title: Sperm organelle morphologic abnormalities: contributing factors and effects on intracytoplasmic sperm injection cycles outcomes.
abstract: OBJECTIVE
  To (1) analyze possible relationships between motile sperm organelle morphology examination (MSOME) and sperm chromatin status, aneuploidy incidence, and patient's age; (2) determine the effects of sperm morphologic abnormalities on intracytoplasmic sperm injection (ICSI) outcomes; and (3) identify the benefits of intracytoplasmic morphologically selected sperm injection (IMSI) in patients with high DNA fragmentation rate.
  
  
  METHODS
  The study was performed in 50 patients undergoing ICSI cycles. The MSOME, sperm DNA fragmentation, and sperm aneuploidy incidence were performed in 200 sperm cells of each patient. Regression models were used to assess the relationships among sperm morphology and sperm aneuploidy, sperm DNA fragmentation, patient's age, and ICSI outcomes. In cycles with patients showing a high incidence of DNA fragmentation, oocytes were split into 2 groups according to the sperm selection method: Standard-ICSI (n = 82) and IMSI (n = 79). Fertilization and high-quality embryo rates were compared between the groups.
  
  
  RESULTS
  A close relationship between sperm DNA fragmentation and the presence of vacuoles in the MSOME was noted. The patient's age was correlated to the presence of vacuoles. No correlation between sperm aneuploidy and IMSI was observed. Vacuolated cells were negatively correlated with fertilization, pregnancy, and implantation. In patients with a high incidence of sperm DNA fragmentation, fertilization and high-quality embryo rates were similar when comparing IMSI and Standard-ICSI.
  
  
  CONCLUSIONS
  Our data demonstrate a correlation between paternal age and the incidence of nuclear vacuoles, as well as an effect of large and small vacuoles on late embryo development.
authors.affiliation: Fertility-Assisted Fertilization Center, São Paulo, Brazil. dbraga@fertility.com.br
authors.forename: Daniela Paes
authors.initials: DP
authors.lastname: de Almeida Ferreira Braga
authors.forename: Amanda S
authors.initials: AS
authors.lastname: Setti
authors.forename: Rita C S
authors.initials: RC
authors.lastname: Figueira
authors.forename: Marcilio
authors.initials: M
authors.lastname: Nichi
authors.forename: Ciro D
authors.initials: CD
authors.lastname: Martinhago
authors.forename: Assumpto
authors.initials: A
authors.lastname: Iaconelli
authors.forename: Edson
authors.initials: E
authors.lastname: Borges
mesh_terms: D000328:Adult; D000782:Aneuploidy; D002843:Chromatin / Q000378:metabolism; D053938:DNA Fragmentation; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D007248:Infertility, Male / Q000628:therapy; D008297:Male; D008856:Microscopy, Fluorescence / Q000379:methods; D009865:Oocytes / Q000166:cytology; D011247:Pregnancy; D018873:Pregnancy Rate; D012044:Regression Analysis; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D013094:Spermatozoa / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D002843:Chromatin