title: Flow Cytometry: A Novel Approach for Indirect Assessment of Protamine Deficiency by CMA3 Staining, Taking into Account the Presence of M540 or Apoptotic Bodies.
abstract: BACKGROUND
  Chromomycin A3 (CMA3) staining, either by the slide method or fluorescence microscopy, is widely used for indirect assessment of protamine deficiency in a semen sample. Flow cytometry is the most suitable tool to improve assessment accuracy, both in terms of statistical analysis and for prevention of observer variation. This study provides a simple procedure to account for merocyanine 540 (M540) or apoptotic bodies, which result in underestimation of the percentage of CMA3 positivity, by using propidium iodide (PI) staining. Therefore, this study aims to evaluate the percentage of CMA3 by PI staining to exclude M540 bodies that prevent underestimation of CMA3 staining.
  
  
  METHODS
  This study is an experimental study. Semen samples collected from 104 infertile men who referred to the Andrology Unit of the Isfahan Fertility and Infertility Center were initially assessed according to World Health Organization (WHO) criteria. Samples were washed twice with Ham's. Each sample was divided into two portions, a control and the other processed for density gradient centrifugation (DGC). Each portion was assessed for CMA3 staining by both the slide and flow cytometry methods. Coefficients of correlation and student t-test were carried out using the Statistical Package for the Social Studies (SPSS 11.5).
  
  
  RESULTS
  Detection of CMA3 staining was more appropriate with fluorescence detector 3 (FL-3) rather than fluorescence detector 2 (FL-2) in the evaluation of protamine deficiency to exclude M540 bodies.
  
  
  CONCLUSIONS
  This study, for the first time, provides the basis for assessment of CMA3 staining for flow cytometry. However, since the maximum excitation for CMA3 is not covered by the 488 nm laser, we recommend further experimentation using a flow cytometer with optimal excitation.
authors.affiliation: Department of Reproduction and Development, Reproductive Biomedicine Center, Royan Institute for Animal Biotechnology, ACECR, Isfahan, Iran ; Payame Noor University, Isfahan, Iran.
authors.forename: Zohreh
authors.initials: Z
authors.lastname: Fathi
authors.affiliation: Department of Reproduction and Development, Reproductive Biomedicine Center, Royan Institute for Animal Biotechnology, ACECR, Isfahan, Iran.
authors.forename: Marziyeh
authors.initials: M
authors.lastname: Tavalaee
authors.affiliation: Department of Reproduction and Development, Reproductive Biomedicine Center, Royan Institute for Animal Biotechnology, ACECR, Isfahan, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Kiani
authors.affiliation: Department of Reproduction and Development, Reproductive Biomedicine Center, Royan Institute for Animal Biotechnology, ACECR, Isfahan, Iran ; Isfahan Fertility and Infertility Center, Isfahan, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Deemeh
authors.affiliation: Islamic Azad University-Khorasgan Branch, Isfahan, Iran.
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Modaresi
authors.affiliation: Department of Reproduction and Development, Reproductive Biomedicine Center, Royan Institute for Animal Biotechnology, ACECR, Isfahan, Iran ; Isfahan Fertility and Infertility Center, Isfahan, Iran ; Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Nasr-Esfahani
keywords: Flow Cytometry; Merocyanine; Protamine; Sperm
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