{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T09:05:13Z","timestamp":1790586313403,"version":"4.1.0"},"reference-count":36,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2020,7,22]],"date-time":"2020-07-22T00:00:00Z","timestamp":1595376000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012774","name":"Innovationsfonden","doi-asserted-by":"publisher","award":["14-2013-4"],"award-info":[{"award-number":["14-2013-4"]}],"id":[{"id":"10.13039\/100012774","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The acrosome of the spermatozoa is required for fertilization and in the raw ejaculate the percentage of viable acrosome-intact spermatozoa, the acrosomal status, is higher among men with good semen quality. Here we investigated if the acrosomal status of the processed semen preparations used at a fertility clinic can also be informative and whether it is associated with fecundity. The acrosomal status was measured by image cytometry on purified semen samples from couples during in vitro fertilization (IVF) (n = 99) and intracytoplasmic sperm injection (ICSI) (n = 107) treatment. Purified frozen-thawed donor samples were also analyzed (n = 199). In purified semen preparations the acrosomal status was significantly higher among sperm donors (p = 5.3 \u00d7 10\u22128) and men from IVF couples (p = 2.2 \u00d7 10\u22125) when compared to men from ICSI couples. A significant difference was also found between female, male and mixed factor infertility (p = 0.003). No association with lifestyle factors was found. In frozen-thawed donor samples, a significant positive (r = 0.16, p = 0.025) association with the number of pregnancies per sold straw was observed together with an area under the curve of 75.3%, when comparing the top and bottom deciles. Our results indicate that the acrosomal status may be a valuable parameter for personalizing fertility treatments and might be a good predictor of pregnancy success among normozoospermic men.<\/jats:p>","DOI":"10.3390\/jcm9082327","type":"journal-article","created":{"date-parts":[[2020,7,22]],"date-time":"2020-07-22T07:31:28Z","timestamp":1595403088000},"page":"2327","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Acrosomal Status of Density Purified Spermatozoa Differentiates Men from Couples in IVF and ICSI Treatment and Is Associated with Fecundity"],"prefix":"10.3390","volume":"9","author":[{"given":"Pernille Badsberg","family":"Norup","sequence":"first","affiliation":[{"name":"Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark"},{"name":"International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorte L.","family":"Egeberg Palme","sequence":"additional","affiliation":[{"name":"European Sperm Bank ApS, DK-2200 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten R.","family":"Petersen","sequence":"additional","affiliation":[{"name":"The Fertility Clinic, Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7259-1039","authenticated-orcid":false,"given":"Katharina M.","family":"Main","sequence":"additional","affiliation":[{"name":"Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark"},{"name":"International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1832-0307","authenticated-orcid":false,"given":"Kristian","family":"Almstrup","sequence":"additional","affiliation":[{"name":"Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark"},{"name":"International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,7,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1586","DOI":"10.1093\/humrep\/dey242","article-title":"ART in Europe, 2014: Results generated from European registries by ESHRE: The European IVF-monitoring Consortium (EIM) for the European Society of Human Reproduction and Embryology (ESHRE)","volume":"33","author":"Kupka","year":"2018","journal-title":"Hum. Reprod."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.rbmo.2019.10.013","article-title":"Mapping research in assisted reproduction worldwide","volume":"40","author":"Massucci","year":"2020","journal-title":"Reprod. Biomed. Online"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s12958-016-0225-2","article-title":"Systematic review of worldwide trends in assisted reproductive technology 2004\u20132013","volume":"15","author":"Kushnir","year":"2017","journal-title":"Reprod. Biol. Endocrinol."},{"key":"ref_4","unstructured":"(2020, January 07). Dansk Fertilitetsselskab. Available online: https:\/\/fertilitetsselskab.dk\/dataark-pr-aar\/."},{"key":"ref_5","first-page":"4177","article-title":"Evaluation and Treatment of the Infertile Couple","volume":"83","author":"Forti","year":"1998","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"421.e1","DOI":"10.1016\/j.ajog.2017.12.224","article-title":"Assisted reproductive technology with donor sperm: National trends and perinatal outcomes","volume":"218","author":"Gerkowicz","year":"2018","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_7","unstructured":"World Health Organization (2010). WHO Laboratory Manual for the Examination and Processing of Human Semen, World Health Organization. [5th ed.]."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1056\/NEJMoa003005","article-title":"Sperm morphology, motility, and concentration in fertile and infertile men","volume":"345","author":"Guzick","year":"2001","journal-title":"N. Engl. J. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1152\/physrev.00028.2010","article-title":"Calcium channels in the development, maturation, and function of spermatozoa","volume":"91","author":"Darszon","year":"2011","journal-title":"Physiol. Rev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"s110","DOI":"10.1017\/S1751731118000526","article-title":"Review: The epic journey of sperm through the female reproductive tract","volume":"12","author":"Miller","year":"2018","journal-title":"Animal"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1093\/humupd\/dmz032","article-title":"Human sperm ion channel (dys)function: Implications for fertilization","volume":"25","author":"Brown","year":"2019","journal-title":"Hum. Reprod. Update"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1095\/biolreprod15.4.471","article-title":"The use of zona-free animal ova as a test-system for the assessment of the fertilizing capacity of human spermatozoa","volume":"15","author":"Yanagimachi","year":"1976","journal-title":"Biol. Reprod."},{"key":"ref_13","first-page":"444","article-title":"Agglutination of normal, coated and enzyme-treated human spermatozoa with heterophile agglutinins","volume":"23","author":"Uhlenbruck","year":"1972","journal-title":"Vox Sang."