Cap-Scores were significantly lower in MQF versus fertile men (P < 0.001). Notably, 64% of MQF with normal volume, concentration and motility (757/1183) had PGP of 39% or less (Cap-Scores ≤31), versus 25% of fertile men.

Conclusions

Sperm capacitation prospectively predicted male fertility. Impaired capacitation affects many MQF with normal semen analysis results, informing diagnosis versus idiopathic infertility.

中文翻译：

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多中心的前瞻性观察数据表明，精子获能可预测男性的生育能力，而队列比较显示，对生育能力提出质疑的男性获能能力受损的比例很高。

研究问题

先前定义的精子获能与一个男人在三个周期内发生怀孕的可能性之间的关系是否可以预测各种临床情况下的男性生育能力？第二项研究问，对男性的精子受精能力（MQF）提出质疑的男性中，精子受精能力受损的患病率是多少？这与传统的精液分析指标有关吗？

设计

在多中心，前瞻性观察性研究中，分析了数据（n = 128；六个诊所），以测试在三个周期内受精能力，精子获能的百分比（Cap-Score）和发生妊娠的可能性（PGP）之间的已公开关系。宫腔内人工授精。总妊娠结局（n = 252）的逻辑回归评估为适合。在队列比较中，比较了MQF的Cap-Scores（n = 2155； 22个诊所）与76名可育男性的Cap-Scores 。

结果

Cap-Score对新结局（n = 128）进行排序，并分为五分位数（每组25–26）；卡方检验显示，预测怀孕与观察怀孕之间没有差异（P = 0.809）。汇总总结果（n = 252； 128个新结果+ 124个以前的结果），并重新计算模型，从而得出改善的拟合度（P <0.001）。应用Akaike信息准则发现，最佳模型仅使用Cap-Score。对2155名男性进行了盖帽评分（可提供1948年的精液分析数据）。为了比较受精能力，将男性按PGP分类（≤19％，20-29％，30-39％，40-49％，50-59％，≥60％）。与可育男性相比，MQF中PGP和相应的Cap-Scores分布明显较低（P<0.001）。值得注意的是，具有正常体积，浓度和运动能力（757/1183）的MQF的64％的PGP为39％或更低（Cap-Scores≤31），而可育男性为25％。

结论

精子获能可预测男性的生育能力。获能能力下降会影响许多具有正常精液分析结果的MQF，从而提示诊断与特发性不育。