Skip to main content
Top
Published in: Journal of Assisted Reproduction and Genetics 11/2012

01-11-2012 | Technological Innovations

Sperm head vacuolization affects clinical outcome in ICSI cycle. A proposal of a cut-off value

Authors: Doriana Falagario, Anna Maria Brucculeri, Raffaella Depalo, Paolo Trerotoli, Ettore Cittadini, Giovanni Ruvolo

Published in: Journal of Assisted Reproduction and Genetics | Issue 11/2012

Login to get access

Abstract

Objective

To evaluate the relationship between sperm nuclear vacuoles and sperm morphology and to investigate the influence of the rate of spermatozoa with head vacuolization (SVR) in a seminal sample on the clinical outcomes in couples undergoing intracytoplasmic sperm injection.

Materials

26 patients undergoing infertility investigations were included and were divided in two groups according to an SVR ≤ 20,28 % (Group A) or > 20,28 % (Group B), and were investigated to verify the influence of SVR on the fertilization rate, embryo quality, pregnancy and implantation rates.

Results

Abnormal spermatozoa with nuclear vacuoles were significantly higher (p < 0.001) than the percentage of normal spermatozoa with nuclear vacuoles. Patients in group A had a percentage of abnormal sperm with nuclear vacuole significantly lower compared to group B (p < 0,001), but there was no difference in the percentage of normal sperm with nuclear vacuoles. Fertilization rates and the number of top quality embryos did not differ between the two groups. The pregnancy and implantation rates were significantly higher in Group A compared to Group B (respectively p < 0,05 and p < 0.001).