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"197","DOI":"10.3109\/01485018108987531","article-title":"Lectins as probes of the spermatozoon surface","volume":"6","author":"Koehler","year":"1981","journal-title":"Arch. Androl."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1093\/humrep\/dex380","article-title":"Viable acrosome-intact human spermatozoa in the ejaculate as a marker of semen quality and fertility status","volume":"33","author":"Rehfeld","year":"2018","journal-title":"Hum. Reprod."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Rehfeld, A., Egeberg Palme, D.L., Almstrup, K., Juul, A., and Skakkebaek, N.E. (2019). Medium-throughput Screening Assays for Assessment of Effects on Ca2+-Signaling and Acrosome Reaction in Human Sperm. J. Vis. Exp., e59212.","DOI":"10.3791\/59212-v"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1016\/j.fertnstert.2012.03.002","article-title":"Recording and sorting live human sperm undergoing acrosome reaction","volume":"97","author":"Zoppino","year":"2012","journal-title":"Fertil. Steril."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1093\/oxfordjournals.humrep.a137628","article-title":"Comparison of Percoll, mini-Percoll and swim-up methods for sperm preparation from abnormal semen samples","volume":"7","author":"Ng","year":"1992","journal-title":"Hum. Reprod."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1016\/S0015-0282(98)00002-8","article-title":"Preparation by differential gradient centrifugation is better than swim-up in selecting sperm with normal morphology (strict criteria)","volume":"69","author":"Prakash","year":"1998","journal-title":"Fertil. Steril."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.ejogrb.2014.10.037","article-title":"Fertilization failure after IVF in 304 couples\u2014A case-control study on predictors and long-term prognosis","volume":"184","author":"Krog","year":"2015","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Robin, X., Turck, N., Hainard, A., Tiberti, N., Lisacek, F., Sanchez, J.-C., and M\u00fcller, M. (2011). pROC: An open-source package for R and S+ to analyze and compare ROC curves. BMC Bioinform., 12.","DOI":"10.1186\/1471-2105-12-77"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1034\/j.1600-0412.2001.080004342.x","article-title":"Intrauterine insemination with donor semen. An evaluation of prognostic factors based on a review of 1131 cycles","volume":"80","author":"Khalil","year":"2001","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_23","unstructured":"Amiri, M.F.I. (2007). Analysis of prognostic factors for successful outcome in patients undergoning intrauterine insemination. Acta Med. Iran., 101\u2013106."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e14975","DOI":"10.1097\/MD.0000000000014975","article-title":"Pregnancy and offspring outcomes after artificial insemination with donor sperm: A retrospective analysis of 1805 treatment cycles performed in Northwest China","volume":"98","author":"Zhang","year":"2019","journal-title":"Medicine"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1530\/EC-17-0156","article-title":"EDC IMPACT: Chemical UV filters can affect human sperm function in a progesterone-like manner","volume":"7","author":"Rehfeld","year":"2018","journal-title":"Endocr. Connect."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"758","DOI":"10.15252\/embr.201438869","article-title":"Direct action of endocrine disrupting chemicals on human sperm","volume":"15","author":"Schiffer","year":"2014","journal-title":"EMBO Rep."},{"key":"ref_27","first-page":"323","article-title":"The effects of male age on sperm DNA damage: An evaluation of 2,178 semen samples","volume":"22","author":"Petersen","year":"2018","journal-title":"JBRA Assist. Reprod."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2749","DOI":"10.18632\/aging.101946","article-title":"Male age: Negative impact on sperm DNA fragmentation","volume":"11","author":"Albani","year":"2019","journal-title":"Aging"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1963","DOI":"10.1093\/humrep\/dey283","article-title":"Decrease in semen quality and Leydig cell function in infertile men: A longitudinal study","volume":"33","author":"Olesen","year":"2018","journal-title":"Hum. Reprod."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1093\/oxfordjournals.humrep.a136938","article-title":"Female age, the length of involuntary infertility prior to investigation and fertility outcome","volume":"4","author":"Dunphy","year":"1989","journal-title":"Hum. Reprod."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1016\/0140-6736(91)93060-M","article-title":"Poor oocyte quality rather than implantation failure as a cause of age-related decline in female fertility","volume":"337","author":"Navot","year":"1991","journal-title":"Lancet"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1093\/humrep\/deu040","article-title":"Comparative analysis of three sperm DNA damage assays and sperm nuclear protein content in couples undergoing assisted reproduction treatment","volume":"29","author":"Simon","year":"2014","journal-title":"Hum. Reprod."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"356","DOI":"10.21037\/tau.2019.06.22","article-title":"The effect of sperm DNA fragmentation index on assisted reproductive technology outcomes and its relationship with semen parameters and lifestyle","volume":"8","author":"Yang","year":"2019","journal-title":"Transl. Androl. Urol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1007\/978-3-030-21664-1_5","article-title":"Sperm DNA Fragmentation: Mechanisms of Origin","volume":"1166","author":"Muratori","year":"2019","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1186\/s12958-018-0436-9","article-title":"Lifestyle and fertility: The influence of stress and quality of life on male fertility","volume":"16","author":"Ilacqua","year":"2018","journal-title":"Reprod. Biol. Endocrinol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1080\/19396368.2018.1491074","article-title":"Lifestyle and demographic factors associated with human semen quality and sperm function","volume":"64","author":"Shi","year":"2018","journal-title":"Syst. Biol. Reprod. Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/8\/2327\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:50:37Z","timestamp":1760176237000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/8\/2327"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,22]]},"references-count":36,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2020,8]]}},"alternative-id":["jcm9082327"],"URL":"https:\/\/doi.org\/10.3390\/jcm9082327","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,22]]}}}