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Bhatt S, Butola A, Acuña S, Hansen DH, Tinguely JC, Nystad M, Mehta DS, Agarwal K. Characterizing the consistency of motion of spermatozoa through nanoscale motion tracing. F&S SCIENCE 2024; 5:215-224. [PMID: 38977198 DOI: 10.1016/j.xfss.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 06/23/2024] [Accepted: 07/03/2024] [Indexed: 07/10/2024]
Abstract
OBJECTIVE To demonstrate nanoscale motion tracing of spermatozoa and present analysis of the motion traces to characterize the consistency of motion of spermatozoa as a complement to progressive motility analysis. DESIGN Anonymized sperm samples were videographed under a quantitative phase microscope, followed by generating and analyzing superresolution motion traces of individual spermatozoa. SETTING Not applicable. PATIENT(S) Centrifuged human sperm samples. INTERVENTION(S) Not applicable. MAIN OUTCOME MEASURE(S) Precision of motion trace of individual sperms, presence of a helical pattern in the motion trace, mean and standard deviations of helical periods and radii of sperm motion traces, speed of progression. RESULT(S) Spatially sensitive quantitative phase imaging with a superresolution computational technique MUltiple SIgnal Classification ALgorithm allowed achieving motion precision of 340 nm using ×10, 0.25 numerical aperture lens whereas the diffraction-limited resolution at this setting was 1,320 nm. The motion traces thus derived facilitated new kinematic features of sperm, namely the statistics of helix period and radii per sperm. Through the analysis, 47 sperms with a speed >25 μm/s were randomly selected from the same healthy donor semen sample, it is seen that the kinematic features did not correlate with the speed of the sperms. In addition, it is noted that spermatozoa may experience changes in the periodicity and radius of the helical path over time. Further, some very fast sperms (e.g., >70 μm/s) may demonstrate irregular motion and need further investigation. Presented computational analysis can be used directly for sperm samples from both fertility patients with normal and abnormal sperm cell conditions. We note that MUltiple SIgnal Classification ALgorithm is an image analysis technique that may vaguely fall under the machine learning category, but the conventional metrics for reporting found in Enhancing the QUAlity and Transparency Of health Research network do not apply. Alternative suitable metrics are reported, and bias is avoided through random selection of regions for analysis. Detailed methods are included for reproducibility. CONCLUSION(S) Kinematic features derived from nanoscale motion traces of spermatozoa contain information complementary to the speed of the sperms, allowing further distinction among the progressively motile sperms. Some highly progressive spermatozoa may have irregular motion patterns, and whether irregularity of motion indicates poor quality regarding artificial insemination needs further investigation. The presented technique can be generalized for sperm analysis for a variety of fertility conditions.
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Affiliation(s)
- Sunil Bhatt
- Bio-photonics and Green-photonics Laboratory, Department of Physics, Indian Institute of Technology Delhi, Hauz-Khas, New Delhi, India
| | - Ankit Butola
- Department of Physics and Technology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sebastian Acuña
- Department of Physics and Technology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Daniel Henry Hansen
- Department of Physics and Technology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Jean-Claude Tinguely
- Department of Physics and Technology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Mona Nystad
- Department of Clinical Medicine, Women's Health and Perinatology Research Group, UiT The Arctic University of Norway, Tromsø, Norway; Department of Obstetrics and Gynecology, University Hospital of North Norway, Tromsø, Norway
| | - Dalip Singh Mehta
- Bio-photonics and Green-photonics Laboratory, Department of Physics, Indian Institute of Technology Delhi, Hauz-Khas, New Delhi, India
| | - Krishna Agarwal
- Department of Physics and Technology, UiT The Arctic University of Norway, Tromsø, Norway.
