Abstract：
OBJECTIVE: Is acrosin activity related to cumulative live birth rate (CLBR) over 1 year after IVF, intracytoplasmic sperm injection (ICSI) treatment or both?
METHODS: Retrospective monocentric cohort study of 5704 couples who started IVF/ICSI treatments between 2016 and 2021. Acrosin activity was determined by a modified Kennedy method using a commercial kit. Patients were divided into two groups according to their acrosin activity: below 25 μIU/106 spermatozoa; and an acrosin activity 25 μIU/106 spermatozoa or above. Primary outcome was the CLBR, defined as an ongoing pregnancy leading to live birth that had arisen from all embryo transfers carried out within 1 year after the first ovum retrieval. Both conservative and optimistic methods were used for estimating CLBRs.
RESULTS: The CLBRs of patients with an acrosin activity below 25 μIU/106 spermatozoa were found to be significantly lower than those of patients with an acrosin activity 25 μIU/106 spermatozoa or above by conservative (48.5% versus 55.4%, P = 0.02) and optimistic (63.7% versus 70.3%, P = 0.047) methods after adjusting for confounders. When acrosin activity was regarded as a continuous variable, significant negative relationships between acrosin activity and CLBR were identified in subgroups: young couples (men and women aged younger than 30 years) and couples from whom no more than 10 eggs were retrieved.
CONCLUSIONS: Low acrosin activity levels were correlated with decreasing CLBRs over 1 year. These findings suggest that acrosin activity can be used as a predictor for CLBRs before starting IVF/ICSI treatment to enhance the effectiveness of counselling.
METHODS: Retrospective monocentric cohort study of 5704 couples who started IVF/ICSI treatments between 2016 and 2021. Acrosin activity was determined by a modified Kennedy method using a commercial kit. Patients were divided into two groups according to their acrosin activity: below 25 μIU/106 spermatozoa; and an acrosin activity 25 μIU/106 spermatozoa or above. Primary outcome was the CLBR, defined as an ongoing pregnancy leading to live birth that had arisen from all embryo transfers carried out within 1 year after the first ovum retrieval. Both conservative and optimistic methods were used for estimating CLBRs.
RESULTS: The CLBRs of patients with an acrosin activity below 25 μIU/106 spermatozoa were found to be significantly lower than those of patients with an acrosin activity 25 μIU/106 spermatozoa or above by conservative (48.5% versus 55.4%, P = 0.02) and optimistic (63.7% versus 70.3%, P = 0.047) methods after adjusting for confounders. When acrosin activity was regarded as a continuous variable, significant negative relationships between acrosin activity and CLBR were identified in subgroups: young couples (men and women aged younger than 30 years) and couples from whom no more than 10 eggs were retrieved.
CONCLUSIONS: Low acrosin activity levels were correlated with decreasing CLBRs over 1 year. These findings suggest that acrosin activity can be used as a predictor for CLBRs before starting IVF/ICSI treatment to enhance the effectiveness of counselling.
摘要：
目的：顶体酶活性是否与IVF后1年的累积活产率（CLBR）有关，
方法:回顾性单中心队列研究,纳入2016年至2021年开始IVF/ICSI治疗的5704对夫妇.使用商业试剂盒通过改良的Kennedy方法测定顶蛋白酶活性。根据其顶体酶活性将患者分为两组：低于25μIU/106精子；顶体酶活性25μIU/106精子或以上。主要结果是CLBR，定义为持续妊娠，导致活产，这是由于在第一个卵子取出后1年内进行的所有胚胎移植而产生的。保守和乐观两种方法均用于估计CLBR。
结果：发现顶体酶活性低于25μIU/106精子的患者的CLBRs显着低于顶体酶活性25μIU/106精子或以上的患者保守（48.5％对55.4％，P=0.02)和乐观(63.7%对70.3%，P=0.047)校正混杂因素后的方法。当顶体酶活性被视为连续变量时，在以下亚组中发现了顶体酶活性与CLBR之间的显着负相关：年轻夫妇（年龄小于30岁的男女）和从中取出不超过10个卵的夫妇。
结论：顶体酶活性水平低与1年以上CLBR的降低相关。这些发现表明，在开始IVF/ICSI治疗之前，顶体酶活性可以用作CLBRs的预测因子，以提高咨询的有效性。
方法:回顾性单中心队列研究,纳入2016年至2021年开始IVF/ICSI治疗的5704对夫妇.使用商业试剂盒通过改良的Kennedy方法测定顶蛋白酶活性。根据其顶体酶活性将患者分为两组：低于25μIU/106精子；顶体酶活性25μIU/106精子或以上。主要结果是CLBR，定义为持续妊娠，导致活产，这是由于在第一个卵子取出后1年内进行的所有胚胎移植而产生的。保守和乐观两种方法均用于估计CLBR。
结果：发现顶体酶活性低于25μIU/106精子的患者的CLBRs显着低于顶体酶活性25μIU/106精子或以上的患者保守（48.5％对55.4％，P=0.02)和乐观(63.7%对70.3%，P=0.047)校正混杂因素后的方法。当顶体酶活性被视为连续变量时，在以下亚组中发现了顶体酶活性与CLBR之间的显着负相关：年轻夫妇（年龄小于30岁的男女）和从中取出不超过10个卵的夫妇。
结论：顶体酶活性水平低与1年以上CLBR的降低相关。这些发现表明，在开始IVF/ICSI治疗之前，顶体酶活性可以用作CLBRs的预测因子，以提高咨询的有效性。
