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Table 7 Summary of SEN, SPE, PLR, NLR, DS, DOR, and AUC values for AE assay

From: Human sperm acrosome function assays are predictive of fertilization rate in vitro: a retrospective cohort study and meta-analysis

Subgroup N SEN (95% CI) SPE (95% CI) PLR (95% CI) NLR (95% CI) DS (95% CI) DOR (95% CI) AUC (95% CI) P a
Overall 12 0.57 (0.41–0.71) 0.85 (0.73–0.93) 3.91
(2.31–6.61) 		0.50
(0.37–0.68) 		2.05 (1.43–2.67) 7.78 (4.19–14.46) 0.78 (0.74–0.81)  
Outlier excluded 11 0.51 (0.39–0.62) 0.88 (0.79–0.94) 4.22
(2.42–7.36) 		0.56
(0.45–0.69) 		2.02 (1.37–2.67) 7.53 (3.92–14.47) 0.73 (0.69–0.77)  
Storage method
 Cryopreservation 1 0.51 0.51 1.06 0.95 −c 1.12 – < 0.001
 Fresh 11 0.60 (0.41–0.76) 0.87 (0.77–0.93) 4.64 (3.04–7.08) 0.46 (0.32–0.68) 2.30 (1.80–2.80) 9.99 (6.05–16.49) 0.83 (0.80–0.86)  
Preparation method
 No preparation 6 0.72 (0.50–0.87) 0.80 (0.59–0.92) 3.68 (1.90–7.13) 0.35 (0.21–0.59) 2.36 (1.71–3.01) 10.56 (5.51–20.26) 0.83 (0.79–0.86) 0.006
 Swim up 4b 0.38 (0.24–0.54) 0.86 (0.49–0.97) 2.63 (0.75–9.18) 0.73 (0.62–0.85) 1.29 (− 0.06–2.63) 3.62 (0.94–13.90) 0.51 (0.47–0.56)  
 Discontinuous gradient 4 0.46 (0.28–0.65) 0.90 (0.87–0.93) 4.83 (2.64–8.83) 0.60 (0.41–0.87) 2.09 (1.14–3.04) 8.08 (3.13–20.88) 0.90 (0.87–0.92)  
FR cut-off value combined with AE assay method
<  50% Spectrophotometry          NC
Spectrophotometry/BAPNA 4b 0.63 (0.48–0.76) 0.87 (0.60–0.97) 4.96 (1.51–16.37) 0.42 (0.32–0.57) 2.46 (1.24–3.67) 11.68 (3.47–39.36) 0.75 (0.71–0.79)  
Substrate assay
Acrosin target with gelatine substrate assay 1 0.50 0.93 7.00 0.54 – 13.00 0.80d  
≤ 50% Substrate assay
Acrosin target with gelatine substrate assay 1 0.26 0.97 9.64 0.76 – 12.63 –  
= 0% Fluorometry
PAb-acrosin 1 0.63 0.92 9.23 0.39 – 23.87 –  
PAb-hyaluronidase 1 0.23 0.90 2.29 0.86 – 2.68 –  
MAb 4D4-proacrosin 1 0.40 0.96 10.00 0.63 – 16.00 0.71d  
Spectrophotometry
Spectrophotometry/BAPNA 4 0.78 (0.38–0.95) 0.63 (0.40–0.81) 2.11 (1.25–3.55) 0.35 (0.11–1.18) 1.78 (0.29–3.27) 5.94 (1.34–26.34) 0.74 (0.70–0.78)  
Accu-sperm
Spectrophotometry/BAPNA 		1 0.61 0.84 3.90 0.46 – 8.4 –  
  1. SEN sensitivity, SPE specificity, PLR positive likelihood ratio, NLR negative likelihood ratio, DS diagnostic score, DOR diagnostic odds ratio, AUC area under the summary receiver operating characteristic curve, CI confidence interval, NC not compared
  2. aComparison between subgroups with the Q test for heterogeneity
  3. bConverted number = actual number × 2. Studies were duplicated for numbers ≥ 2 and < 4, based on the computation of bivariate mixed effects regression model for the lowest threshold of 4 studies
  4. cNot calculated in original data or not reported
  5. dCoordinates in scatter plots were converted with the Engauge digitizer to calculate AUC
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