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Short report | Open | Published:

Correlation of sperm penetration assay score with polyspermy rate in in-vitro fertilization



The sperm penetration assay (SPA) is used to predict the fertilizing capacity of sperm. Thus, some programs rely on SPA scores to formulate insemination plans in conjunction with in-vitro fertilization (IVF) cycles. The purpose of this study was to evaluate if a relationship exists between SPA scores and polyspermy rates during conventional IVF cycles.


A total of 1350 consecutive IVF patients using conventional IVF insemination were evaluated in the study. Oocytes were inseminated three hours post-retrieval by the addition of 150,000 to 300,000 progressively motile sperm. Approximately 18 hours after insemination, the oocytes were evaluated for fertilization by the visualization of pronuclei. The presence of three or more pronuclei was indicative of polyspermy. Polyspermy rates, fertilization success, embryo quality, and pregnancy rates were analyzed retrospectively to evaluate their relationship with SPA score, count, motility, number of progressively motile sperm inseminated, oocyte pre-insemination incubation time, patient age, and diagnosis.


A significant positive relationship was observed between SPA score and polyspermy rate (rs = 0.10, p < 0.05). Patients with a normal SPA score had significantly higher polyspermy rates than those with abnormal SPA scores (6.3% ± 1.5% vs. 2.0% ± 0.7%, p < 0.05). Fertilization percentage was significantly lower in the group with severely abnormal SPA scores versus all other SPA groups (57.5% ± 2.1% vs. 70.2% ± 1.3%, p < 0.005). Although embryo quality was not affected, both clinical pregnancy and implantation rates improved slightly as SPA score increased. In addition, there was a decrease in the rate of spontaneous abortion as SPA score increased.


These data indicate SPA score is positively correlated with polyspermy rates and IVF fertilization percentage. Additionally, there is a slight increase in clinical pregnancy rates, and embryo implantation rates with increased SPA. Furthermore, there is a slight decrease in spontaneous abortions rates related to increased SPA.


  1. 1.

    Carrell DT: Semen analysis at the turn of the century: an evaluation of potential uses of new sperm function assays. Arch Androl. 2000, 44: 65-75. 10.1080/014850100262434.

  2. 2.

    Zahalsky MP, Zoltan E, Medley N, Nagler HM: Morphology and the sperm penetration assay. Fertil Steril. 2003, 79: 39-41. 10.1016/S0015-0282(02)04412-6.

  3. 3.

    Ho PC, Yeung WS, Chan YF, So WW, Chan ST: Factors affecting the incidence of polyploidy in a human in vitro fertilization program. Int J Fertil Menopausal Stud. 1994, 39: 14-19.

  4. 4.

    van der Ven HH, Al-Hasani S, Diedrich K, Hamerich U, Lehmann F, Krebs D: Polyspermy in in vitro fertilization of human oocytes: frequency and possible causes. Ann N Y Acad Sci. 1985, 442: 88-95.

  5. 5.

    Wang WH, Day BN, Wu GM: How does polyspermy happen in mammalian oocytes?. Microsc Res Tech. 2003, 61: 335-341. 10.1002/jemt.10346.

  6. 6.

    Carrell DT, Bradshaw WS, Jones KP, Middleton RG, Peterson CM, Urry RL: An evaluation of various treatments to increase sperm penetration capacity for potential use in an in vitro fertilization program. Fertil Steril. 1992, 57: 134-138.

  7. 7.

    Carrell DT, Peterson CM, Jones KP, Hatasaka HH, Udoff LC, Cornwell CE, Thorp C, Kuneck P, Erickson L, Campbell B: A simplified coculture system using homologous, attached cumulus tissue results in improved human embryo morphology and pregnancy rates during in vitro fertilization. Journal of Assisted Reproduction and Genetics. 1999, 16: 344-349. 10.1023/A:1020533711711.

  8. 8.

    Porter R, Han T, Tucker MJ, Graham J, Liebermann J, Sills ES: Estimation of second polar body retention rate after conventional insemination and intracytoplasmic sperm injection: in vitro observations from more than 5000 human oocytes. J Assist Reprod Genet. 2003, 20: 371-376. 10.1023/A:1025481011680.

  9. 9.

    Carrell DT, Udoff LT, Hatasaka HH, Jones KP, Peterson CM: Predictability / variability of a modified sperm penetration assay (SPA): review of 1033 patients undergoing zona-free hamster oocyte sperm penetration analyses / IVF. Adv Reprod. 1998, 1: 45-56.

  10. 10.

    Maher ER, Brueton LA, Bowdin SC, Luharia A, Cooper W, Cole TR, Macdonald F, Sampson JR, Barratt CL, Reik W, Hawkins MM: Beckwith-Wiedemann syndrome and assisted reproduction technology (ART). J Med Genet. 2003, 40: 62-64. 10.1136/jmg.40.1.62.

  11. 11.

    Gosden R, Trasler J, Lucifero D, Faddy M: Rare congenital disorders, imprinted genes, and assisted reproductive technology. Lancet. 2003, 361: 1975-1977. 10.1016/S0140-6736(03)13592-1.

  12. 12.

    DeBaun MR, Niemitz EL, Feinberg AP: Association of in vitro fertilization with Beckwith-Wiedemann syndrome and epigenetic alterations of LIT1 and H19. Am J Hum Genet. 2003, 72: 156-160. 10.1086/346031.

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Correspondence to Douglas T Carrell.

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Authors' Contributions

VWA designed the study, carried out statistical evaluation, and was the primary author of the manuscript. CMP, KPJ, HHH, MG, and IH were involved in management of the IVF cases and collection of the clinical data. DTC was responsible for the implementation of the study, administrative requirements including IRB approval, statistical evaluation of the data, and preparation of the manuscript.

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