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Quispe-Ccasa HA, Briceño-Mendoza YM, Cayo-Colca IS. Guinea Pig Sperm Morphology and Fertility under Different Photoperiod. Animals (Basel) 2023; 13:2249. [PMID: 37508028 PMCID: PMC10376535 DOI: 10.3390/ani13142249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/23/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
Sperm morphology can predict the reproductive male fertilizing potential. This study aimed to determine the morphological and morphometric spermatozoa characteristics from guinea pigs subjected to different photoperiodic stimulation. Thirty F1 guinea pigs were randomly assigned to three photoperiodic treatments: FT1 (photoperiod with 10 Light/14 Dark LED light), FT2 (photoperiod with 10L/14D sunlight), and FT0 (room without direct light source). At 107 ± 9.8 days of age, sperm concentration and motility were higher in the FT0 and FT1 groups (p < 0.05); furthermore, there were no differences in nucleus length and ellipticity between the FT0 and FT1 groups, but the sperm of the FT1 group was higher in perimeter and nuclear area, while that of the FT0 group was higher in roughness, regularity, midpiece length, and tail (p < 0.01). Expanding acrosome (Type 2) was more frequent in the FT2 group, but there was variation in head measurements between all morphological categories. Pregnancy rate, calving age, and mating age were higher in the FT0 group; meanwhile, the FT1 group initiated successful matings earlier (p < 0.01). The FT0 group had a higher fertility rate, and the age of mating and first calving were earlier in the FT1 group than the FT0 group, but no pregnancies were reported for the FT2 group. Photoperiodic stimulation can increase the morphometric dimensions of guinea pig spermatozoa, favoring the reproductive characteristics, but sunlight could reduce their size due to heat stress.
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Affiliation(s)
- Hurley Abel Quispe-Ccasa
- Graduate School, Universidad Nacional Toribio Rodríguez de Mendoza of Amazonas, Chachapoyas 01001, Amazonas, Peru
| | - Yander M Briceño-Mendoza
- Facultad de Ingeniería Zootecnista, Agronegocios y Biotecnología (FIZAB), Universidad Nacional Toribio Rodríguez de Mendoza of Amazonas, Chachapoyas 01001, Amazonas, Peru
| | - Ilse Silvia Cayo-Colca
- Facultad de Ingeniería Zootecnista, Agronegocios y Biotecnología (FIZAB), Universidad Nacional Toribio Rodríguez de Mendoza of Amazonas, Chachapoyas 01001, Amazonas, Peru
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Morphometric Characteristics of the Spermatozoa of Blue Fox ( Alopex lagopus) and Silver Fox ( Vulpes vulpes). Animals (Basel) 2020; 10:ani10101927. [PMID: 33092144 PMCID: PMC7589158 DOI: 10.3390/ani10101927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/08/2020] [Accepted: 10/18/2020] [Indexed: 02/06/2023] Open
Abstract
Simple Summary The present study describes a detailed morphometric analysis of the sperm of the blue fox (Alopex lagopus) and silver fox (Vulpes vulpes), together with determination of the shape indices of the sperm head. Staining with silver nitrate enables precise identification of the acrosome and reveals structural details of the sperm tail, so that they can be accurately measured. Statistically significant differences were found for most of the morphometric parameters of the two fox species. The blue fox sperm were generally larger, but the acrosome area and coverage were greater in the silver fox. There are no clear recommendations regarding sperm staining techniques for foxes, and no reference values for morphometric parameters of the sperm of foxes or for canines in general. Staining with silver nitrate for evaluation of the morphometry of fox sperm can be used as an independent technique or an auxiliary technique in routine analysis of canine semen. Abstract The results presented in this study are the first such extensive characterization of the sperm morphometry of the blue fox (Alopex lagopus) and silver fox (Vulpes vulpes), as representatives of the family Canidae. Canine spermatozoa, especially the sperm of farmed foxes, are not often described in studies on reproduction. The aim of the study was a detailed comparison of the morphometric dimensions and shape of the sperm of two fox species: silver fox and blue fox. Semen collected from 10 silver foxes and 10 blue foxes was used for the study. The specimens were stained with silver nitrate. Measurements were performed of the length, width, perimeter, and area of the head; the area of the acrosome and its coverage; the length of the midpiece and its coverage; the length of the tail; and the length of the end piece of the tail. In addition, four head shape indices were calculated: ellipticity, elongation, roughness and regularity. The following values for the morphometric parameters and shape indices were obtained for blue fox and silver fox, respectively: head length—6.72 µm and 6.33 µm; head width—4.54.µm and 4.21 µm; head perimeter—18.11 µm and 17.37 µm; head area—21.94 µm2 and 21.11 µm2; acrosome area—11.50 µm2 and 10.92 µm2; midpiece length—12.85 µm and 12.79 µm; tail end piece length—3.44 µm and 3.28 µm; tail length—65.23 µm and 65.09 µm; acrosome coverage—52.43% and 52.83%; midpiece coverage—19.71% and 19.65%; sperm length—71.95 µm and 71.42 µm; ellipticity—1.49 and 1.52; elongation—0.19 and 0.20; roughness—0.84 and 1.88; regularity—1.09 and 0.99. The significance of differences between species was verified by Tukey’s test at p ≤ 0.05. Statistically significant differences between species were found for the following parameters: head length, width, perimeter and area; acrosome area; tail, end piece, and total sperm length; roughness and regularity. The differences in the size and shape of sperm can be used to establish reference patterns for fox sperm enabling more accurate species identification.
