Pathophysiological interest of human sperm vacuoles

Depuis plus de 30 ans, de nombreuses publications se sont attachées à expliquer la physiopathologie des anomalies morphologiques du spermatozoïde humain et ont mis en évidence des corrélations entre le pourcentage de formes normales et certaines anomalies fonctionnelles et des relations avec certains facteurs d'exposition. Le caractère physiologique de la plupart des " traits " morphologiques du spermatozoïde humain rend très difficile l'interprétation du spermocytogramme en dehors des syndromes d'anomalies monomorphes. A ces difficultés d'interprétation, viennent se rajouter le manque cruel de fiabilité analytique des techniques actuelles pour l'évaluation de la morphologie du spermatozoïde humain rendant très difficile l'utilisation de seuil décisionnel pour le choix d'une technique d'Assistance Médicale à la Procréation. Cette morphologie est classiquement observée sur lame après coloration (de Schorr le plus souvent). Il a récemment été développé une technique d'observation des spermatozoïdes mobiles associant un contraste interférentiel de Nomarski et un fort grossissement numérique et optique de x6000 au total permettant de mieux déceler certaines anomalies et notamment des vacuoles au niveau de la tête des spermatozoïdes. Cette technique est appelé MSOME (Motile Sperm Organelle MorphologyExamination). L'origine de ces vacuoles reste controversée, sont-elles d'origine nucléaire ou acrosomique ? Certains auteurs ont mis en évidence une relation entre la présence de larges vacuoles et des anomalies de condensation de la chromatine. De plus, beaucoup de questions subsistent quant au réel intérêt diagnostic du MSOME. Au cours d'un premier travail j'ai essayé d'amener un argument supplémentaire à l'origine des vacuoles. J'ai étudié le cas de deux patients atteints de globozoospermie totale (patients porteurs de spermatozoïdes sans acrosome confirmé par microscopie électronique). Au cours de ce travail, outre l'analyse morphométrique des vacuoles avec le MSOME, j'ai utilisé des techniques d'immunofluorescence (lectines PNA et anticorps anti-CD46) pour analyser le statut acrosomique et des techniques TUNEL (terminal deoxynucleotidyltransferase-mediateddUTPnick-end labelling assay) et SCSA (spermchromatin structure assay) pour le statut nucléaire du spermatozoïde. Les deux patients avaient un nombre et une surface vacuolaire (6,3% et 5%) très similaires à celles de 12 témoins fertiles (5%) permettant d'exclure une origine acrosomique de la plupart de ces vacuoles. Je me suis ensuite intéressé à l'impact de la congélation du sperme (très utilisé en pratique clinique) sur l'apparition de ces vacuoles. Après analyse morphométrique précise à l'aide d'un logiciel d'analyse d'image de plus de 2000 spermatozoïdes avant et après congélation (27 individus) je n'ai retrouvé aucune différence statistiquement significative en termes de nombre, surface et position de ces vacuoles entre avant et après congélation. De nombreux auteurs plaident en faveur d'une utilisation en pratique clinique de cette évaluation des vacuoles à fort grossissement sans qu'il n'y ait aucune donnée sur la présence de ces vacuoles dans une population de référence (témoins fertiles). J'ai donc réalisé une analyse morphométrique précise de ces vacuoles dans une population de 50 témoins fertiles. La très grande fréquence de ces vacuoles (95,8 %) dans cette population souligne le caractère physiologique de la plupart d'entre elles.For over 30 years, many publications have sought to explain the pathophysiology of human sperm morphological abnormalities and showed correlations between the percentage of normal forms and functional defect and some relationships with some exposure factors. The physiological nature of most of the "features" of human sperm morphology makes the interpretation of human sperm morphology very difficult except for monomorphic defects. To these difficulties of interpretation, come to add the lack of analytical reliability of current techniques for assessing human sperm morphology making very difficult the use of threshold of normal forms for the choice of medical treatment of infertile couple in Assisted Reproductive Treatment. Recently a new aspect of sperm morphology, the head vacuoles, has shown to be of interest. The vacuoles can be easily observed using Nomarski interference contrast microscopy at high magnification: ×6000 to 10000 (optical magnification ×1000 associated with digital enhancements that achieves a final magnification up to 6000) even on motile spermatozoa (MSOME: Motile Sperm Organellar Morphology Examination). The origin of these vacuoles raises many questions. Several studies have found a link between chromatin condensation defects and the presence of sperm head vacuoles and clinical interest of MSOME is still somewhat debated. To add new arguments concerning the origin of the sperm-head vacuoles observed under high magnification with interference contrast microscopy, we carried out in two patients with total globozoospermia confirmed using transmission electron microscopy (TEM), a detailed sperm morphometric analysis with MSOME, an acrosomal status analysis (using fluorescent labelling with peanut agglutinin (PNA) lectins and anti-CD46 antibodies) and a nuclear status analysis (using terminal deoxynucleotidyl transferase-mediated dUTP nick-end labelling assay TUNEL, sperm chromatin structure assay SCSA and aniline blue staining). Our two patients with globozoospermia had relative sperm vacuole areas of 6.3% and 5%, similar to those observed in a reference population of 12 fertile men (5.9%). This study provides further information on the non-acrosomal origin of the sperm-head vacuoles. Since the development of MSOME for observing the cephalic vacuoles at high magnification, no study as yet assessed the effect of cryopreservation on these vacuoles, although sperm freezing-thawing procedures are known to affect sperm quality. In 27 sperm samples from fertile men, morphological analysis at high magnification (·6000) using image analysis software was performed before freezing and after thawing, there was no evidence for any difference in any vacuolar criteria (relative vacuole area, total vacuole area, vacuole area in the anterior, median and basal parts of the head, percentage of spermatozoa with a vacuole area 13%). Freezing-thawing procedures have no effect on human sperm vacuoles. In order to establish reference values concerning sperm vacuoles and to know if the assessment of sperm vacuoles at high magnification can contribute to the explanation of idiopathic infertility, I investigated the number, position and area of sperm head vacuoles using an image analysis software in 50 fertile men and 50 infertile men were within couples who had unexplained infertility and were consulting in our centre. After analysis, the characteristics of sperm head vacuoles (number, area, position) are no different between fertile controls and patients with unexplained infertility

