title: Impact of sperm chromatin evaluation on fertilization rate in intracytoplasmic sperm injection.
abstract: BACKGROUND
  Sperm DNA in human beings and most vertebrates is packed by protamines into highly compact form of chromatin. There are many staining methods to assess sperm chromatin. Three different methods of staining were used simultaneously in this study and the goal was to determine which of these sperm tests has a relation with fertilization rate in intracytoplasmic sperm injection (ICSI).
  
  
  METHODS
  Thirty couples who referred to Yamagata University Hospital (Yamagata, Japan) for ICSI were included in this study. The greater part of semen was prepared for ICSI. The remaining part was used for staining with aniline blue, acridine orange, and chromomycin A3 (CMA3). For evaluation of abnormal morphology and abnormality of head, Papanicolaou-stained smears were used. The analysis of data was done using Spearman coefficient of correlation and logistic regression model. Receiver operator characteristic (ROC) curve was used for discrimination of CMA3 staining power to identify ICSI rates.
  
  
  RESULTS
  Percentage of CMA3 positivity, unlike those of aniline blue and acridine orange, showed significant negative correlation with fertilization rate. Moreover, the percentage of CMA3 positivity showed a positive correlation with the percentage of abnormal morphology and abnormality of head. By dividing patients into CMA3 <48% and CMA3> 48% groups, the area under the curve was 0.646.
  
  
  CONCLUSIONS
  CMA3 staining (protamine deficiency) could be considered as a useful tool for evaluation of male fertility prior to infertility treatment.
authors.affiliation: Department of Anatomical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Farhad Golshan
authors.initials: FG
authors.lastname: Iranpour
keywords: Acridine orange; aniline blue; chromomycin A3; intracytoplasmic sperm injection; sperm