title: Chromosomal analysis of spermatozoa with normal-sized heads in two infertile patients with macrocephalic sperm head syndrome.
abstract: OBJECTIVE
  To study the chromosomal content of spermatozoa that could be selected for intracytoplasmic sperm injection (ICSI) in cases of macrocephalic sperm head syndrome.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Obstetrics, gynecology, urology, and reproductive biology departments.
  
  
  METHODS
  Two infertile patient candidates for ICSI presenting with total teratozoospermia (100%) with mainly large-headed spermatozoa (91% and 82%, respectively).
  
  
  METHODS
  Fluorescence in situ hybridization with X, Y, 18 centromeric probes on unselected spermatozoa (all migrated spermatozoa) and specifically on selected spermatozoa with normal-sized heads.
  
  
  METHODS
  Percentage of polyploid, diploid, aneuploid, and normal haploid spermatozoa, according to X, Y, 18 chromosome centromeric probes on selected spermatozoa (head size compatible with ICSI).
  
  
  RESULTS
  All the nonselected spermatozoa were abnormal, diploid, or polyploid. The rate of normal ploidy (haploid cells) among the selected sperm population was 1 per 28 for patient 1 and 5 per 51 for patient 2.
  
  
  CONCLUSIONS
  This very low proportion of normal haploid spermatozoa among selected spermatozoa contraindicated ICSI for the two patients. We suggest performance of this selection and analysis before including (or not), in an ICSI program, patients with macrocephalic sperm head syndrome, associated or not with preimplantation genetic diagnosis.
authors.affiliation: Department of Reproductive Biology, Centre Hospitalier de Dreux, Dreux, France. brunoguthauser@hotmail.com
authors.forename: Bruno
authors.initials: B
authors.lastname: Guthauser
authors.forename: François
authors.initials: F
authors.lastname: Vialard
authors.forename: Mbarka
authors.initials: M
authors.lastname: Dakouane
authors.forename: Vincent
authors.initials: V
authors.lastname: Izard
authors.forename: Martine
authors.initials: M
authors.lastname: Albert
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Selva
mesh_terms: D002869:Chromosome Aberrations; D002887:Chromosomes, Human, Pair 18; D041321:Chromosomes, Human, X; D041322:Chromosomes, Human, Y; D000075202:Contraindications; D004171:Diploidy; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D007248:Infertility, Male / Q000235:genetics* / Q000473:pathology*; D008297:Male; D009845:Oligospermia / Q000235:genetics / Q000473:pathology; D011003:Ploidies; D011123:Polyploidy; D013077:Sperm Head / Q000473:pathology*; D020554:Sperm Injections, Intracytoplasmic; D013094:Spermatozoa / Q000002:abnormalities*