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Magli MC, Crippa A, Perruzza D, Azzena S, Graziosi S, Coppola F, Tabanelli C, Ferraretti AP, Gianaroli L. Birefringence properties of human immotile spermatozoa and ICSI outcome. Reprod Biomed Online 2023; 46:597-606. [PMID: 36642560 DOI: 10.1016/j.rbmo.2022.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/05/2022] [Accepted: 11/25/2022] [Indexed: 12/03/2022]
Abstract
RESEARCH QUESTION In sperm samples with complete asthenozoospermia, pregnancies are achieved by intracytoplasmic sperm injection (ICSI), but this condition has a negative impact on fertilization and embryo development owing to the difficulty of identifying viable cells for oocyte injection. Is the selection of sperm cells with head birefringence properties under polarizing light a successful strategy to identify viable spermatozoa? DESIGN This study included 192 ICSI cycles with complete asthenozoospermia (83 ejaculated and 109 testicular samples) performed under polarized light. Two types of sperm head birefringence were distinguished: partial (presumably reacted spermatozoa) and total (presumably intact acrosome). In some sperm cells, no birefringence was present. The main outcome of the study was the cumulative live birth rate (cLBR) per ICSI cycle. RESULTS Seventy-three deliveries resulted with 38.0% cLBR per ICSI cycle. The injection of birefringent spermatozoa led to significantly higher rates of fertilization, embryo development and implantation compared with the absence of birefringence (P < 0.001). Similarly, the resulting cLBR were 53.6% and 9.0%, respectively (P < 0.001). Spermatozoa with partial head birefringence yielded significantly higher fertilization and embryo utilization rates compared with total birefringence. The cLBR showed the same trend (62.7% and 46.7%, respectively, P = 0.048). Multiple logistic regression analysis showed the pattern of partial birefringence to be strongly associated with live birth rate. CONCLUSIONS Immotile sperm cells with birefringence properties under polarized light have higher chances of inducing fertilization and embryo development compared with non-birefringent cells. In addition, a pattern of partial birefringence, associated with a reacted acrosome, is the strongest predictive factor for live birth delivery, both in ejaculated and testicular samples.
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Affiliation(s)
- M Cristina Magli
- SISMER, Reproductive Medicine Unit, Via Mazzini 12, 40138 Bologna, Italy.
| | - Andor Crippa
- SISMER, Reproductive Medicine Unit, Via Mazzini 12, 40138 Bologna, Italy
| | - Davide Perruzza
- SISMER, Reproductive Medicine Unit, Via Mazzini 12, 40138 Bologna, Italy
| | - Silvia Azzena
- SISMER, Reproductive Medicine Unit, Via Mazzini 12, 40138 Bologna, Italy
| | - Serena Graziosi
- SISMER, Reproductive Medicine Unit, Via Mazzini 12, 40138 Bologna, Italy
| | | | - Carla Tabanelli
- SISMER, Reproductive Medicine Unit, Via Mazzini 12, 40138 Bologna, Italy
| | - Anna P Ferraretti
- SISMER, Reproductive Medicine Unit, Via Mazzini 12, 40138 Bologna, Italy
| | - Luca Gianaroli
- SISMER, Reproductive Medicine Unit, Via Mazzini 12, 40138 Bologna, Italy
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Nixon B, Schjenken JE, Burke ND, Skerrett-Byrne DA, Hart HM, De Iuliis GN, Martin JH, Lord T, Bromfield EG. New horizons in human sperm selection for assisted reproduction. Front Endocrinol (Lausanne) 2023; 14:1145533. [PMID: 36909306 PMCID: PMC9992892 DOI: 10.3389/fendo.2023.1145533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 02/08/2023] [Indexed: 02/24/2023] Open
Abstract
Male infertility is a commonly encountered pathology that is estimated to be a contributory factor in approximately 50% of couples seeking recourse to assisted reproductive technologies. Upon clinical presentation, such males are commonly subjected to conventional diagnostic andrological practices that rely on descriptive criteria to define their fertility based on the number of morphologically normal, motile spermatozoa encountered within their ejaculate. Despite the virtual ubiquitous adoption of such diagnostic practices, they are not without their limitations and accordingly, there is now increasing awareness of the importance of assessing sperm quality in order to more accurately predict a male's fertility status. This realization raises the important question of which characteristics signify a high-quality, fertilization competent sperm cell. In this review, we reflect on recent advances in our mechanistic understanding of sperm biology and function, which are contributing to a growing armory of innovative approaches to diagnose and treat male infertility. In particular we review progress toward the implementation of precision medicine; the robust clinical adoption of which in the setting of fertility, currently lags well behind that of other fields of medicine. Despite this, research shows that the application of advanced technology platforms such as whole exome sequencing and proteomic analyses hold considerable promise in optimizing outcomes for the management of male infertility by uncovering and expanding our inventory of candidate infertility biomarkers, as well as those associated with recurrent pregnancy loss. Similarly, the development of advanced imaging technologies in tandem with machine learning artificial intelligence are poised to disrupt the fertility care paradigm by advancing our understanding of the molecular and biological causes of infertility to provide novel avenues for future diagnostics and treatments.
