|Year : 2001 | Volume
| Issue : 2 | Page : 156-158
A study of the hypo-osmotic swelling test of spermatozoa in both fertile and infertile male subjects and its relationship with the standard spermiogram
Kingshuk Majumdar, Gita Rajagopalan, A Bupathy
Department of Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondichery, India
Plot No. 31, 4th Cross, Thanthai Periyar Nagar Extension, Pondicherry - 605 005
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Objective: To compare the hypo-osmotic swelling test (HOST) of spermatozoa with the standard spermiogram in both fertile and infertile male subjects.
Materials and Methods: The HOST was performed on 50 men of proven fertility and 51 infertile men. The results from both the groups were compared with the standard spermiogram.
Study Design: Prospective case-control study.
Analysis: The statistical analysis was done using the Karl Pearsons coefficient of correlation.
Results: The HOST values were higher in the fertile group. The correlation between hypo-osmotic swelling and semen variables was higher in the infertile group than in the fertile group. 2 patients in the infertile group with greater than 50% hypo-osmotic swelling got their spouses pregnant during the study period.
Conclusion: The HOST is inexpensive, easy to perforrn and can be used to evaluate sperm tail function. It can also be used to predict the fertilizing potential of the semen sample.
Keywords: Infertility; Spermatozoa; Hypo-osmotic Swelling Test.
|How to cite this article:|
Majumdar K, Rajagopalan G, Bupathy A. A study of the hypo-osmotic swelling test of spermatozoa in both fertile and infertile male subjects and its relationship with the standard spermiogram. Indian J Urol 2001;17:156-8
|How to cite this URL:|
Majumdar K, Rajagopalan G, Bupathy A. A study of the hypo-osmotic swelling test of spermatozoa in both fertile and infertile male subjects and its relationship with the standard spermiogram. Indian J Urol [serial online] 2001 [cited 2021 Jul 24];17:156-8. Available from: https://www.indianjurol.com/text.asp?2001/17/2/156/21047
| Introduction|| |
The analysis of semen is a major tool in the evaluation of male infertility. The standard semen variables for the diagnosis of fertility/infertility are often insufficient by themselves, unless one of them is extremely low. For a more comprehensive evaluation of the ejaculate, a large number of assays like the HOST have been developed.  The hypo-osmotic swelling test assesses the functional integrity of the sperm plasma membrane. Fluid transport occurs across an intact plasma membrane under hypoosmotic conditions until equilibrium is reached between the inside and outside of the cell. Due to the influx of fluid, the cell will expand causing a bulging of the plasma membrane. The fibres of the sperm tail are normally closely surrounded by the plasma membrane. Curling or bending of the tail fibres will occur within the plasma membrane following influx of fluid. This is best visualized by phase contrast microscopy. Spermatozoa that show a curled tail are also called "swollen". Only spermatozoa with a chemically and physically intact membrane will show tail curling under hypo-osmotic conditions. The plasma membrane of a spermatozoon is also essential for capacitation, acrosome reaction, binding of the sperm to the egg surface and fertilization. The HOST is easy to perform, inexpensive, reliable and can also give an idea about the fertilizing potential of the ejaculate.
In the present study, the hypo-osmotic swelling test was performed in both fertile and infertile male subjects and correlated with the standard semen variables. Most studies on the HOST have involved both fertile and infertile male subjects. However, the present study stands out because the fertile group consists of men with proven fertility of short duration (3 months), which is equal to a single spermatogenesis cycle.
| Materials and Methods|| |
Male partners of 51 infertile couples attending the infertility clinic run by the Department of Obstetrics and Gynaecology of JIPMER Hospital. Pondicherry were investigated from November 1993 to June 1995. There was no obvious cause for infertility in the female partners of the 51 infertile couples after examination and routine diagnostic investigations. During the same time period 50 men of proven fertility, who had got their spouses pregnant within the last 3 months were taken as the control group. The men taken in the control group had got their spouses pregnant without intervention or investigation for infertility. The male partners of both the groups were matched with respect to age and occupation.
