Andrology: Improved diagnosis of male fertility potential via a combination of quantitative ultramorphology and routine semen analyses

Abstract

The aim of this study was to develop a new male fertility diagnostic profile based on quantitative ultramorphology parameters and to determine the contribution of this profile to the enhancement of the routine semen analysis index reported previously. Semen samples from 208 males of known fertility and suspected infertility were evaluated for the ultrafine structure of the following sperm cell organelles: acrosome, post-acrosomal lamina, nucleus, neck, axonema, mitochondrial and fibrous sheaths. For each of these organelles, four pathological states (agenesis, incomplete genesis, malformation and degradation) and an intact state were defined. A quantitative ultramorphology index based on the incidence of intact nucleus, acrosome and fibrous sheath malformations enabled high accuracy in the classification (97% sensitivity and 90% specificity) of 74% of the cases. A combined semen quality index based on a proportional combination of the semen analysis and quantitative ultramorphology indices was found to increase the percentage of cases classified correctly to 80%. It was proposed that semen specimens of males whose fertility status cannot be predicted clearly using routine semen analysis should be fixed and sent for quantitative ultramorphology analysis to specialized laboratories so that their fertility potential can be determined more accurately using the semen quality index.

Sperm morphology examination

“…Pr Nathalie RIVES -Laboratoire de Biologie de la I rue de Germont, CHU H6pitaux de Rouen, 76031, 158 anomalies ultrastructurales qui sont les seules associees au devenir de I'ICSI ne peuvent pas (~tre d~tect~es ni au grossissement xl00, ni au grossissement x200-400 [4,6]. L'analyse morphologique du sperme ou spermocytogramme est une dtude descriptive de la forme des spermatozofdes partir d'un ~chantillon repr6sentatif d'un 6jaculat.…”

“…La morphologie, le param6tre le plus constant du sperme, figure parmi les moyens les plus fiables de cette 6valuation. Le premier probl~me peut r r6solu par une classification morphologique des spermatozo'fdes selon les diff~rentes anomalies qu'ils pr~sentent [4]. L'analyse ultrastructurale des spermatozoi'des par la ME a la valeur predictive la plus importante pour 6valuer le pouvoir f~condant des spermatozofdes [16].…”

“…Pr Nathalie RIVES -Laboratoire de Biologie anomalies ultrastructurales qui sont les seules associees au devenir de I'ICSI ne peuvent pas (~tre d~tect~es ni au grossissement xl00, ni au grossissement x200-400 [4,6].…”

The prevalence of sperm with large nuclear vacuoles is a prognostic tool in the prediction of ICSI success

“…One particular sperm alteration is the presence of large nuclear vacuoles (LNV); their occurrence has a negative association with natural male fertility potential [19,20] and has been related to reduced ICSI outcomes [11], increased DNA fragmentation [8] and failure of chromatin condensation [16].…”

Ultramorphological sperm characteristics in the risk assessment of health effects after radiation exposure among salvage workers in Chernobyl.

“…With TEM and appropriate staining techniques, it is possible to view both cross-sections of the cell and two-dimensional images of ultrafine anatomical details. Forty-two specific sperm malformations are revealed by this technique (24,25,28 (29).…”