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Huanca-Marca NF, Ordoñez-Rodríguez CD, Quispe-Ccasa HA, Antezana-Julian WO, Jordan-Misme LA, Ampuero-Casquino E, Cucho-Dolmos HC. Parámetros morfométricos del espermatozoide de alpaca ( Vicugna pacos), obtenidos por tres métodos de colección. JOURNAL OF THE SELVA ANDINA ANIMAL SCIENCE 2020. [DOI: 10.36610/j.jsaas.2020.070200050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Huanca-Marca NF, Ordoñez-Rodríguez CD, Quispe-Ccasa HA, Antezana-Julian WO, Jordan-Misme LA, Ampuero-Casquino E, Cucho-Dolmos HC. Morphometric parameters of alpaca spermatozoa ( Vicugna pacos), obtained by three collection methods. JOURNAL OF THE SELVA ANDINA ANIMAL SCIENCE 2020. [DOI: 10.36610/j.jsaas.2020.070200050x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Palacin I, Santolaria P, Alquezar-Baeta C, Soler C, Silvestre MA, Yániz J. Relationship of sperm plasma membrane and acrosomal integrities with sperm morphometry in Bos taurus. Asian J Androl 2020; 22:578-582. [PMID: 32341212 PMCID: PMC7705972 DOI: 10.4103/aja.aja_2_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
To date, sperm morphometric studies have assessed whole sperm populations without considering sperm function. The aim of this study was to evaluate the relationship of sperm membrane and acrosomal integrity with sperm morphometry in liquid semen samples collected from bulls. To this end, sperm morphometry was performed on cryopreserved semen samples from 16 bulls by a combination of fluorescent dyes, including Hoechst 33343, carboxyfluorescein diacetate, and propidium iodide. This allowed discrimination of different subpopulations on the basis of sperm membrane and acrosomal integrity and analysis of the morphometrics of the sperm head, nucleus, and acrosome using a specific plug-in module created on ImageJ. Acrosomal integrity was related to sperm morphometry as the heads of spermatozoa with a damaged acrosome were significantly smaller than those with a normal acrosome (P < 0.001). In the case of spermatozoa with an intact acrosome, those with a damaged plasma membrane had a larger sperm head and acrosome than spermatozoa with an intact plasma membrane (P < 0.001). No significant differences in the sperm head size were observed between sperm subpopulations without an acrosome or in the nuclear sperm morphometry of the different subpopulations. There was a positive correlation between the sperm motility values of the samples and the morphometric parameters for intact spermatozoa. These correlations were particularly strong for the morphometric parameters of the sperm acrosome. We conclude that there are clear differences in the sperm morphometry depending on the status of the sperm membrane and acrosome and this should be considered when performing this kind of analysis.
