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- Title
IS HMS (HIGH MAGNIFICATION SPERM SELECTION) SUFFICIENT TO COUNSEL PATIENTS TOWARD IMSI?
- Authors
Belloc, S.; Cohen-Bacrie, P.; Benkhalifa, M.; Cohen-Bacrie, M.; Izard, V.; Aubriot, F. X.; Glissant, A.; Amar, E.; Olivennes, F.; Raveneau, P.; Prisant, N.
- Abstract
Introduction: Sperm selection according to Baartov criteria, constitute the High Magnification Sperm selection (HMS). This test is used in order to decide which couple to direct toward IMSI (Intracytoplasmic Morphologically Selected sperm Injection). But other sperm evaluation tests are also of value. The objective of this work was to evaluate the relative weight of sperm DNA fragmentation, chromatin decondensation, and vacuole impact (area and localisation) on therapeutic counsel. The age factor was also integrated. Materials and Methods: A total of 1059 sperm tests (excluding severe oligozoospermia and akinetospermia) between July 2007 and June 2010 were analysed according to 4 age groups (<30, 30-40, 40-50, >50 years old). For HMS, 4 types of sperm were defined at x6600 observation: Type 1: normal heads, without vacuoles or vacuoles less than 4% of the head area. Type 2: abnormal heads, without vacuoles or vacuoles less than 4% of the head area. Type 3: normal heads, with vacuoles. Type 4: abnormal heads, with vacuoles. Mean vacuoles area was evaluated for 444 tests, as well as their localisation on the head (apical, basal or both) by two separate technicians on an Olympus microscope. Sperm DNA fragmentation was measured by TUNEL with flux cytometry in 4 groups (<20, 20-30, 30-40, >40%), chromatin decondensation with anhiline blue essay in 3 groups (<20, 20-30, >30%). Statistical significance (p) was determined by Kruskall-Wallis test. Results: No difference was observed except for type 3 sperm levels (normal head with vacuoles) which increase with age (p = 0.04). There was no statistical association when combining levels of type 1+2 and 3+4 (without or with vacuoles) nor 1+3 and 2+4 (normal or abnormal heads), conversely almost significantly correlated (p = 0.06). No correlation was found neither between age and vacuoles localization. DNA fragmentation and chromatin decondensation showed no significant differences according to the Bartoov selected sperm, except for the level of type 1, which was higher when DNA fragmentation was normal (p < 0.035). Finally, vacuoles area and localization were not related to DNA fragmentation rates or chromatin decondensation. Conclusions: Sperm high magnification selection, DNA fragmentation and chromatin decondensation are independent criteria, each one helping build a sound clinical advice.
- Subjects
SPERMATOZOA; CHROMATIN; CHROMOSOMES; MICROINJECTIONS; OLIGOSPERMIA
- Publication
Reproductive BioMedicine Online (Reproductive Healthcare Limited), 2010, Vol 20, pS26
- ISSN
1472-6483
- Publication type
Article
- DOI
10.1016/S1472-6483(10)62480-7