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Affiliation(s)
- Brett Nixon
- Priority Research Centre for Reproductive Science, School of Environmental and Life Sciences, The University of Newcastle, Callaghan, NSW, Australia
- Infertility and Reproduction Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- *Correspondence: Brett Nixon,
| | - John E. Schjenken
- Priority Research Centre for Reproductive Science, School of Environmental and Life Sciences, The University of Newcastle, Callaghan, NSW, Australia
- Infertility and Reproduction Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Nathan D. Burke
- Priority Research Centre for Reproductive Science, School of Environmental and Life Sciences, The University of Newcastle, Callaghan, NSW, Australia
- Infertility and Reproduction Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - David A. Skerrett-Byrne
- Priority Research Centre for Reproductive Science, School of Environmental and Life Sciences, The University of Newcastle, Callaghan, NSW, Australia
- Infertility and Reproduction Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Hanah M. Hart
- Priority Research Centre for Reproductive Science, School of Environmental and Life Sciences, The University of Newcastle, Callaghan, NSW, Australia
- Infertility and Reproduction Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Geoffry N. De Iuliis
- Priority Research Centre for Reproductive Science, School of Environmental and Life Sciences, The University of Newcastle, Callaghan, NSW, Australia
- Infertility and Reproduction Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Jacinta H. Martin
- Priority Research Centre for Reproductive Science, School of Environmental and Life Sciences, The University of Newcastle, Callaghan, NSW, Australia
- Infertility and Reproduction Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Tessa Lord
- Priority Research Centre for Reproductive Science, School of Environmental and Life Sciences, The University of Newcastle, Callaghan, NSW, Australia
- Infertility and Reproduction Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Elizabeth G. Bromfield
- Priority Research Centre for Reproductive Science, School of Environmental and Life Sciences, The University of Newcastle, Callaghan, NSW, Australia
- Infertility and Reproduction Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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Moretti E, Signorini C, Noto D, Corsaro R, Collodel G. The relevance of sperm morphology in male infertility. FRONTIERS IN REPRODUCTIVE HEALTH 2022; 4:945351. [PMID: 36303645 PMCID: PMC9580829 DOI: 10.3389/frph.2022.945351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/11/2022] [Indexed: 11/23/2022] Open
Abstract
This brief report concerns the role of human sperm morphology assessment in different fields of male infertility: basic research, genetics, assisted reproduction technologies, oxidative stress. One of the best methods in studying sperm morphology is transmission electron microscopy (TEM) that enables defining the concept of sperm pathology and classifying alterations in non-systematic and systematic. Non-systematic sperm defects affect head and tail in variable ratio, whereas the rare systematic defects are characterized by a particular anomaly that marks most sperm of an ejaculate. TEM analysis and fluorescence in situ hybridization represent outstanding methods in the study of sperm morphology and cytogenetic in patients with altered karyotype characterizing their semen quality before intracytoplasmic sperm injection. In recent years, the genetic investigations on systematic sperm defects, made extraordinary progress identifying candidate genes whose mutations induce morphological sperm anomalies. The question if sperm morphology has an impact on assisted fertilization outcome is debated. Nowadays, oxidative stress represents one of the most important causes of altered sperm morphology and function and can be analyzed from two points of view: 1) spermatozoa with cytoplasmic residue produce reactive oxygen species, 2) the pathologies with inflammatory/oxidative stress background cause morphological alterations. Finally, sperm morphology is also considered an important endpoint in in vitro experiments where toxic substances, drugs, antioxidants are tested. We think that the field of sperm morphology is far from being exhausted and needs other research. This parameter can be still considered a valuable indicator of sperm dysfunction both in basic and clinical research.
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Deemeh MR, Mesbah-Namin SA, Movahedin M. Selecting motile, non-apoptotic and induced spermatozoa for capacitation without centrifuging by MACS-Up method. Andrologia 2022; 54:e14405. [PMID: 35218061 DOI: 10.1111/and.14405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/07/2022] [Accepted: 02/16/2022] [Indexed: 11/26/2022] Open
Abstract
In newly improved MACS-Up method, magnetic field has been applied to separate non-apoptotic spermatozoa directly from the neat semen. The spermatozoa during passing through a viscous layer, located on the neat semen, contacted with progesterone and induced for the capacitation. Then, a clean population of non-apoptotic, and capacitated spermatozoa were selected in the pure culture media. Selected spermatozoa may be useful for use in ART. The 80 semen samples from normozoospermic individuals were divided separately into 4 attempts. Semen analysis, SCSA (sperm chromatin structure assay), FLICA (fluorescein-labelled inhibitors of caspase) methods, immunoassay of phosphorylation of tyrosine residues of sperm proteins, nuclear DNA integrity, caspase 3 activity and sperm capacitation rate were all performed for evaluation of sperm parameters respectively. To examine all aspects, the MACS-Up method compared with DGC (density gradient centrifuging) and MACS-DGC methods separately. This method can isolate non-apoptotic spermatozoa directly from the neat semen, which has similar performance compared to the MACS-DGC method. Movement and passing spermatozoa through the viscous layer, and contact with progesterone, significantly induced spermatozoa for capacitation compared with the control group. Also, the MACS-Up in comparison with routine DGC method could select spermatozoa with significantly higher total and progressive motility, DNA integrity, induced sperm population for capacitation and normal morphology. MACS-Up can be developed as an effective, short-time, and ease of performing method and used practically to select functional spermatozoa as novel sperm selection procedure. However, for clinical use of MACS-Up, all clinical aspects of this method should be considered and evaluated.