Conclusions

For the first time, we propose a cut off value in the proportion of sperms with nuclear vacuolization on the total of sperm in seminal samples, and demonstrate a relationship between SNV and clinical outcomes after ICSI. The SNV rate could be introduced as an easy diagnostic evaluation prior to perform an ICSI cycle.
Literature
1.
go back to reference Akl LD, Oliveira JB, Petersen CG, Mauri AL, Silva LF, Massaro FC, Baruffi RL, Cavagna M, Franco Jr JG. Efficacy of the motile sperm organelle morphology examination (MSOME) in predicting pregnancy after intrauterine insemination. Reprod Biol Endocrinol. 2011;9:120.PubMedCrossRef Akl LD, Oliveira JB, Petersen CG, Mauri AL, Silva LF, Massaro FC, Baruffi RL, Cavagna M, Franco Jr JG. Efficacy of the motile sperm organelle morphology examination (MSOME) in predicting pregnancy after intrauterine insemination. Reprod Biol Endocrinol. 2011;9:120.PubMedCrossRef
2.
go back to reference Bartoov B, Eltes F, Pansky M, Lederman H, Caspi E, Soffer Y. Estimating fertility potential via semen analysis data. Hum Reprod. 1993;8(1):65–70.PubMedCrossRef Bartoov B, Eltes F, Pansky M, Lederman H, Caspi E, Soffer Y. Estimating fertility potential via semen analysis data. Hum Reprod. 1993;8(1):65–70.PubMedCrossRef
3.
go back to reference Bartoov B, Eltes F, Pansky M, Langzam J, Reichart M, Soffer Y. Improved diagnosis of male fertility potential via a combination of quantitative ultramorphology and routine semen analyses. Hum Reprod. 1994;9(11):2069–75.PubMed Bartoov B, Eltes F, Pansky M, Langzam J, Reichart M, Soffer Y. Improved diagnosis of male fertility potential via a combination of quantitative ultramorphology and routine semen analyses. Hum Reprod. 1994;9(11):2069–75.PubMed
4.
go back to reference Bartoov B, Berkovitz A, Eltes F. Selection of spermatozoa with normal nuclei to improve pregnancy rate with intracitoplasmatic sperm injection. N Engl J Med. 2001;345:1067–8.PubMedCrossRef Bartoov B, Berkovitz A, Eltes F. Selection of spermatozoa with normal nuclei to improve pregnancy rate with intracitoplasmatic sperm injection. N Engl J Med. 2001;345:1067–8.PubMedCrossRef
5.
go back to reference Bartoov B, Berkovitz A, Eltes F, Kogosowski A, Menezo Y, Barak Y. Real-time fine morphology of motile sperm cells is asociated with IVF-ICSI outcome. J Androl. 2002;23:1–8.PubMed Bartoov B, Berkovitz A, Eltes F, Kogosowski A, Menezo Y, Barak Y. Real-time fine morphology of motile sperm cells is asociated with IVF-ICSI outcome. J Androl. 2002;23:1–8.PubMed
6.
go back to reference Bartoov B, Berkoviz A, Eltes F, Kogosowski A, Yogoda A, Lederman H, Artzi S, Gross M, Barak Y. Pregnancy rate are higher with intracitoplsmatic morphologically selected sperm injection than with conventional intracytoplasmatic injection. Fertil Steril. 2003;80:1413–9.PubMedCrossRef Bartoov B, Berkoviz A, Eltes F, Kogosowski A, Yogoda A, Lederman H, Artzi S, Gross M, Barak Y. Pregnancy rate are higher with intracitoplsmatic morphologically selected sperm injection than with conventional intracytoplasmatic injection. Fertil Steril. 2003;80:1413–9.PubMedCrossRef
7.
go back to reference Berkovitz A, Eltes F, Soffer Y, Zabludovsky N, Beyth Y, Farhi J, Levran D, Bartoov B. ART success and in vivo sperm cell selection depend on the ultramorphological status of spermatozoa. Andrologia. 1999;31:1–8.PubMed Berkovitz A, Eltes F, Soffer Y, Zabludovsky N, Beyth Y, Farhi J, Levran D, Bartoov B. ART success and in vivo sperm cell selection depend on the ultramorphological status of spermatozoa. Andrologia. 1999;31:1–8.PubMed
8.
go back to reference Berkovitz A, Eltes F, Yaari S, Katz N, Barr I, Fishman A, Bartoov B. The morphological normalcy of the sperm nucleus and pregnancy rate of intracytoplasmic injection with morphologically selected sperm. Hum Reprod. 2005;20:185–90.PubMedCrossRef Berkovitz A, Eltes F, Yaari S, Katz N, Barr I, Fishman A, Bartoov B. The morphological normalcy of the sperm nucleus and pregnancy rate of intracytoplasmic injection with morphologically selected sperm. Hum Reprod. 2005;20:185–90.PubMedCrossRef
9.
