High magnification opens different approaches of sperm head morphology examination.
To understand the correlation between sperm normalcy, fertilization, and early embryo development we established, a detailed sperm scoring classification according to strict morphology criteria; permitting to discard the worst spermatozoon, in real time, prior intracytoplasmic sperm injection.
Our consideration of maternal age correlated to sperm score revealed a difference between oocytes from women younger than 30 and oocytes from elderly women.
We showed that high-magnified spermatozoa, in cases of Robertsonian translocation carriers cannot be used to select sperm cells with a balanced chromosomal content.
However, there is a significant correlation between sperm-head morphology assessed by high magnification and sperm chromatin-decondensation rate of specific kind of spermatozoa.
This suggests that this spermatozoon should not be selected for intracytoplasmic sperm injection and must be discarded.
The high magnified spermatozoon observation seems to impact the birth outcome leading to lower risks of major malformation mainly affecting urogenital system and more often boys.
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J.R. Kovac is an NIH K12 scholar supported by a Male Reproductive Health Research (MRHR) Career Development Physician-Scientist Award (HD073917-01) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Program awarded to Dolores J. Lamb (DJL). DJL is supported by NIH grants P01HD36289 from the Eunice Kennedy Shriver NICHD and 1R01DK078121 from the National Institute of Kidney and Digestive Diseases.
Palermo G, Joris H, Devroey P, Van Steirteghem AC. Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte. Lancet. 1992;340(8810):17–8.PubMedCrossRefGoogle Scholar
Bartoov B, Berkovitz A, Eltes F. Selection of spermatozoa with normal nuclei to improve the pregnancy rate with intracytoplasmic sperm injection. N Engl J Med. 2001;345(14):1067–8.PubMedCrossRefGoogle Scholar
Bartoov B, Berkovitz A, Eltes F, Kogosowski A, Menezo Y, Barak Y. Real-time fine morphology of motile human sperm cells is associated with IVF-ICSI outcome. J Androl. 2002;23(1):1–8.PubMedGoogle Scholar
Bartoov B, Berkovitz A, Eltes F, et al. Pregnancy rates are higher with intracytoplasmic morphologically selected sperm injection than with conventional intracytoplasmic injection. Fertility and Sterility. 2003;80: 1413–9.PubMedCrossRefGoogle Scholar
Vanderzwalmen P, Hiemer A, Rubner P, Bach M, Neyer A, Stecher A, Uher P, Zintz M, Lejeune B, Vanderzwalmen S, Cassuto G, Zech NH. Blastocyst development after sperm selection at high magnification is associated with size and number of nuclear vacuoles. Reprod Biomed Online. 2008;17:617–27.PubMedCrossRefGoogle Scholar
Berkovitz A, Eltes F, Ellenbogen E, et al. Does the presence of nuclear vacuoles in human sperm selected for ICSI affect pregnancy outcome? Human Reproduction. 2006;21:1787–90.PubMedCrossRefGoogle Scholar
Greco E, Scarselli F, Fabozzi G, Colasante A, Zavaglia D, Alviggi E, Litwicka K, Varricchio MT, Minasi MG, Tesarik J. Sperm vacuoles negatively affect outcomes in intracytoplasmic morphologically selected sperm injection in terms of pregnancy, implantation, and live-birth rates. Fertil Steril. 2013;100(2):379–85.PubMedCrossRefGoogle Scholar
Cassuto NG, Hazout A, Hammoud I, Balet R, Bouret D, Barak Y, Jellad S, Plouchart JM, Selva J, Yazbeck C. Correlation between DNA defect and sperm-head morphology. Reprod Biomed Online. 2012;24:211–8.PubMedCrossRefGoogle Scholar
Tanaka A, Nagayoshi M, Tanaka I, Kusunoki H. Human sperm head vacuoles are physiological structures formed during the sperm development and maturation process. Fertil Steril. 2012;98(2):315–20.PubMedCrossRefGoogle Scholar
