About this Journal Submit a Manuscript Table of Contents
BioMed Research International
Volume 2013 (2013), Article ID 945825, 10 pages
http://dx.doi.org/10.1155/2013/945825
Review Article

Hemizona Assay and Sperm Penetration Assay in the Prediction of IVF Outcome: A Systematic Review

1Assisted Reproduction Unit, 3rd Department of Obstetrics and Gynecology, University of Athens, Attikon Hospital, Rimini 1, Chaidari, 12642 Athens, Greece
23rd Department of Obstetrics and Gynecology, University of Athens, Attikon Hospital, Rimini 1, Chaidari, 12642 Athens, Greece
3School of Clinical Sciences, University of Bristol, Level D, St Michael’s Hospital, Bristol BS2 8EG, UK
42nd Department of Obstetrics and Gynecology, University of Athens, Aretaieion Hospital, Vasilissis Sofias 76, 11528 Athens, Greece

Received 9 July 2013; Accepted 1 September 2013

Academic Editor: Benjamin N. Breyer

Copyright © 2013 Paraskevi Vogiatzi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The limited predictive value of semen analysis in achieving natural conception or in IVF outcome confirms the need for sperm function tests to determine optimal management. We reviewed HZA and SPA predictive power in IVF outcome, with statistical significance of diagnostic power of the assays. HZA was readily efficient in predicting IVF outcome, while evident inconsistency among the studies analysed framed the SPA’s role in male fertility evaluation. Considerable variation was noted in the diagnostic accuracy values of SPA with wide sensitivity (52–100%), specificity (0–100%), and PPV (18–100%) and NPV (0–100%) together with fluctuation and notable differentiation in methodology and cutoff values employed by each group. HZA methodology was overall consistent with minor variation in cutoff values and oocyte source, while data analysis reported strong correlation between HZA results with IVF outcome, high sensitivity (75–100%), good specificity (57–100%), and high PPV (79–100%) and NPV (68–100%). HZA correlated well with IVF outcome and demonstrated better sensitivity/specificity and positive/negative predictive power. Males with normal or slightly abnormal semen profiles could benefit by this intervention and could be evaluated prior to referral to assisted reproduction. HZA should be used in a sequential fashion with semen analysis and potentially other bioassays in an IVF setting.