go back to reference Berkoviz A, Eltes F, Ellenbogen A, Peer S, Feldberg D, Bartoov B. Does the presence of nuclear vacuoles in human sperm selected for ICSI affect pregnancy outcome? Hum Reprod. 2006;21:1787–90.CrossRef Berkoviz A, Eltes F, Ellenbogen A, Peer S, Feldberg D, Bartoov B. Does the presence of nuclear vacuoles in human sperm selected for ICSI affect pregnancy outcome? Hum Reprod. 2006;21:1787–90.CrossRef
10.
go back to reference Boitrelle F, Ferfouri F, Petit JM, Segretain D, Tourain C, Bergere M, Bailly M, Vialard F, Albert M, Selva J. Large human sperm vacuoles observed in motile spermatozoa under high magnification: nuclear thumbprint linked to failure of chromatin condensation. Hum Reprod. 2011;26:1650–8.PubMedCrossRef Boitrelle F, Ferfouri F, Petit JM, Segretain D, Tourain C, Bergere M, Bailly M, Vialard F, Albert M, Selva J. Large human sperm vacuoles observed in motile spermatozoa under high magnification: nuclear thumbprint linked to failure of chromatin condensation. Hum Reprod. 2011;26:1650–8.PubMedCrossRef
11.
go back to reference Cassuto NG, Bouret D, Plouchart JM, Jellard S, Vanderzwalmen P, Balet R, Larue L, Barak Y. A new real-time morphology classification for human spermtozoa: a link for fertilization and improved embryo quality. Fertil Steril. 2009;92:1616–25.PubMedCrossRef Cassuto NG, Bouret D, Plouchart JM, Jellard S, Vanderzwalmen P, Balet R, Larue L, Barak Y. A new real-time morphology classification for human spermtozoa: a link for fertilization and improved embryo quality. Fertil Steril. 2009;92:1616–25.PubMedCrossRef
12.
go back to reference De Vos A, Van De Velde H, Joris H, Verheyen G, Devroey P, Van Steirteghem A. Influence of individual sperm morphology on fertilization, embryo morphology, and pregnancy outcome of intracytoplasmic sperm injection. Fertil Steril. 2003;79(1):42–8.PubMedCrossRef De Vos A, Van De Velde H, Joris H, Verheyen G, Devroey P, Van Steirteghem A. Influence of individual sperm morphology on fertilization, embryo morphology, and pregnancy outcome of intracytoplasmic sperm injection. Fertil Steril. 2003;79(1):42–8.PubMedCrossRef
13.
go back to reference Franco Jr JG, Baruffi RLB, Mauri AL, Petersen CG, Oliveira JBA, Vagnini L. Significance of large nuclear vacuoles in human spermatozoa: implications for ICSI. Reprod Biomed Online. 2008;17:42–5.PubMedCrossRef Franco Jr JG, Baruffi RLB, Mauri AL, Petersen CG, Oliveira JBA, Vagnini L. Significance of large nuclear vacuoles in human spermatozoa: implications for ICSI. Reprod Biomed Online. 2008;17:42–5.PubMedCrossRef
14.
go back to reference Franco Jr JG, Mauri AL, Petersen CG, Massaro FC, Silva LF, Felipe V, Cavagna M, Pontes A, Baruffi LR, Oliveira JBA, Vagnini LD. Large nuclear vacuoles are indicative of abnormal chromatine packaging in human spermatozoa. Int J Androl. 2012;35(1):46–51.PubMedCrossRef Franco Jr JG, Mauri AL, Petersen CG, Massaro FC, Silva LF, Felipe V, Cavagna M, Pontes A, Baruffi LR, Oliveira JBA, Vagnini LD. Large nuclear vacuoles are indicative of abnormal chromatine packaging in human spermatozoa. Int J Androl. 2012;35(1):46–51.PubMedCrossRef
15.
go back to reference Garolla A, Fortini D, Menegazzo M, De Toni L, Nicoletti V, Moretti A, Selice R, Engl B, Foresta C. High-power microscopy for selecting spermatozoa for ICSI by physiological status. Reprod Biomed Online. 2008;17:610–6.PubMedCrossRef Garolla A, Fortini D, Menegazzo M, De Toni L, Nicoletti V, Moretti A, Selice R, Engl B, Foresta C. High-power microscopy for selecting spermatozoa for ICSI by physiological status. Reprod Biomed Online. 2008;17:610–6.PubMedCrossRef
16.
go back to reference Gianaroli L, Magli MC, Ferraretti AP, Crippa A, Lappi M, Capitani S, Baccetti B. Birefringence characteristics in sperm heads allow for the selection of reacted spermatozoa for intracytoplasmic sperm injection. Fertil Steril. 2010;93(3):807–13.PubMedCrossRef Gianaroli L, Magli MC, Ferraretti AP, Crippa A, Lappi M, Capitani S, Baccetti B. Birefringence characteristics in sperm heads allow for the selection of reacted spermatozoa for intracytoplasmic sperm injection. Fertil Steril. 2010;93(3):807–13.PubMedCrossRef
17.