Morphométrie des vacuoles du spermatozoïde humain : intérêt physiopathologique

Depuis plus de 30 ans, de nombreuses publications se sont attachées à expliquer la physiopathologie des anomalies morphologiques du spermatozoïde humain et ont mis en évidence des corrélations entre le pourcentage de formes normales et certaines anomalies fonctionnelles et des relations avec certains facteurs d'exposition. Le caractère physiologique de la plupart des " traits " morphologiques du spermatozoïde humain rend très difficile l'interprétation du spermocytogramme en dehors des syndromes d'anomalies monomorphes. A ces difficultés d'interprétation, viennent se rajouter le manque cruel de fiabilité analytique des techniques actuelles pour l'évaluation de la morphologie du spermatozoïde humain rendant très difficile l'utilisation de seuil décisionnel pour le choix d'une technique d'Assistance Médicale à la Procréation. Cette morphologie est classiquement observée sur lame après coloration (de Schorr le plus souvent). Il a récemment été développé une technique d'observation des spermatozoïdes mobiles associant un contraste interférentiel de Nomarski et un fort grossissement numérique et optique de x6000 au total permettant de mieux déceler certaines anomalies et notamment des vacuoles au niveau de la tête des spermatozoïdes. Cette technique est appelé MSOME (Motile Sperm Organelle MorphologyExamination). L'origine de ces vacuoles reste controversée, sont-elles d'origine nucléaire ou acrosomique ? Certains auteurs ont mis en évidence une relation entre la présence de larges vacuoles et des anomalies de condensation de la chromatine. De plus, beaucoup de questions subsistent quant au réel intérêt diagnostic du MSOME. Au cours d'un premier travail j'ai essayé d'amener un argument supplémentaire à l'origine des vacuoles. J'ai étudié le cas de deux patients atteints de globozoospermie totale (patients porteurs de spermatozoïdes sans acrosome confirmé par microscopie électronique). Au cours de ce travail, outre l'analyse morphométrique des vacuoles avec le MSOME, j'ai utilisé des techniques d'immunofluorescence (lectines PNA et anticorps anti-CD46) pour analyser le statut acrosomique et des techniques TUNEL (terminal deoxynucleotidyltransferase-mediateddUTPnick-end labelling assay) et SCSA (spermchromatin structure assay) pour le statut nucléaire du spermatozoïde. Les deux patients avaient un nombre et une surface vacuolaire (6,3% et 5%) très similaires à celles de 12 témoins fertiles (5%) permettant d'exclure une origine acrosomique de la plupart de ces vacuoles. Je me suis ensuite intéressé à l'impact de la congélation du sperme (très utilisé en pratique clinique) sur l'apparition de ces vacuoles. Après analyse morphométrique précise à l'aide d'un logiciel d'analyse d'image de plus de 2000 spermatozoïdes avant et après congélation (27 individus) je n'ai retrouvé aucune différence statistiquement significative en termes de nombre, surface et position de ces vacuoles entre avant et après congélation. De nombreux auteurs plaident en faveur d'une utilisation en pratique clinique de cette évaluation des vacuoles à fort grossissement sans qu'il n'y ait aucune donnée sur la présence de ces vacuoles dans une population de référence (témoins fertiles). J'ai donc réalisé une analyse morphométrique précise de ces vacuoles dans une population de 50 témoins fertiles. La très grande fréquence de ces vacuoles (95,8 %) dans cette population souligne le caractère physiologique de la plupart d'entre elles. Après comparaison de ces valeurs à une population de patients atteints d'infertilité idiopathique, aucune différence significative n'a été retrouvé soulignant l'absence d'intérêt de cet examen à fort grossissement pour contribuer à l'explication de ces infertilités inexpliquées. A côté de cette approche physiopathologique, j'ai regardé à travers une étude rétrospective réalisée au sein du centre d'Assistance Médicale à la Procréation du CHU de Toulouse sur 270 couples ayant déjà eu 2 échecs de FIV-ICSI conventionnelle, l'impact de la sélection de spermatozoïde ayant le moins de vacuoles possible avant injection dans l'ovocyte au cours d'une tentative de Fécondation In Vitro. Je n'ai retrouvé aucune différence en terme de taux d'implantation, de taux de grossesse ni de taux d'accouchement par rapport à la FIV ICSI avec sélection du spermatozoïde à un grossissement standard (x400). En dépit de relations avérées entre la présence de larges vacuoles (qui ne sont pas d'origine acrosomique) et des anomalies du matériel