Summary
Malformed spermatids and spermatozoa in the testes, epididymes, and ejaculates of 29 apparently healthy men and in 171 patients suffering from different andrological diseases were investigated with the electron microscope. The following types of malformations are described:
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1)
Malformations of the acrosome in contact with the nucleus of the spermatid: Vesicular inclusions in the acrosome vesicle, asymmetric thickenings of the acrosome cap, enfolding of the acrosomal lamina into the spermatid's nucleus, partial separation of the acrosome from the nucleus, apical knob-like thickenings of the acrosome.
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2)
Malformations of the acrosome independent from the spermatid's nucleus: the acrosomal material is contained in small vesicles, large vacuoles, in ring-like structures, in globular or shell-like laminar structures. The nucleus of such spermatids lacks an acrosome.
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3)
Malformations of the nucleus: inclusions of vesicles or membranes, excessive packages of membranes, gigantic nuclear vacuoles, lack of condensation of the caryoplasm.
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4)
Multinucleate spermatids: two or more nuclei within the pericaryon of one spermatid are joined by an acrosome.
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5)
Duplicate acrosome anlagen.
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6)
Malformations of the tail: disorganization of the axonema, a lack or excessive numbers of tubules and fibres, doublets of the axial filaments, destruction of the neck region, a lack of the mitochondrial sheath, and enlargement of the fibrous sheath.
Malformed germ cells were observed to occur in varying amounts both in apparently healthy men and in those who were apparently infertile. This indicates that germ cell malformations are no absolute indicator of male infertility. However, certain distinct types of malformations (such as round-headed spermatozoa) are definitely associated with infertility, but only if all spermatozoa in the ejaculate of a patient have the same defect.
Zusammenfassung
Fehlgebildete Spermatiden und Spermatozoen in den Hoden, Nebenhoden und Ejaculaten von 29 gesunden Männern und von 171 Patienten mit verschiedenen andrologischen Erkrankungen wurden elektronenmikroskopisch untersucht. Die folgenden Mißbildungstypen lassen sich beschreiben:
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1.
Akrosomfehlbildungen in Kontakt zum Spermatidenkern: bläschenförmige Einschlüsse in der Akrosomblase, asymmetrische Verdickungen der Akrosomkappe, Einfaltungen der akrosomalen Lamina in den Spermatidenkern, teilweise Abhebung des Akrosoms vom Kern, apikale knopfartige Verdickungen des Akrosoms.
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2.
Akrosomfehlbildungen unabhängig vom Spermatidenkern: das akrosomale Material ist enthalten in kleinen Bläschen, ringförmigen Strukturen, in rundlichen oder schalenartigen Formen. Der Kern solcher Spermatiden hat kein Akrosom.
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3.
Fehlbildungen des Kerns: Einschlüsse von Bläschen oder Membranen, ausgedehnte Membranbildungen, sehr große Kernvacuolen, fehlende Kondensation des Karyoplasma.
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4.
Mehrkernige Spermatiden: zwei oder mehr Kerne in einem Perikaryon sind durch ein Akrosom verbunden.
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5.
Doppelte Akrosomanlagen.
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6.
Fehlbildungen des Schwanzes: Zerstörung des Axonema, Unterdrückung oder Überzahl von Tubuli und Fasern, doppelte axiale Filamentenbündel, Destruktion der Halsregion, Fehlen der Mitochondrienscheide, Auftreibung der Faserscheide.
Mißgebildete Keimzellen treten in unterschiedlichen Prozentsätzen sowohl bei gesunden Männern als auch bei infertilen Patienten auf. Damit ist das Vorkommen fehlgebildeter Keimzellen nicht unbedingt ein Hinweis auf eine bestehende Infertilität. Nur bei bestimmten Mißbildungstypen, wie den rundköpfigen Spermatozoen, ist — wenn alle Spermatozoen im Ejaculat den gleichen Defekt aufweisen — mit Infertilität zu rechnen.
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Herrn Prof. Dr. med Dr. med h. c. Carl Krauspe mit herzlichen Glückwünschen zum 80. Geburtstag gewidmet.
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Holstein, AF. Morphologische Studien an abnormen Spermatiden und Spermatozoen des Menschen. Virchows Arch. A Path. Anat. and Histol. 367, 93–112 (1975). https://doi.org/10.1007/BF00430948
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DOI: https://doi.org/10.1007/BF00430948