Cassuto NG, Bouret D, Plouchart JM, Jellad S, Vanderzwalmen P, Balet R, Larue L, Barak Y. A new real-time morphology classification for human spermatozoa: a link for fertilization and improved embryo quality. Fertil Steril. 2009;92:1616–25.PubMedCrossRefGoogle Scholar
Cassuto N, Le Foll N, Chantot-Bastaraud S, Balet R, Bouret D, Rouen A, Bhouri R, Hyon C, Siffroi JP. Sperm fluorescence in situ hybridization study in nine men carrying a Robertsonian or a reciprocal translocation: relationship between segregation modes and high-magnification sperm morphology examination. Fertil Steril. 2011;96(4):826–32.PubMedCrossRefGoogle Scholar
De Vos A, Van De Velde H, Joris H, Verheyen G, Devroey P, Van Steirteghem A. Influence of individual sperm morphology on fertilization, embryo morphology, and pregnancy outcome of intracytoplasmic sperm injection. Fertil Steril. 2003;79:42–8.PubMedCrossRefGoogle Scholar
Antinori M, Licata E, Dani G, Cerusico F, Versaci C, d’Angelo D, Antinori S. Intracytoplasmic morphologically selected sperm injection: a prospective randomized trial. Reprod Biomed online. 2008;16:835–41.PubMedCrossRefGoogle Scholar
Wilding M, Coppola G, di Matteo L, Palagiano A, Fusco E, Dale B. Intracytoplasmic injection of morphologically selected spermatozoa (IMSI) improves outcome after assisted reproduction by deselecting physiologically poor quality spermatozoa. J Assist Reprod Genet. 2011;28(3):253–62.PubMedCentralPubMedCrossRefGoogle Scholar
Setti AS, Figueira RC, Braga DP, Aoki T, Iaconelli Jr A, Borges Jr E. Intracytoplasmic morphologically selected sperm injection is beneficial in cases of advanced maternal age: a prospective randomized study. Eur J Obstet Gynecol Reprod Biol. 2013;171(2):286–90.PubMedCrossRefGoogle Scholar
Cassuto NG, Hazout A, Bouret D, Balet R, Larue L, Benifla JL, Viot G. Low birth defects by deselecting abnormal spermatozoa before ICSI. Reprod BioMed Online. 2014;28(1):47–53.PubMedCrossRefGoogle Scholar
Simon L, Proutski I, Stevenson M, Jennings D, McManus J, Lutton D, Lewis SE. Sperm DNA damage has a negative association with live-birth rates after IVF. Reprod Biomed Online. 2013;26:68–78.PubMedCrossRefGoogle Scholar
Aitken RJ, Nixon B. Sperm capacitation: a distant landscape glimpsed but unexplored. Mol Hum Reprod. 2013;19(12):785–93.PubMedCrossRefGoogle Scholar
Avendano C, Oehninger S. DNA fragmentation in morphologically normal spermatozoa: how much should we be concerned in the ICSI era? J Androl. 2011;32:356–63.PubMedCrossRefGoogle Scholar
Klement AH, Koren-Morag N, Itsykson P, Berkovitz A. Intracytoplasmic morphologically selected sperm injection versus intracytoplasmic sperm injection: a step toward a clinical algorithm. Fertil Steril. 2013;99(5):1290–3.PubMedCrossRefGoogle Scholar
Marci R, Murisier F, Lo Monte G, Soave I, Chanson A, Urner F, Germond M. Clinical outcome after IMSI procedure in an unselected infertile population: a pilot study. Reprod Health. 2013;10:16.PubMedCentralPubMedCrossRefGoogle Scholar
De Vos A, Van de Velde H, Bocken G, Eylenbosch G, Franceus N, Meersdom G, Tistaert S, Vankelecom A, Tournaye H, Verheyen G. Does intracytoplasmic morphologically selected sperm injection improve embryo development? A randomized sibling-oocyte study. Hum Reprod. 2013;28:617–26.PubMedCrossRefGoogle Scholar
Balaban B, Yakin K, Alatas C, Oktem O, Isiklar A, Urman B. Clinical outcome of intracytoplasmic injection of spermatozoa morphologically selected under high magnification: a prospective randomized study. Reprod Biomed Online. 2011;22:472–6.CrossRefGoogle Scholar
Souza Setti A, Ferreira RC, de Almeida P, Ferreira Braga D, de Cassia Savio Figueira R, Iaconelli Jr A, Borges Jr E. Intracytoplasmic sperm injection outcome versus intracytoplasmic morphologically selected sperm injection outcome: a meta-analysis. Reprod Biomed Online. 2010;21:450–5.PubMedCrossRefGoogle Scholar
Hazout A, Dumont-Hassan M, Junca AM, et al. High-magnification ICSI overcomes paternal effect resistant to conventional ICSI. Reprod Biomed Online. 2006;12:19–25.PubMedCrossRefGoogle Scholar