go back to reference Junca A, Cohen-Bacrie M, Hazout PA. Improvement of fertilization and pregnancy rate after intracytoplasmic fine morphology selected sperm injection. Fertil Steril. 2004;82:S173.CrossRef Junca A, Cohen-Bacrie M, Hazout PA. Improvement of fertilization and pregnancy rate after intracytoplasmic fine morphology selected sperm injection. Fertil Steril. 2004;82:S173.CrossRef
18.
go back to reference Kacem O, Sifer C, Barraud-Lange V, Ducot B, De Ziegler D, Poirot C, Wolf J. Sperm nuclear vacuoles, as assessed by motile sperm organellar morphological examination, are mostly of acrosomal origin. Reprod Biomed Online. 2010;20:132–7.PubMedCrossRef Kacem O, Sifer C, Barraud-Lange V, Ducot B, De Ziegler D, Poirot C, Wolf J. Sperm nuclear vacuoles, as assessed by motile sperm organellar morphological examination, are mostly of acrosomal origin. Reprod Biomed Online. 2010;20:132–7.PubMedCrossRef
19.
go back to reference Kruger TF, Swanson RJ, Hamilton M, Simmons KF, Acosta AA, Matta JF, Oehinger S, Morshedi M. Abnormal sperm morphology and other semen parameters related to the outcome of the hamster oocyte human sperm penetration assay. Int J Androl. 1988;11(2):107–13.PubMedCrossRef Kruger TF, Swanson RJ, Hamilton M, Simmons KF, Acosta AA, Matta JF, Oehinger S, Morshedi M. Abnormal sperm morphology and other semen parameters related to the outcome of the hamster oocyte human sperm penetration assay. Int J Androl. 1988;11(2):107–13.PubMedCrossRef
20.
go back to reference Oliveira JB, Massaro FC, Mauri AL, Petersen CG, Nicoletti AP, Baruffi RL, Franco Jr JG. Motile sperm organelle morphology examination is stricter than Tygerberg criteria. Reprod Biomed Online. 2009;18(3):320–6.PubMedCrossRef Oliveira JB, Massaro FC, Mauri AL, Petersen CG, Nicoletti AP, Baruffi RL, Franco Jr JG. Motile sperm organelle morphology examination is stricter than Tygerberg criteria. Reprod Biomed Online. 2009;18(3):320–6.PubMedCrossRef
21.
go back to reference Ombelet W, Bosmans E, Janssen M, Cox A, Vlasselaer J, Gyselaere W, Vandeput H, Gielen J, Pollet H, Maes M, Steeno O, Kruger T. Semen parameters in a fertile versus subfertile population: a need for change in the interpretation of semen testing. Hum Reprod. 1997;12(5):987–93.PubMedCrossRef Ombelet W, Bosmans E, Janssen M, Cox A, Vlasselaer J, Gyselaere W, Vandeput H, Gielen J, Pollet H, Maes M, Steeno O, Kruger T. Semen parameters in a fertile versus subfertile population: a need for change in the interpretation of semen testing. Hum Reprod. 1997;12(5):987–93.PubMedCrossRef
22.
go back to reference Palermo F, Joris H, Devroey P, Van Steirteghem AC. Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte. Lancet. 1992;340(8810):17–8.PubMedCrossRef Palermo F, Joris H, Devroey P, Van Steirteghem AC. Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte. Lancet. 1992;340(8810):17–8.PubMedCrossRef
23.
go back to reference Perdrix A, Travers A, Chelli MH, Escalier D, Do Rego JL, Milazzo JP, Mousset-Siméon N, Macé B, Rives N. Assessment of acrosome and nuclear abnormalities in human spermatozoa with large vacuoles. Hum Reprod. 2011;26:47–58.PubMedCrossRef Perdrix A, Travers A, Chelli MH, Escalier D, Do Rego JL, Milazzo JP, Mousset-Siméon N, Macé B, Rives N. Assessment of acrosome and nuclear abnormalities in human spermatozoa with large vacuoles. Hum Reprod. 2011;26:47–58.PubMedCrossRef
24.
go back to reference Petersen CG, Massaro FC, Mauri AL, Oliveira JB, Baruffi RL, Franco Jr JG. Efficacy of hyaluronic acid binding assay in selecting motile spermatozoa with normal morphology at high magnification. Reprod Biol Endocrinol. 2010;3(8):149.CrossRef Petersen CG, Massaro FC, Mauri AL, Oliveira JB, Baruffi RL, Franco Jr JG. Efficacy of hyaluronic acid binding assay in selecting motile spermatozoa with normal morphology at high magnification. Reprod Biol Endocrinol. 2010;3(8):149.CrossRef
25.
go back to reference Razavi SH, Nasr-Esfahani MH, Deemeh MR, Shayesteh M, Tavalee M. Evaluation of zeta and HA-binding methods for selection of spermatozoa with normal morphology, protamine content and DNA integrity. Andrologia. 2010;42(1):13–9.PubMedCrossRef Razavi SH, Nasr-Esfahani MH, Deemeh MR, Shayesteh M, Tavalee M. Evaluation of zeta and HA-binding methods for selection of spermatozoa with normal morphology, protamine content and DNA integrity. Andrologia. 2010;42(1):13–9.PubMedCrossRef