nucléaire, nous pouvons souligner le caractère physiologique de la plupart de ces vacuoles et l'absence d'intérêt diagnostic de cette technique dans les infertilités inexpliquées.For over 30 years, many publications have sought to explain the pathophysiology of human sperm morphological abnormalities and showed correlations between the percentage of normal forms and functional defect and some relationships with some exposure factors. The physiological nature of most of the "features" of human sperm morphology makes the interpretation of human sperm morphology very difficult except for monomorphic defects. To these difficulties of interpretation, come to add the lack of analytical reliability of current techniques for assessing human sperm morphology making very difficult the use of threshold of normal forms for the choice of medical treatment of infertile couple in Assisted Reproductive Treatment. Recently a new aspect of sperm morphology, the head vacuoles, has shown to be of interest. The vacuoles can be easily observed using Nomarski interference contrast microscopy at high magnification: ×6000 to 10000 (optical magnification ×1000 associated with digital enhancements that achieves a final magnification up to 6000) even on motile spermatozoa (MSOME: Motile Sperm Organellar Morphology Examination). The origin of these vacuoles raises many questions. Several studies have found a link between chromatin condensation defects and the presence of sperm head vacuoles and clinical interest of MSOME is still somewhat debated. To add new arguments concerning the origin of the sperm-head vacuoles observed under high magnification with interference contrast microscopy, we carried out in two patients with total globozoospermia confirmed using transmission electron microscopy (TEM), a detailed sperm morphometric analysis with MSOME, an acrosomal status analysis (using fluorescent labelling with peanut agglutinin (PNA) lectins and anti-CD46 antibodies) and a nuclear status analysis (using terminal deoxynucleotidyl transferase-mediated dUTP nick-end labelling assay TUNEL, sperm chromatin structure assay SCSA and aniline blue staining). Our two patients with globozoospermia had relative sperm vacuole areas of 6.3% and 5%, similar to those observed in a reference population of 12 fertile men (5.9%). This study provides further information on the non-acrosomal origin of the sperm-head vacuoles. Since the development of MSOME for observing the cephalic vacuoles at high magnification, no study as yet assessed the effect of cryopreservation on these vacuoles, although sperm freezing-thawing procedures are known to affect sperm quality. In 27 sperm samples from fertile men, morphological analysis at high magnification (·6000) using image analysis software was performed before freezing and after thawing, there was no evidence for any difference in any vacuolar criteria (relative vacuole area, total vacuole area, vacuole area in the anterior, median and basal parts of the head, percentage of spermatozoa with a vacuole area 13%). Freezing-thawing procedures have no effect on human sperm vacuoles. In order to establish reference values concerning sperm vacuoles and to know if the assessment of sperm vacuoles at high magnification can contribute to the explanation of idiopathic infertility, I investigated the number, position and area of sperm head vacuoles using an image analysis software in 50 fertile men and 50 infertile men were within couples who had unexplained infertility and were consulting in our centre. After analysis, the characteristics of sperm head vacuoles (number, area, position) are no different between fertile controls and patients with unexplained infertility. The prevalence of small vacuoles found in fertile men was extremely high, leading us to conclude that most of them should be considered as a common feature in normal human sperm and not associated with any pathology. After these pathophysiological studies on human sperm vacuoles, I assessed the benefit of sperm selection by this technique by carrying out a retrospective comparative study on 270 couples with two previous IVF-ICSI failures. Results did not significantly improve the clinical outcomes either for implantation (12 vs 10 %), clinical pregnancy (23 vs 21 %), or live birth rates (20 vs 19 %). Despite proven relationship between the large vacuoles and nuclear abnormalities, we can highlight the physiological nature of most of these vacuoles and the lack of diagnostic value of this technique in unexplained infertility

