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Clinical characteristics and light and transmission electron microscopic sperm defects of infertile men with
M Courtade1, C Lagorce, L Bujan
1Laboratoire d'Histologie-Embryologie-Cytogénétique, Faculté de Médecine, Hôpital de La Grave, Toulouse, France.
Objective:
To determine, with the use of transmission electron microscopy (TEM), the proportion of patients with permanent unexplained asthenozoospermia (<30% motility) who have an abnormality of sperm axonemal and periaxonemal structures.
Design:
Retrospective study.
Setting:
A university-affiliated public hospital.
Patient(S):
Sixty-one infertile men whose semen was submitted to TEM analysis because of persistent unexplained asthenozoospermia.
Main Outcome Measure(S):
The results of quantitative TEM analysis of the tails of the spermatozoa.
Intervention(S):
None.
Result(S):
Based on a comparison with the axonemal anomalies observed in nine fertile control patients, the infertile population was divided into three groups: group I, with no detectable axonemal defects (26.2%); group II, with axonemal anomalies in either the midpiece or the principal piece (29.5%); and group III, with axonemal anomalies in both the midpiece and the principal piece (44.3%). However, defects in the mitochondrial sheath, fibrous sheath, and sperm head (acrosomic and postacrosomic cap) were observed in at least 50%, 30%, and 50%, respectively, of the patients in each group. The proportion of dense fiber anomalies of the midpiece increased significantly from group I to group III. No differences were observed between the three groups in sperm characteristics, anamnesis information, or clinical data.
Conclusion(S):
In patients with persistent unexplained asthenozoospermia, the frequent association of periaxonemal anomalies with axonemal deficiencies strongly suggests that axonemal deficiencies are not the unique cause of decreased motility.