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Affiliation(s)
- Inmaculada Palacin
- BIOFITER Research Group, Environmental Sciences Institute (IUCA), Department of Animal Production and Food Sciences, University of Zaragoza, Huesca 22071, Spain
| | - Pilar Santolaria
- BIOFITER Research Group, Environmental Sciences Institute (IUCA), Department of Animal Production and Food Sciences, University of Zaragoza, Huesca 22071, Spain
| | | | - Carles Soler
- Department of Cellular Biology, Functional Biology and Physical Anthropology, University of Valencia, Burjassot 46100, Spain
| | - Miguel A Silvestre
- Department of Cellular Biology, Functional Biology and Physical Anthropology, University of Valencia, Burjassot 46100, Spain
| | - Jesús Yániz
- BIOFITER Research Group, Environmental Sciences Institute (IUCA), Department of Animal Production and Food Sciences, University of Zaragoza, Huesca 22071, Spain
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Yániz J, Soler C, Alquézar-Baeta C, Santolaria P. Toward an integrative and predictive sperm quality analysis in Bos taurus. Anim Reprod Sci 2017; 181:108-114. [DOI: 10.1016/j.anireprosci.2017.03.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/23/2017] [Accepted: 03/30/2017] [Indexed: 10/19/2022]
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Maroto-Morales A, García-Álvarez O, Ramón M, Martínez-Pastor F, Fernández-Santos MR, Soler AJ, Garde JJ. Current status and potential of morphometric sperm analysis. Asian J Androl 2017; 18:863-870. [PMID: 27678465 PMCID: PMC5109877 DOI: 10.4103/1008-682x.187581] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The spermatozoon is the most diverse cell type known and this diversity is considered to reflect differences in sperm function. How the diversity in sperm morphology arose during speciation and what role the different specializations play in sperm function, however, remain incompletely characterized. This work reviews the hypotheses proposed to explain sperm morphological evolution, with a focus on some aspects of sperm morphometric evaluation; the ability of morphometrics to predict sperm cryoresistance and male fertility is also discussed. For this, the evaluation of patterns of change of sperm head morphometry throughout a process, instead of the study of the morphometric characteristics of the sperm head at different stages, allows a better identification of the males with different sperm cryoconservation ability. These new approaches, together with more studies employing a greater number of individuals, are needed to obtain novel results concerning the role of sperm morphometry on sperm function. Future studies should aim at understanding the causes of sperm design diversity and the mechanisms that generate them, giving increased attention to other sperm structures besides the sperm head. The implementation of scientific and technological advances could benefit the simultaneous examination of sperm phenotype and sperm function, demonstrating that sperm morphometry could be a useful tool for sperm assessment.
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Affiliation(s)
| | - Olga García-Álvarez
- SaBio IREC (CSIC - UCLM - JCCM), Albacete, Spain.,Biomedical Center, Medical Faculty in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | - Manuel Ramón
- Regional Center of Animal Selection and Reproduction (CERSYRA) JCCM, Valdepeñas, Spain
| | - Felipe Martínez-Pastor
- Institute for Animal Health and Cattle Development, University of León, León, Spain.,Department of Molecular Biology, University of León, León, Spain
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Santolaria P, Pauciullo A, Silvestre MA, Vicente-Fiel S, Villanova L, Pinton A, Viruel J, Sales E, Yániz JL. Computer-assisted sperm morphometry fluorescence-based analysis has potential to determine progeny sex. Asian J Androl 2017; 18:858-862. [PMID: 27624989 PMCID: PMC5109876 DOI: 10.4103/1008-682x.187578] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This study was designed to determine the ability of computer-assisted sperm morphometry analysis (CASA-Morph) with fluorescence to discriminate between spermatozoa carrying different sex chromosomes from the nuclear morphometrics generated and different statistical procedures in the bovine species. The study was divided into two experiments. The first was to study the morphometric differences between X- and Y-chromosome-bearing spermatozoa (SX and SY, respectively). Spermatozoa from eight bulls were processed to assess simultaneously the sex chromosome by FISH and sperm morphometry by fluorescence-based CASA-Morph. SX cells were larger than SY cells on average (P < 0.001) although with important differences between bulls. A simultaneous evaluation of all the measured features by discriminant analysis revealed that nuclear area and average fluorescence intensity were the variables selected by stepwise discriminant function analysis as the best discriminators between SX and SY. In the second experiment, the sperm nuclear morphometric results from CASA-Morph in nonsexed (mixed SX and SY) and sexed (SX) semen samples from four bulls were compared. FISH allowed a successful classification of spermatozoa according to their sex chromosome content. X-sexed spermatozoa displayed a larger size and fluorescence intensity than nonsexed spermatozoa (P < 0.05). We conclude that the CASA-Morph fluorescence-based method has the potential to find differences between X- and Y-chromosome-bearing spermatozoa in bovine species although more studies are needed to increase the precision of sex determination by this technique.