26.
go back to reference Saïdi R, Rives N, Gruel E, Mazurier S, Mousset-Siméon N, Macé B. Nouvelle classification du spermocytogramme à fort grossissement. Méd Reprod Gyn Endo. 2008;10:315–24. Saïdi R, Rives N, Gruel E, Mazurier S, Mousset-Siméon N, Macé B. Nouvelle classification du spermocytogramme à fort grossissement. Méd Reprod Gyn Endo. 2008;10:315–24.
27.
go back to reference Sermondade N, Vialard F, Bergère M, Hammound I, Cavelot P, Selva J, Albert M. Evaluation de l’apport de la méthode d’observation des spermatoides à fort groissessement eh ICSI. Andrologie. 2007;17:212–21.CrossRef Sermondade N, Vialard F, Bergère M, Hammound I, Cavelot P, Selva J, Albert M. Evaluation de l’apport de la méthode d’observation des spermatoides à fort groissessement eh ICSI. Andrologie. 2007;17:212–21.CrossRef
28.
go back to reference Taşdemir I, Taşdemir M, Tavukçuoglu S, Kahraman S, Biberoģlu K. Effect of abnormal sperm head morphology on the outcome of intracytoplasmic sperm injection in humans. Hum Reprod. 1997;12(6):1214–7.PubMedCrossRef Taşdemir I, Taşdemir M, Tavukçuoglu S, Kahraman S, Biberoģlu K. Effect of abnormal sperm head morphology on the outcome of intracytoplasmic sperm injection in humans. Hum Reprod. 1997;12(6):1214–7.PubMedCrossRef
29.
go back to reference van der Merwe FH, Kruger TF, Oehninger SC, Lombard CJ. The use of semen parameters to identify the subfertile male in the general population. Gynecol Obstet Invest. 2005;59(2):86–91.PubMedCrossRef van der Merwe FH, Kruger TF, Oehninger SC, Lombard CJ. The use of semen parameters to identify the subfertile male in the general population. Gynecol Obstet Invest. 2005;59(2):86–91.PubMedCrossRef
30.
go back to reference Vanderzwalmet P, Hiemer A, Rubner P, Bach M, Neyer A, Stecher A, Uher P, Zint M, Lejeune B, Vanderzwalmet S, et al. Blastocyst development after sperm selection at high magnification is associated with size and number of nuclear vacuoles. Reprod Biomed Online. 2008;17:617–27.CrossRef Vanderzwalmet P, Hiemer A, Rubner P, Bach M, Neyer A, Stecher A, Uher P, Zint M, Lejeune B, Vanderzwalmet S, et al. Blastocyst development after sperm selection at high magnification is associated with size and number of nuclear vacuoles. Reprod Biomed Online. 2008;17:617–27.CrossRef
31.
go back to reference Veeck LL. Atlas of the human oocyte and early conceptus. Baltimore: Williams & Wilkins; 1986. Veeck LL. Atlas of the human oocyte and early conceptus. Baltimore: Williams & Wilkins; 1986.
32.
go back to reference Watanabe S, Tanaka A, Fujii S, Mizunuma H, Fukui A, Fukuhara R, Nakamura R, Yamada K, Tanaka I, Awata S, Nagayoshi M. An investigation of the potential effect of vacuoles in human sperm on DNA damage using a chromosome assay and the TUNEL assay. Hum Reprod. 2011;26(5):978–86.PubMedCrossRef Watanabe S, Tanaka A, Fujii S, Mizunuma H, Fukui A, Fukuhara R, Nakamura R, Yamada K, Tanaka I, Awata S, Nagayoshi M. An investigation of the potential effect of vacuoles in human sperm on DNA damage using a chromosome assay and the TUNEL assay. Hum Reprod. 2011;26(5):978–86.PubMedCrossRef
33.
go back to reference World Health Organization. WHO laboratory manual for examination and processing of human semen 5th ed Cambridge. UK: Cambridge University Press; 2010. World Health Organization. WHO laboratory manual for examination and processing of human semen 5th ed Cambridge. UK: Cambridge University Press; 2010.
Metadata
Title
Sperm head vacuolization affects clinical outcome in ICSI cycle. A proposal of a cut-off value
Authors
Doriana Falagario
Anna Maria Brucculeri
Raffaella Depalo
Paolo Trerotoli
Ettore Cittadini
Giovanni Ruvolo
Publication date
01-11-2012
Publisher
Springer US
Published in
Journal of Assisted Reproduction and Genetics / Issue 11/2012
Print ISSN: 1058-0468
Electronic ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-012-9858-z

Other articles of this Issue 11/2012

Journal of Assisted Reproduction and Genetics 11/2012 Go to the issue