Sperm penetration assay in predicting successful in vitro fertilization. A meta-analysis.

OBJECTIVE

To determine if the performance of the sperm penetration assay (SPA) is useful in predicting successful in vitro fertilization (IVF).

METHODS

A meta-analysis was set up to determine the performance of SPA in the prediction of IVF success. We collected data on 647 patients in 24 studies. For each study, a two-by-two table was constructed from the results of SPA and IVF.

RESULTS

The sensitivity and specificity of SPA as compared to IVF were heterogeneous. A summary receiver operating characteristics curve could be estimated, showing that the sensitivity of SPA was only 37%, with a specificity of 95%. Subgroup analysis did not explain the lack of homogeneity.

CONCLUSION

Since withholding IVF inappropriately has major consequences, performing SPA is insufficient for selecting patients for treatment with IVF-embryo transfer.