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Affiliation(s)
- Pilar Santolaria
- TECNOGAM research group, Environmental Sciences Institute (IUCA), Department of Animal Production and Food Sciences, Higher Polytechnic School, University of Zaragoza, Ctra. Cuarte S/N 22071 Huesca, Spain
| | - Alfredo Pauciullo
- Department of Agriculture, Forest and Food Sciences, University of Torino, Largo Paolo Braccini 2, 10095 Grugliasco, TO, Italy
| | - Miguel A Silvestre
- Department of Functional Biology and Physical Anthropology, University of Valencia, 469100 Burjassot, Valencia, Spain
| | - Sandra Vicente-Fiel
- TECNOGAM research group, Environmental Sciences Institute (IUCA), Department of Animal Production and Food Sciences, Higher Polytechnic School, University of Zaragoza, Ctra. Cuarte S/N 22071 Huesca, Spain
| | - Leyre Villanova
- TECNOGAM research group, Environmental Sciences Institute (IUCA), Department of Animal Production and Food Sciences, Higher Polytechnic School, University of Zaragoza, Ctra. Cuarte S/N 22071 Huesca, Spain
| | - Alain Pinton
- UMR 1388 INRA-ENVT INPT Animal Cytogenetis GenPhySE, National veterinary school of Toulouse, 23 Chemin des Capelles, 31076 Toulouse Cedex 3, France
| | - Juan Viruel
- TECNOGAM research group, Environmental Sciences Institute (IUCA), Department of Animal Production and Food Sciences, Higher Polytechnic School, University of Zaragoza, Ctra. Cuarte S/N 22071 Huesca, Spain.,Mediterranean Institute of marine and terrestrial Biodiversity and Ecology (IMBE), University of Aix Marseille, Chemin de la Batterie des Lions, 13007 Marseille, France
| | - Ester Sales
- TECNOGAM research group, Environmental Sciences Institute (IUCA), Department of Agricultural and Environmental Sciences, Higher Polytechnic School, University of Zaragoza, Ctra. Cuarte S/N 22071 Huesca, Spain
| | - Jesús L Yániz
- TECNOGAM research group, Environmental Sciences Institute (IUCA), Department of Animal Production and Food Sciences, Higher Polytechnic School, University of Zaragoza, Ctra. Cuarte S/N 22071 Huesca, Spain
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Soler C, Cooper TG, Valverde A, Yániz JL. Afterword to Sperm morphometrics today and tomorrow special issue in Asian Journal of Andrology. Asian J Androl 2017; 18:895-897. [PMID: 27751989 PMCID: PMC5109882 DOI: 10.4103/1008-682x.188451] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Carles Soler
- Department of Functional Biology and Physical Anthropology, University of València, 46100 Burjassot, Spain.,Department of R+D, Proiser R+D, Science Park, University of València, 46980 Paterna, Spain
| | | | - Anthony Valverde
- Department of Animal Production and Food Science, Higher Polytechnic School of Huesca, University of Zaragoza, Ctra. Cuarte S/N 22071 Huesca, Spain
| | - Jesús L Yániz
- Department of Animal Production and Food Science, Higher Polytechnic School of Huesca, University of Zaragoza, Ctra. Cuarte S/N 22071 Huesca, Spain
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Yániz JL, Capistrós S, Vicente-Fiel S, Hidalgo CO, Santolaria P. A comparative study of the morphometry of sperm head components in cattle, sheep, and pigs with a computer-assisted fluorescence method. Asian J Androl 2017; 18:840-843. [PMID: 27624987 PMCID: PMC5109873 DOI: 10.4103/1008-682x.186877] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The aim of this study was to compare the sperm nuclear and acrosomal morphometry of three species of domestic artiodactyls; cattle (Bos taurus), sheep (Ovis aries), and pigs (Sus scrofa). Semen smears of twenty ejaculates from each species were fixed and labeled with a propidium iodide-Pisum sativum agglutinin (PI/PSA) combination. Digital images of the sperm nucleus, acrosome, and whole sperm head were captured and analyzed. The use of the PI/PSA combination and CASA-Morph fluorescence-based method allowed the capture, morphometric analysis, and differentiation of most sperm nuclei, acrosomes and whole heads, and the assessment of acrosomal integrity with a high precision in the three species studied. For the size of the head and nuclear area, the relationship between the three species may be summarized as bull > ram > boar. However, for the other morphometric parameters (length, width, and perimeter), there were differences in the relationships between species for sperm nuclei and whole sperm heads. Bull sperm acrosomes were clearly smaller than those in the other species studied and covered a smaller proportion of the sperm head. The acrosomal morphology, small in the bull, large and broad in the sheep, and large, long, and with a pronounced equatorial segment curve in the boar, was species-characteristic. It was concluded that there are clear variations in the size and shape of the sperm head components between the three species studied, the acrosome being the structure showing the most variability, allowing a clear distinction of the spermatozoa of each species.
