Background: This study aimed to evaluate the application value of sperm acrosome integrity rate in male fertility assessment, its impact on in vitro fertilization (IVF) outcomes, and its predictive value for low IVF fertilization rates. Methods: (1) Semen analysis and sperm acrosome integrity rate testing were performed on 82 male outpatients from the andrology department of our hospital. Correlations between acrosome integrity rate and semen parameters were statistically analyzed. (2) Semen samples from 51 couples undergoing IVF were processed and assessed for both semen parameters and sperm acrosome integrity rate. Correlations between acrosome integrity rate and IVF fertilization outcomes were examined. Results: (1) The sperm acrosome integrity rate was negatively correlated with abstinence duration (p < 0.05) and positively correlated with sperm concentration, progressive motility, and vitality (p < 0.05). (2) The sperm acrosome integrity rate showed a significant positive correlation with IVF fertilization rate (p < 0.05). (3) Logistic regression analysis demonstrated that sperm acrosome integrity rate had a positive effect on IVF fertilization rate. (4) Receiver operating characteristic (ROC) curve analysis indicated that the optimal threshold of sperm acrosome integrity rate for predicting low IVF fertilization rate (<50%) was 95.75%. Conclusions: (1) Sperm acrosome integrity rate is not an independent index but is correlated with semen parameters. (2) It is positively correlated with IVF fertilization rate and can be used as a predictive indicator for low fertilization outcomes in IVF.
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