title: Two cases of sperm immotility: a mosaic of flagellar alterations related to dysplasia of the fibrous sheath and abnormalities of head-neck attachment.
abstract: OBJECTIVE
  To characterize the association of two systematic sperm defects.
  
  
  METHODS
  Case report.
  
  
  METHODS
  University, Interdepartmental Centre for Research and Therapy of Male Infertility.
  
  
  METHODS
  Patient 1, 42 years old, and patient 2, 38 years old, both with severe asthenozoospermia.
  
  
  METHODS
  Family history, physical examination, hormonal analysis, microbial assays, semen analysis, transmission and scanning electron microscopy, immunocytochemistry for tubulin, and fluorescence in situ hybridization (FISH) for chromosomes 18, X, and Y.
  
  
  METHODS
  Admixture of dysplasia of the fibrous sheath (DFS) and head-tail misalignment up to acephalic sperm detected by microscopic methods.
  
  
  RESULTS
  In both patients, DFS was present in incomplete form and was associated with acephalic sperm and abnormal head-tail attachment. In patient 2, spermatozoa were also affected by necrosis that may cause fragmentation leading to short flagella; submicroscopic examination allowed defining only the origin of these "stumpy" tails. Immunofluorescence confirmed the sperm alterations. FISH revealed an altered frequency of diploidy and disomy in patient 2 and a slight increase in diploidy in patient 1.
  
  
  CONCLUSIONS
  The importance of ultrastructural sperm evaluation for correct identification of sperm pathologies is evident, particularly regarding assisted reproduction technology and genetic risk assessment.
authors.affiliation: Department of Biomedical Sciences, Applied Biology Section, Interdepartmental Center for Research and Therapy of Male Infertility, University of Siena, Siena, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Moretti
authors.forename: Michela
authors.initials: M
authors.lastname: Geminiani
authors.forename: Gaia
authors.initials: G
authors.lastname: Terzuoli
authors.forename: Tommaso
authors.initials: T
authors.lastname: Renieri
authors.forename: Nicola
authors.initials: N
authors.lastname: Pascarelli
authors.forename: Giulia
authors.initials: G
authors.lastname: Collodel
mesh_terms: D000328:Adult; D053627:Asthenozoospermia / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D008297:Male; D055101:Semen Analysis; D013077:Sperm Head / Q000473:pathology* / Q000648:ultrastructure; D013081:Sperm Motility / Q000502:physiology; D013082:Sperm Tail / Q000473:pathology* / Q000648:ultrastructure; D013094:Spermatozoa / Q000002:abnormalities* / Q000473:pathology / Q000648:ultrastructure