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Affiliation(s)
- Jesús L Yániz
- TECNOGAM research group, Environmental Sciences Institute (IUCA), Department of Animal Production and Food Sciences, University of Zaragoza, Huesca, Spain
| | - Sara Capistrós
- TECNOGAM research group, Environmental Sciences Institute (IUCA), Department of Animal Production and Food Sciences, University of Zaragoza, Huesca, Spain
| | - Sandra Vicente-Fiel
- TECNOGAM research group, Environmental Sciences Institute (IUCA), Department of Animal Production and Food Sciences, University of Zaragoza, Huesca, Spain
| | - Carlos O Hidalgo
- Animal Genetics and Reproduction Area, Regional Agrifood Research and Development Service (SERIDA), 33394 Deva, Gijón, Spain
| | - Pilar Santolaria
- TECNOGAM research group, Environmental Sciences Institute (IUCA), Department of Animal Production and Food Sciences, University of Zaragoza, Huesca, Spain
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Yániz JL, Soler C, Santolaria P. Computer assisted sperm morphometry in mammals: A review. Anim Reprod Sci 2015; 156:1-12. [PMID: 25802026 DOI: 10.1016/j.anireprosci.2015.03.002] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 02/26/2015] [Accepted: 03/01/2015] [Indexed: 11/19/2022]
Affiliation(s)
- J L Yániz
- TECNOGAM Research Group, Environmental Sciences Institute (IUCA), University of Zaragoza, Huesca, Spain.
| | - C Soler
- Department of Functional Biology and Physical Anthropology, University of Valencia, Valencia, Spain
| | - P Santolaria
- TECNOGAM Research Group, Environmental Sciences Institute (IUCA), University of Zaragoza, Huesca, Spain
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12
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Andolfi L, Trevisan E, Troian B, Prato S, Boscolo R, Giolo E, Luppi S, Martinelli M, Ricci G, Zweyer M. The application of scanning near field optical imaging to the study of human sperm morphology. J Nanobiotechnology 2015; 13:2. [PMID: 25591971 PMCID: PMC4302611 DOI: 10.1186/s12951-014-0061-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 12/18/2014] [Indexed: 11/16/2022] Open
Abstract
Background The morphology of spermatozoa is a fundamental aspect to consider in fertilization, sperm pathology, assisted reproduction and contraception. Head, neck, midpiece, principal and terminal part of flagellum are the main sperm components to investigate for identifying morphological features and related anomalies. Recently, scanning near-field optical microscopy (SNOM), which belongs to the wide family of nanoscopic techniques, has opened up new routes for the investigation of biological systems. SNOM is the only technique able to provide simultaneously highly resolved topography and optical images with a resolution beyond the diffraction limit, typical of conventional optical microscopy. This offers the advantage to obtain complementary information about cell surface and cytoplasmatic structures. Results In this work human spermatozoa both healthy and with morphological anomalies are analyzed by SNOM, to demonstrate the potentiality of such approach in the visualization of sperm morphological details. The combination of SNOM topography with optical (reflection and transmission) images enables to examine typical topographic features of spermatozoa together with underlying cytoplasmic structures. Indeed the head shape and inner components as acrosome and nucleus, and the organization of mitochondria in the midpiece region are observed. Analogously for principal tract of the tail, the ridges and the columns are detected in the SNOM topography, while their internal arrangement can be observed in the corresponding SNOM optical transmission images, without requiring specific staining procedures or invasive protocols. Conclusions Such findings demonstrate that SNOM represents a versatile and powerful tool to describe topographical and inner structural details of spermatozoa simultaneously. This analysis could be helpful for better characterizing several morphological anomalies, often related to sperm infertility, which cannot be examined by conventional techniques all together. Electronic supplementary material The online version of this article (doi:10.1186/s12951-014-0061-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Laura Andolfi
- IOM-CNR, Area Science Park, Basovizza, Trieste, Italy.
| | - Elisa Trevisan
- Department of Life Sciences University of Trieste, Trieste, Italy.
| | - Barbara Troian
- A.P.E. Research Srl, AREA Science Park, Basovizza, Trieste, Italy.
| | - Stefano Prato
- A.P.E. Research Srl, AREA Science Park, Basovizza, Trieste, Italy.
| | - Rita Boscolo
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
| | - Elena Giolo
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
| | - Stefania Luppi
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
| | - Monica Martinelli
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
| | - Giuseppe Ricci
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy. .,Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.
| | - Marina Zweyer
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.
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