A Study to Sustain the Hypothesis of the Multiple Genesis of Oligoasthenoteratospermia in Human Idiopathic Infertile Males

Abstract

Interdependence between sperm concentration, motility, morphology, and the percentage of aneuploid sperm was explored to test whether oligoasthenoteratospermia (OAT) may have a multiple origin in idiopathic infertile males. A total of 174 men (age, 35.8 +/- 4.3 yr) with idiopathic infertility were studied. Seven patients had nonobstructive azoospermia, 55 had severe OAT, 30 had OAT, 27 had isolated alterations of motility, 45 had alterations of morphology and of motility, and 10 had isolated alterations of morphology. The sperm morphology was assessed with strict criteria. The percentage of aneuploid sperm was assessed with fluorescent in situ hybridization for chromosomes X, Y, 13, 15, 16, 17, 18, 21, and 22. Relationships between sperm features, and the relationship between sperm features and aneuploidies were analyzed with multivariate regression analysis. Statistical analysis did not find any significant relationship between the percentage of typical forms and sperm concentration or between morphology and motility. On the other hand, a positive and significant relationship was found between sperm concentration and motility. The percentage of aneuploid sperm was inversely and significantly related to the percentage of typical forms but not to motility and concentration. Sperm morphology is an independent characteristic with respect to concentration and motility, whereas it showed a significant inverse relationship with respect to the percentage of aneuploid sperm. This means that idiopathic OAT may occur by means of at least two independent pathways, the first affecting concentration and/or motility and the second affecting morphology.

Reduction in sperm aneuploidy levels in severe oligoasthenoteratospermic patients after medical therapy: a preliminary report

“…Our data confirm the link between sperm morphology and aneuploidy and indicate that morphology is a semen parameter that seems to be independent of sperm concentration and motility. 13 Our results support the view that sperm morphology is the most informative semen measurement for discriminating fertile men from infertile men. 14 The outcome of ICSI is also believed to be linked to sperm concentration 19,20 and/or to sperm motility.…”

“…First, we compared the patients that exhibited reductions in their sperm aneuploidy levels (group 1) and the patients in whom there was no reduction (group 2). It was possible to plan this kind of comparison a priori, because idiopathic OAT has multiple aetiologies, 13 and carnitines improve semen parameters only in the presence of the normal activity of mitochondrial phospholipid hydroperoxide glutathione peroxidase. 24 Second, we evaluated the intra-individual variability of the FISH test results in 15 cases, and there were no significant differences.…”

“…30 This made the recruitment of couples for the present paper particularly difficult. Although sperm morphology is an independent characteristic with respect to concentration and motility, which, by contrast, are directly linked to each other, 13 we were compelled to recruit couples arbitrarily only on the basis of sperm concentration to avoid an excessively long study period.…”

“…The evaluation of the incidence of aneuploidy followed a conservative approach by doubling the incidence of disomy. 13 The lack of a hybridisation signal for each of the chromosomes studied was not taken into account because, although these sperm may be theoretically nullisomic for one of these chromosomes, it is impossible to distinguish between nullisomies and hybridisation failures. 13 The following female partner variables were compared between the ICSI cycles carried out before and after male therapy: the numbers of oocytes collected, injected and fertilized (defined as the presence of two distinct pronuclei 16-18 h after sperm injection), the number of embryos transferred (embryos were transferred 4 days after injection, i.e., at the eight-cell stage), the number of biochemical pregnancies (detected by measuring serum b-hCG on at least two occasions 14 days after embryo transfer), and the numbers of clinical pregnancies (defined as detectable heart activity), miscarriages and live births (defined as any birth event in which at least one baby was born alive and survived for .1 month).…”

“…15 At present, the identification of a normal threshold or normal range of variation for the percentage of aneuploid sperm is regarded as impossible, because notable differences exist among laboratories. 13 Thus, data related to aneuploidy in all severe OAT patients included in the study were considered.…”