Sperm chromatin packaging as an indicator of in-vitro fertilization rates
The development of a sequential diagnostic schedule for patients consulting for infertility disturbances would be an ideal method of approach for clinicians in the absence of an aetiological or pathophysiological diagnosis. Since sperm morphology recorded by strict criteria has often been correlated with fertilization failure, the present study aimed to evaluate the relationship between normal morphology as well as in-vitro fertilization (IVF) rates, with chromatin staining among fertile and subfertile men. Two semen smears were prepared from each specimen obtained from 72 men to record normal morphology and chromatin packaging as recorded by chromomycin A3 (CMA3) staining. Following the semen analyses, the 72 men were divided into the two morphological groups, namely <4% and >4% normal forms. Significantly different percentages of CMA3 staining (mean ± SE) were recorded between the two morphological groups, namely 65.9% ± 3.5 and 44.5% ± 1.7 (P ± 0.001). A highly negative significant correlation existed between percentage of normal morphology as recorded by strict criteria and CMA3 staining. A highly significant and positive correlation was recorded for normal morphology and IVF rates (r ± 0.45, P ± 0.0001). A significant negative correlation (r ± -0.51, P ± 0.0001) existed between CMA3 values and IVF rates. The discriminating power of nuclear maturity, as recorded by CMA3 staining, to identify abnormal morphology values and poor IVF rates was calculated with receiver operator characteristic (ROC) analyses. The areas under the ROC curves were 0.86 for sperm morphology and 0.74 for IVF rates. The calculated threshold values for CMA3 staining to distinguish between morphology groups were 48 and 50% for IVF. Chromatin packaging assessment is a valuable addition to the sequential diagnostic programme in an assisted reproductive arena.