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Affiliation(s)
- Mohammad Reza Deemeh
- Department of Clinical Biochemistry, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Seyed Alireza Mesbah-Namin
- Department of Clinical Biochemistry, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mansoureh Movahedin
- Department of Anatomical Sciences, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Sperm Selection for ICSI: Do We Have a Winner? Cells 2021; 10:cells10123566. [PMID: 34944074 PMCID: PMC8700516 DOI: 10.3390/cells10123566] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 12/26/2022] Open
Abstract
In assisted reproductive technology (ART), the aim of sperm cells’ preparation is to select competent spermatozoa with the highest fertilization potential and in this context, the intracytoplasmic sperm injection (ICSI) represents the most applied technique for fertilization. This makes the process of identifying the perfect spermatozoa extremely important. A number of methods have now been developed to mimic some of the natural selection processes that exist in the female reproductive tract. Although many studies have been conducted to identify the election technique, many doubts and disagreements still remain. In this review, we will discuss all the sperm cell selection techniques currently available for ICSI, starting from the most basic methodologies and continuing with those techniques suitable for sperm cells with reduced motility. Furthermore, different techniques that exploit some sperm membrane characteristics and the most advanced strategy for sperm selection based on microfluidics, will be examined. Finally, a new sperm selection method based on a micro swim-up directly on the ICSI dish will be analyzed. Eventually, advantages and disadvantages of each technique will be debated, trying to draw reasonable conclusions on their efficacy in order to establish the gold standard method.
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Marzano G, Chiriacò MS, Primiceri E, Dell’Aquila ME, Ramalho-Santos J, Zara V, Ferramosca A, Maruccio G. Sperm selection in assisted reproduction: A review of established methods and cutting-edge possibilities. Biotechnol Adv 2020; 40:107498. [DOI: 10.1016/j.biotechadv.2019.107498] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 11/26/2019] [Accepted: 12/06/2019] [Indexed: 12/31/2022]
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Tarozzi N, Nadalini M, Borini A. Effect on Sperm DNA Quality Following Sperm Selection for ART: New Insights. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1166:169-187. [DOI: 10.1007/978-3-030-21664-1_10] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Simopoulou M, Gkoles L, Bakas P, Giannelou P, Kalampokas T, Pantos K, Koutsilieris M. Improving ICSI: A review from the spermatozoon perspective. Syst Biol Reprod Med 2016; 62:359-371. [PMID: 27646677 DOI: 10.1080/19396368.2016.1229365] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Intracytoplasmic sperm injection (ICSI) is the most frequently applied method for fertilization making the process of identifying the perfect spermatozoon fundamental. Herein we offer a critical and thorough presentation on the techniques reported regarding (i) handling and preparing semen samples, (ii) identifying and 'fishing' spermatozoa, and (iii) improving key factors, such as motility for a successful ICSI practice. These approaches are suggested to make the process easier and more effective especially in atypical and challenging circumstances. Furthermore, we present an epigrammatic opinion-where appropriate-based upon our collective experience. Techniques such as intracytoplasmic morphologically selected sperm injection, hyaluronic binding, polarized light microscopy, and annexin V agent identification for comparing sperm cells and their chromatin integrity are analyzed. Moreover, for the demanding cases of total sperm immotility the use of the hypoosmotic swelling test, methylxanthines, as well as the option of laser assisted immotile sperm selection are discussed. Finally, we refer to the employment of myoinositol as a way to bioreactively improve ICSI outcome for oligoasthenoteratozoospermic men. The diversity and the constant development of novel promising techniques to improve ICSI from the spermatozoon perspective, is certainly worth pursuing. The majority of the techniques discussed are still a long way from being established in routine practices of the standard IVF laboratory. In most cases an experienced embryologist could yield the same results. Although some of the techniques show great benefits, there is a need for large scale multicenter randomized control studies to be conducted in order to specify their importance before