Clinical characteristics and light and transmission electron microscopic sperm defects of infertile men with persistent unexplained asthenozoospermia.
OBJECTIVE
To determine, with the use of transmission electron microscopy (TEM), the proportion of patients with permanent unexplained asthenozoospermia (<30% motility) who have an abnormality of sperm axonemal and periaxonemal structures.


METHODS
Retrospective study.


METHODS
A university-affiliated public hospital.


METHODS
Sixty-one infertile men whose semen was submitted to TEM analysis because of persistent unexplained asthenozoospermia.


METHODS
The results of quantitative TEM analysis of the tails of the spermatozoa.


METHODS
None.


RESULTS
Based on a comparison with the axonemal anomalies observed in nine fertile control patients, the infertile population was divided into three groups: group I, with no detectable axonemal defects (26.2%); group II, with axonemal anomalies in either the midpiece or the principal piece (29.5%); and group III, with axonemal anomalies in both the midpiece and the principal piece (44.3%). However, defects in the mitochondrial sheath, fibrous sheath, and sperm head (acrosomic and postacrosomic cap) were observed in at least 50%, 30%, and 50%, respectively, of the patients in each group. The proportion of dense fiber anomalies of the midpiece increased significantly from group I to group III. No differences were observed between the three groups in sperm characteristics, anamnesis information, or clinical data.


CONCLUSIONS
In patients with persistent unexplained asthenozoospermia, the frequent association of periaxonemal anomalies with axonemal deficiencies strongly suggests that axonemal deficiencies are not the unique cause of decreased motility.
Laboratoire d'Histologie-Embryologie-Cytogénétique, Faculté de Médecine, Hôpital de La Grave, Toulouse, France.
M
M
Courtade
C
C
Lagorce
L
L
Bujan
C
C
Caratero
R
R
Mieusset
D000328:Adult; D002908:Chronic Disease; D006801:Humans; D007248:Infertility, Male / Q000209:etiology / Q000473:pathology*; D008297:Male; D008853:Microscopy / Q000379:methods; D008854:Microscopy, Electron; D008875:Middle Aged; D009845:Oligospermia / Q000209:etiology / Q000473:pathology*; D012189:Retrospective Studies; D012661:Semen / Q000166:cytology; D013077:Sperm Head / Q000648:ultrastructure*; D013081:Sperm Motility / Q000502:physiology*; D013082:Sperm Tail / Q000648:ultrastructure*