Human Reproduction, Vol 13, 2521-2526, Copyright © 1998 by Oxford University Press
HE Chemes, SB Olmedo, C Carrere, R Oses, C Carizza, M Leisner and J Blaquier
An ultrastructural study of spermatozoa in a series of 247 severely
asthenozoospermic patients disclosed two kinds of anomalies. The first was
dysplasia of the fibrous sheath, a primary defect of spermatozoa with
hypertrophy and hyperplasia of the fibrous sheath, associated axonemal
anomalies, familial incidence and chronic respiratory disease. The patients
could be divided into two subgroups: the complete form (all spermatozoa
affected) and the incomplete form (alterations in 70- 80% spermatozoa).
There were no spontaneous or in-vitro fertilization (IVF) pregnancies.
Intracytoplasmic sperm injection (ICSI) in six patients resulted in
successful fertilizations, but only two pregnancies were obtained. These
features configure a phenotype that suggests a genetic origin. The second
anomaly was non-specific flagellar anomaly (NSFA), random secondary
flagellar alterations affecting variable numbers of spermatozoa, without
respiratory disease or familial incidence. 54 men with NSFA were followed
for 2-6 years. Of these, 18 achieved conception, either spontaneous or by
means of assisted fertilization, followed by 14 pregnancies and 12 live
births. Their sperm motility significantly increased during the follow-up
period. In the remaining 36 men motility did not change during the
follow-up period and there were no fertilizations or pregnancies. We
conclude that in severe asthenozoospermia, ultrastructural examination of
spermatozoa has an effective prognostic value, identifying two syndromes
with very different flagellar alterations and fertility potentials.
ARTICLES
Ultrastructural pathology of the sperm flagellum: association between flagellar pathology and fertility prognosis in severely asthenozoospermic men
Laboratory of Testicular Physiology and Pathology, Endocrinology Division, Buenos Aires Children's Hospital, Argentina.
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