Garolla A, Fortini D, Menegazzo M, De Toni L, Nicoletti V, Moretti A, Selice R, Engl B, Foresta C. High-power microscopy for selecting spermatozoa for ICSI by physiological status. Reprod Biomed Online. 2008;17:610–6.PubMedCrossRefGoogle Scholar
Perdrix A, Travers A, Chelli MH, Escalier D, Do Rego JL, Milazzo JP, Mousset-Simeon N, Mace B, Rives N. Assessment of acrosome and nuclear abnormalities in human spermatozoa with large vacuoles. Hum Reprod. 2011;26:47–58.PubMedCrossRefGoogle Scholar
Berkovitz A, Eltes F, Lederman H, et al. How to improve IVF-ICSI outcome by sperm selection. Reprod Biomed Online. 2006;12:634–8.PubMedCrossRefGoogle Scholar
Boitrelle F, Ferfouri F, Petit JM, Segretain D, Tourain C, Bergere M, Bailly M, Vialard F, Albert M, Selva J. Large human sperm vacuoles observed in motile spermatozoa under high magnification: nuclear thumbprints linked to failure of chromatin condensation. Hum Reprod. 2011;26:1650–8.PubMedCrossRefGoogle Scholar
Franco Jr JG, Baruffi RL, Mauri AL, Petersen CG, Oliveira JB, Vagnini L. Significance of large nuclear vacuoles in human spermatozoa: implications for ICSI. Reprod Biomed Online. 2008;17:42–5.PubMedCrossRefGoogle Scholar
Franco Jr JG, Mauri AL, Petersen CG, Massaro FC, Silva LF, Felipe V, Cavagna M, Pontes A, Baruffi RL, Oliveira JB, Vagnini LD. Large nuclear vacuoles are indicative of abnormal chromatin packaging in human spermatozoa. Int J Androl. 2012;35:46–51.PubMedCrossRefGoogle Scholar
Oliveira JB, Massaro FC, Baruffi RL, Mauri AL, Petersen CG, Silva LF, Vagnini LD, Franco Jr JG. Correlation between semen analysis by motile sperm organelle morphology examination and sperm DNA damage. Fertil Steril. 2010;94:1937–40.PubMedCrossRefGoogle Scholar
Watanabe S, Tanaka A, Fujii S, Mizunuma H, Fukui A, Fukuhara R, Nakamura R, Yamada K, Tanaka I, Awata S, Nagayoshi M. An investigation of the potential effect of vacuoles in human sperm on DNA damage using a chromosome assay and the TUNEL assay. Hum Reprod. 2011;26:978–86.PubMedCrossRefGoogle Scholar
Montjean D, Belloc S, Benkhalifa M, Dalleac A, Menezo Y. Sperm vacuoles are linked to capacitation and acrosomal status. Hum Reprod. 2012;27:2927–32.PubMedCrossRefGoogle Scholar
Kacem O, Sifer C, Barraud-Lange V, Ducot B, De Ziegler D, Poirot C, Wolf J. Sperm nuclear vacuoles, as assessed by motile sperm organellar morphological examination, are mostly of acrosomal origin. Reprod Biomed Online. 2011;20:132–7.CrossRefGoogle Scholar
Hammoud I, Boitrelle F, Ferfouri F, Vialard F, Bergere M, Wainer B, Bailly M, Albert M, Selva J. Selection of normal spermatozoa with a vacuole-free head (·6300) improves selection of spermatozoa with intact DNA in patients with High sperm DNA fragmentation rates. Andrologia. 2013;45:163–70.PubMedCrossRefGoogle Scholar
Tesarik J, Greco E, Mendoza C. Late, but not early, paternal effect on human embryo development is related to sperm DNA fragmentation. Human Reproduction. 2004;19:611–5.PubMedCrossRefGoogle Scholar
Borini A, Tarozzi N, Bizzaro D, Bonu MA, Fava L, Flamigni C, Coticchio G. Sperm DNA fragmentation: paternal effect on early post-implantation embryo development in ART. Hum Reprod. 2006;21:2876–81.PubMedCrossRefGoogle Scholar
Miller D, Brinkworth M, Iles D. Paternal DNA packaging in spermatozoa: more than the sum of its parts? DNA, histones, protamines and epigenetics. Reproduction. 2010;139:287–301.PubMedCrossRefGoogle Scholar
Palermo GD, Neri QV, Takeuchi T, Squires J, Moy F, Rosenwaks Z. Genetic and epigenetic characteristics of ICSI children. Reprod Biomed Online. 2008;17: 820–33.PubMedCrossRefGoogle Scholar
Setti AS, Ferreira Braga DP, Iaconelli A, Aoki T, Borges E. Twelve years of MSOME and IMSI: a review. Reproductive BioMedicine Online. 2013;27:338–52.PubMedCrossRefGoogle Scholar