title: High-power microscopy for selecting spermatozoa for ICSI by physiological status.
abstract: Sperm selection for intracytoplasmic sperm injection (ICSI), based on standard morphology, can fail to select normal cells, and actual methods to evaluate their physiological status do not allow their later use for ICSI. Some authors have demonstrated that sperm selection based on high-magnification morphology is associated with a better ICSI outcome, above all in subjects with severe testicular failure. In this study there was an evaluation of mitochondrial function, chromatin structure and sperm aneuploidies on whole sperm samples from 30 subjects: 10 normozoospermic controls and 20 patients that were severely oligozoospermic due to testicular damage or partial obstruction of the seminal ducts. All severely oligozoospermic patients showed worse mitochondrial function and chromatin status, while sperm aneuploidies were significantly increased only in those subjects with severe testicular damage (P < 0.001). In the latter patients the analysis of a single spermatozoon, performed after morphological selection by high-magnification microscopy, showed significantly better mitochondrial function, chromatin status and aneuploidy rate than observed in unselected cells (all P < 0.001). Interestingly, these parameters were further improved when nuclear vacuoles were lacking. These results suggest a strong relationship between high-magnification morphology and the status of spermatozoa, and they may explain the better results of ICSI obtained using spermatozoa selected by high-magnification microscopy.
authors.affiliation: Centre for Male Gamete Cryopreservation, Department of Histology, Microbiology, and Medical Biotechnologies, University of Padova, Via Gabelli 63-35100, Padova, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Garolla
authors.forename: Daniela
authors.initials: D
authors.lastname: Fortini
authors.forename: Massimo
authors.initials: M
authors.lastname: Menegazzo
authors.forename: Luca
authors.initials: L
authors.lastname: De Toni
authors.forename: Valentina
authors.initials: V
authors.lastname: Nicoletti
authors.forename: Afra
authors.initials: A
authors.lastname: Moretti
authors.forename: Riccardo
authors.initials: R
authors.lastname: Selice
authors.forename: Bruno
authors.initials: B
authors.lastname: Engl
authors.forename: Carlo
authors.initials: C
authors.lastname: Foresta
mesh_terms: D000328:Adult; D000782:Aneuploidy; D016022:Case-Control Studies; D053938:DNA Fragmentation; D005260:Female; D006801:Humans; D008297:Male; D008853:Microscopy / Q000379:methods*; D008928:Mitochondria / Q000378:metabolism; D009845:Oligospermia / Q000235:genetics / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D013094:Spermatozoa / Q000473:pathology* / Q000502:physiology*