Андрология и генитальная хирургия. 2024; 25: 77-84
Спермиологические нарушения у пациентов с мужским бесплодием, связанным с дисплазией фиброзной оболочки жгутика сперматозоида
https://doi.org/10.62968/2070-9781-2024-25-4-77-84Аннотация
Введение. Дисплазия фиброзной оболочки (ДФО) – специфичная структурная аномалия сперматозоидов, которая характеризуется дезорганизацией поперечных ребер и вертикальных колонн фиброзной оболочки и приводит к нарушению подвижности и морфологии сперматозоидов, патозооспермии и мужскому бесплодию.
Целью данной работы являлось комплексное спермиологическое обследование пациентов с бесплодием, связанным с ДФО.
Материалы и методы. Обследовано 26 неродственных пациентов с мужским бесплодием, у которых по результатам трансмиссионной электронной микроскопии сперматозоидов (ЭМИС) выявлено высокое содержание гамет с ДФО (группа I – 50-79%, n=14; группа II – 80-100%, n=12). Стандартное спермиологическое исследование проводили согласно лабораторному Руководству ВОЗ (2010).
Результаты. У 11 (42%) пациентов диагностирована тотальная астенозооспермия, у 21 (81%) мужчин – тотальная тератозооспермия. У 85% пациентов с ДФО выявлено повышенное содержание сперматозоидов с прореагировавшей акросомой, у 38% – повышенное содержание гамет с нарушением конденсации хроматина. В 88% образцов обнаружены гетерогенные дефекты структуры аксонемы. В 42% случаев диспластические изменения фиброзной оболочки сочетались с отсутствием центральной пары микротрубочек аксонемы жгутика сперматозоида.
Заключение. У пациентов с дисплазией фиброзной оболочки обнаружено выраженное снижение подвижных и морфологически нормальных сперматозоидов, у большинства в сочетании с их пониженной концентрацией (олигоастенотератозооспермия), повышенным содержанием гамет с прореагировавшей акросомой и гетерогенными дефектами структуры аксонемы, характерными для первичной цилиарной дискинезии.
Список литературы
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10. Olmedo SB, Rawe VY, Nodar FN, Galaverna GD, Acosta AA, Chemes HE. Pregnancies established through intracytoplasmic sperm injection (ICSI) using spermatozoa with dysplasia of fibrous sheath. Asian J Androl. 2000 Jun;2(2):125-30.
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12. Pariz JR, Rané C, Drevet J, Hallak J. Dysplasia of the fibrous sheath with axonemal and centriolar defects combined with lack of mitochondrial activity as associated factors of ICSI failure in primary ciliary dyskinesia syndrome. Int Braz J Urol. 2021 MayJun;47(3):617-626. doi: 10.1590/S1677-5538.IBJU.2019.0362.
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Andrology and Genital Surgery. 2024; 25: 77-84
Spermatology defects in patients with male infertility associated with fibrous sheath dysplasia of the sperm flagellum
https://doi.org/10.62968/2070-9781-2024-25-4-77-84Abstract
Dysplasia of the fibrous sheath (DFS) is a specific structural abnormality of sperm, which is characterized by disorganization of the transverse ribs and vertical columns of the fibrous membrane and leads to impaired motility and morphology of sperm, impaired male fertility.
The purpose of this work was a comprehensive spermiological study of patients with infertility associated with DFS.
Material and methods. Twenty-six unrelated patients with male infertility were examined, in whom, according to the results of transmission electron microscopy of spermatozoa (TEM), a high content of gametes with DFO was detected (group I – 50-79%, n=14; group II – 80-100%, n=12). Standard semen examination was performed according to WHO laboratory manual (2010).
Results. Total asthenozoospermia was detected in 11 (42%) patients and total teratozoospermia in 21 (81%) patients.Increased content of spermatozoa with spontaneous acrosome reaction in 85% of patients with DFS and incomplete chromatin condensation in 38% were detected. Heterogeneous defects of axoneme structure were found in 88% of samples. In 42% of cases, dysplastic changes in the fibrous sheath were combined with the absence of the central pair of microtubules of the axoneme of the sperm flagellum.
Conclusion. In patients with severe dysplasia of the fibrous sheath, a decrease in motile and morphologically normal sperm, combined with their reduced concentration (oligoasthenoteratozoospermia), was revealed. DFS is often combined with an increased content of sperm with a reacted acrosome and heterogeneous defects in the axoneme structure, including primary ciliary dyskinesia. In patients with high percentage DFS, severe decrease in sperm motility and morphology was found, in most in combination with their reduced concentration (oligoastenotheratozoospermia). An increased percentage of gametes with a reacted acrosome and heterogeneous defects in the axoneme structures characteristic of primary ciliary dyskinesia also was revealed.
References
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7. Miki K, Qu W, Goulding EH, Willis WD, Bunch DO, Strader LF, Perreault SD, Eddy EM, O’Brien DA. Glyceraldehyde 3-phosphate dehydrogenase-S, a sperm-specific glycolytic enzyme, is required for sperm motility and male fertility. Proc Natl Acad Sci U S A. 2004 Nov 23;101(47):16501-6. doi: 10.1073/pnas.0407708101.
8. Chiriva-Internati M, Gagliano N, Donetti E, Costa F, Grizzi F, Franceschini B, Albani E, Levi-Setti PE, Gioia M, Jenkins M, Cobos E, Kast WM. Sperm protein 17 is expressed in the sperm fibrous sheath. J Transl Med. 2009 Jul 15;7:61. doi: 10.1186/1479-5876-7-61.
9. Dávila Garza SA, Patrizio P. Reproductive outcomes in patients with male infertility because of Klinefelter’s syndrome, Kartagener’s syndrome, round-head sperm, dysplasia fibrous sheath, and ‘stump’ tail sperm: an updated literature review. Curr Opin Obstet Gynecol. 2013 Jun;25(3):229-46. doi: 10.1097/GCO.0b013e32835faae5. 1
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