We have identified a novel population of infertile males with a reduced P1/P2 ratio. Aberrant P1/P2 ratios arise from an abnormal concentration of P1 and/or P2, either of which is associated with male infertility.

ABSTRACT:The objective of this study was to examine the relationship between DNA integrity and protamines in human sperm. One hundred forty-nine male infertility patients were included in an Institutional Review Board-approved study. Sperm were evaluated for DNA fragmentation using the DNA Integrity Assay, a test equivalent to the sperm chromatin structure assay (SCSA). Additionally, nuclear proteins were extracted and the protamine-1/protamine-2 ratio (P1/ P2), protamine-1 (P1), protamine-2 (P2), and total protamine concentrations were evaluated. We identified 37 patients with abnormally low P1/P2 ratios, 99 patients with normal P1/P2 ratios, and 13 patients with abnormally high P1/P2 ratios. DNA fragmentation was significantly elevated in patients with low P1/P2 ratios (37.1 Ϯ 6.02) vs those with normal and high P1/P2 ratios (26.7 Ϯ 1.9 and 23.8 Ϯ 3.2, respectively; P Ͻ .05) and was inversely correlated with the P1/P2 ratio (R s Ϫ0.18, P Ͻ .05), P1 concentration (R s Ϫ0.29, P Ͻ .001), P2 concentration (R s Ϫ0.24, P Ͻ .005), and total protamine concentration (R s Ϫ0.28, P Ͻ .001). Furthermore, 2 analysis revealed a significant increase in the incidence of marked DNA fragmentation in patients with diminished levels of either P1 or P2. The present study is the first to report that human sperm protamine content is significantly related to DNA fragmentation. In particular, sperm P1 and P2 concentrations inversely correlate with DNA fragmentation, indicating a protective role of the protamines against sperm DNA damage. In light of recent studies highlighting the negative effect of sperm DNA damage on ART outcomes, these findings indicate a possible clinical significance for human sperm protamine levels.

Sperm protamine deficiency has been associated with human male infertility. However, most studies have adopted a global approach to assessing sperm protamine levels. Thus, it is not known whether sperm cells from individual human males possess variations in protamine protein content. The objectives of this study were to evaluate variations in protamine-1 (P1) and protamine-2 (P2) content between individual sperm cells of fertile and infertile men and to correlate DNA integrity and sperm cell viability with protamine levels in individual sperm cells. The semen samples of fertile and infertile men were evaluated globally for protamine protein content using nuclear protein extraction, gel electrophoresis, and densitometry analysis. Individual sperm cell P1 and P2 levels were assessed using immunofluorescence microscopy in conjunction with automated image analysis. The terminal transferase dUTP nick end labeling (TUNEL) assay was performed simultaneously with protamine immunostaining to assess the relationship between protamine levels and DNA integrity in individual spermatozoa. Additionally, the relationship between sperm cell viability and protamine levels was assessed via viability staining concomitant with protamine staining. The protamine fluorescence data demonstrate significant variations in protamine content within individual sperm cells of human males. Overall population-based measures of DNA integrity and sperm cell viability correlate significantly with population-based measurements of protamine levels. The data also demonstrate individual sperm cells displaying the lowest protamine levels display diminished viability and increased sperm cell susceptibility to DNA damage.

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