The semen analysis was performed after 3 days of sexual abstinence by the methods described in the laboratory manual of the World Health Organization.  A viability test was also performed as described by Eliasson et al. 
The hypo-osmotic swelling test was performed as described by Jeyendran et al (1984).  A total of 200 sperms were counted and the mean score was calculated. The hypo-osmotic swelling test was performed using an Olympus phase contrast microscope. Depending on the morphological changes of spermatozoa when subjected to hypo-osmotic stress, the swelling patterns were labelled from type `a' to type `g'.
The statistical analysis between the HOST and the different semen variables in the fertile and infertile groups was done using Karl Pearson's coefficient of correlation.
| Results|| |
The average HOST score was 66.8% in the fertile group and 32.0% in the infertile group. Type `b' and `g' swelling patterns were the commonest in both the groups.
The Karl Pearson's coefficient of correlation between the total hypo-osmotic swelling and sperm motility in the infertile group was highly significant (P < 0.001). It was the highest when compared to its correlation with morphology, viability and sperm count. The correlation coefficients were higher in the infertile group compared to the fertile group [Table - 1].
Type `b' swelling pattern, correlated highly with rapid progressive motility (P < 0.001) and total motility (P < 0.001) in the infertile group. In comparison, normal morphology, viability and sperm count showed significant but lower correlation [Table - 2].
80% of the patients in the infertile group showed less than 60% hypo-osmotic swelling and 68.6% showed less than 50% hypo-osmotic swelling. No patients in the fertile group showed less than 50% hypo-osmotic swelling.
In the infertile group, 16 patients (31.4%) had >50% hypo-osmotic swelling scores of which 2 patients (12.5%) got their spouses pregnant during the study period.
| Discussion|| |
The sperm penetration assay is widely accepted for assessment of the fertilizing capacity of human spermatozoa. However, this test is expensive, time consuming, complex and labour intensive. Therefore, an inexpensive, simple and reliable test would be most ideal.The hypoosmotic swelling test fulfils most of the above criteria and can be widely used.
Most investigators have noted that <50% total swollen sperms is definitely abnormal.  No difference in pregnancy rates were noted between women whose partners had subnormal, normal or superior spermiograms as long as the results of the HOST were >50%.  The high percentage of low HOST scores in the infertile group is because only men with no obvious cause for infertility in their female partners were included in this group. The study group therefore comprised mainly of men with either male factor infertility or with idiopathic infertility.
The higher coefficient of correlation in our study between the HOST values and sperm count in the infertile group could be because of most oligozoospermic samples showing a low HOST score. This is in variance compared to most studies, though some investigators have found a significant correlation between these 2 variables. ,,
The correlation between sperm swelling and motility was found to be greater at a lower percentage of sperm swelling (<50%). This is because at a lower percentage swelling, sperm motility may or may not be normal.  The HOST correlates with motility, particularly in oligo-, astheno-, and teratozoospermic semen samples.  Total swelling and type `b' swelling correlated highly with motility in our study.
A small but significant correlation has been found between sperm swelling and sperm morphology by most investigators. Colpi et al,  found mid-piece abnormalities to correlate with the HOST. We found no correlation between any Specific morphologic abnormality and the total HOST score.
The parameter of sperm viability in hypo-osmotic swelling (VHOS) may be a more useful functional test and may eliminate many false positive and false negative results in the HOST.  Though the HOST and viability test assess different parameters of the spermatozoon they show a significant correlation coefficient with each other. A high correlation coefficient was also noted in our study.
| Conclusion|| |
To conclude, the HOST may help to identify infertile subjects with subnormal spermiograms but a normal HOST score who are likely to benefit from assisted reproductive techniques. Also, infertile subjects with a normal spermiogram may have an abnormal HOST which could explain the cause for their infertility.
| References|| |
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[Table - 1], [Table - 2]