suggesting horizontal application. Taking into consideration the a priori invasive nature of ICSI, when clinical application becomes a possibility we need to proceed with caution and ensure that in the pursuit for innovation we are not sacrificing safety and the balance of the physiological and biological pathways of the spermatozoon's dynamic. ABBREVIATIONS ICSI: intracytoplasmic sperm injection; IVF: in vitro fertilization; PGD: reimplantation genetic diagnosis; IVM: in vitro maturation; HCV/HIV: hepatitis C virus/human immunodeficiency virus; IMSI: intracytoplasmic morphologically selected sperm injection; DGC: density gradient centrifugations; S-U: swim-up; ART: assisted reproduction technology; IUI: intrauterine insemination; PVP: polyvinylpyrrolidone; HA: hyaluronic acid; MSOME: motile sperm organelle morphology examination; ZP: zona pellucida; MACS: magnetic activation cell sorting; HOST: hypo-osmotic swelling test; TESE: testicular sperm extraction; MMP: mitochondrial membrane potential; OAT: oligoasthenoteratozoospermic.
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Affiliation(s)
- Mara Simopoulou
- a Department of Physiology, Medical School, National and Kapodistrian University of Athens , Athens , Greece.,b Assisted Conception Unit, 2nd Department of Obstetrics and Gynecology , Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | - Laertis Gkoles
- b Assisted Conception Unit, 2nd Department of Obstetrics and Gynecology , Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | - Panagiotis Bakas
- b Assisted Conception Unit, 2nd Department of Obstetrics and Gynecology , Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | - Polina Giannelou
- b Assisted Conception Unit, 2nd Department of Obstetrics and Gynecology , Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | - Theodoros Kalampokas
- b Assisted Conception Unit, 2nd Department of Obstetrics and Gynecology , Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | | | - Michael Koutsilieris
- a Department of Physiology, Medical School, National and Kapodistrian University of Athens , Athens , Greece
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Moretti E, Sutera G, Collodel G. The importance of transmission electron microscopy analysis of spermatozoa: Diagnostic applications and basic research. Syst Biol Reprod Med 2016; 62:171-83. [PMID: 26980361 DOI: 10.3109/19396368.2016.1155242] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
UNLABELLED This review is aimed at discussing the role of ultrastructural studies on human spermatozoa and evaluating transmission electron microscopy as a diagnostic tool that can complete andrology protocols. It is clear that morphological sperm defects may explain decreased fertilizing potential and acquire particular value in the field of male infertility. Electron microscopy is the best method to identify systematic or monomorphic and non-systematic or polymorphic sperm defects. The systematic defects are characterized by a particular anomaly that affects the vast majority of spermatozoa in a semen sample, whereas a heterogeneous combination of head and tail defects found in variable percentages are typically non-systematic or polymorphic sperm defects. A correct diagnosis of these specific sperm alterations is important for choosing the male infertility's therapy and for deciding to turn to assisted reproduction techniques. Transmission electron microscopy (TEM) also represents a valuable method to explore the in vitro effects of different compounds (for example drugs with potential spermicidal activity) on the morphology of human spermatozoa. Finally, TEM used in combination with immunohistochemical techniques, integrates structural and functional aspects that provide a wide horizon in the understanding of sperm physiology and pathology. ABBREVIATIONS transmission electron microscopy: TEM; World Health Organization: WHO; light microscopy: LM; motile sperm organelle morphology examination: MSOME; intracytoplasmic morphologically selected sperm injection: IMSI; intracytoplasmic sperm injection: ICSI; dysplasia of fibrous sheath: DFS; primary ciliary dyskinesia: PCD; outer dense fibers: ODF; assisted reproduction technologies: ART; scanning electron microscopy: SEM; polyvinylpirrolidone: PVP; tert-butylhydroperoxide: TBHP.
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Affiliation(s)
- Elena Moretti
- a Department of Molecular and Developmental Medicine , University of Siena , Siena , Italy
| | - Gaetano Sutera
- a Department of Molecular and Developmental Medicine , University of Siena , Siena , Italy
| | - Giulia Collodel
- a Department of Molecular and Developmental Medicine , University of Siena , Siena , Italy
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