Évaluation de la morphologie spermatique en microscopie optique à très fort grossissement

TOULOUSE3-BU Santé-Centrale (315552105) / SudocSudocFranceF

Does air pollution play a role in infertility?: a systematic review

Abstract Background Air pollution is involved in many pathologies. These pollutants act through several mechanisms that can affect numerous physiological functions, including reproduction: as endocrine disruptors or reactive oxygen species inducers, and through the formation of DNA adducts and/or epigenetic modifications. We conducted a systematic review of the published literature on the impact of air pollution on reproductive function. Eligible studies were selected from an electronic literature search from the PUBMED database from January 2000 to February 2016 and associated references in published studies. Search terms included (1) ovary or follicle or oocyte or testis or testicular or sperm or spermatozoa or fertility or infertility and (2) air quality or O3 or NO2 or PM2.5 or diesel or SO2 or traffic or PM10 or air pollution or air pollutants. The literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We have included the human and animal studies corresponding to the search terms and published in English. We have excluded articles whose results did not concern fertility or gamete function and those focused on cancer or allergy. We have also excluded genetic, auto-immune or iatrogenic causes of reduced reproduction function from our analysis. Finally, we have excluded animal data that does not concern mammals and studies based on results from in vitro culture. Data have been grouped according to the studied pollutants in order to synthetize their impact on fertility and the molecular pathways involved. Conclusion Both animal and human epidemiological studies support the idea that air pollutants cause defects during gametogenesis leading to a drop in reproductive capacities in exposed populations. Air quality has an impact on overall health as well as on the reproductive function, so increased awareness of environmental protection issues is needed among the general public and the authorities

Environmental pollutants, a possible etiology for premature ovarian insufficiency: a narrative review of animal and human data

Abstract Background Because only 25% of cases of premature ovarian insufficiency (POI) have a known etiology, the aim of this review was to summarize the associations and mechanisms of the impact of the environment on this pathology. Main body of the abstract Eligible studies were selected from an electronic literature search from the PUBMED database from January 2000 to February 2016 and associated references in published studies. Search terms included ovary, follicle, oocyte, endocrine disruptor, environmental exposure, occupational exposure, environmental contaminant, pesticide, polyaromatic hydrocarbon, polychlorinated biphenyl PCB, phenol, bisphenol, flame retardant, phthalate, dioxin, phytoestrogen, tobacco, smoke, cigarette, cosmetic, xenobiotic. The literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We have included the human and animal studies corresponding to the terms and published in English. We have excluded articles that included results that did not concern ovarian pathology and those focused on ovarian cancer, polycystic ovary syndrome, endometriosis or precocious puberty. We have also excluded genetic, auto-immune or iatrogenic causes from our analysis. Finally, we have excluded animal data that does not concern mammals and studies based on results from in vitro culture. Data have been grouped according to the studied pollutants in order to synthetize their impact on follicular development and follicular atresia and the molecular pathways involved. Ninety-seven studies appeared to be eligible and were included in the present study, even though few directly address POI. Phthalates, bisphenol A, pesticides and tobacco were the most reported substances having a negative impact on ovarian function with an increased follicular depletion leading to an earlier age of menopause onset. These effects were found when exposure occured at different times throughout the lifetime from the prenatal to the adult period, possibly due to different mechanisms. The main mechanism seemed to be an increase in atresia of pre-antral follicles. Conclusion Environmental pollutants are probably a cause of POI. Health officials and the general public must be aware of this environmental effect in order to implement individual and global preventive actions

Involvement of CATSPER 2 mutation in a familial context of unexplained infertility and fertilization failure associated with hearing loss: a case report

International audienceOBJECTIVE: To explore the functional implications of a homozygous CATSPER 2 (cation channel for sperm) deletion within the acrosome reaction pathway during fertilization in 2 brothers, who have unexplained infertility and hearing loss. DESIGN: Case report. PATIENTS: Two twin brothers aged 30 years with hearing loss and unexplained infertility. EXPOSURE OR INTERVENTION: Molecular genetic diagnosis of deafness. Evaluation of the acrosome reaction and calcium mobilization assays after induction by progesterone and ionomycin on spermatozoa of the CATSPER 2-mutated patient and on fertile controls. MAIN OUTCOME MEASURES: Fertilization rate during conventional in vitro fertilization. Molecular genetic test. Percentage of acrosome-reacted spermatozoa with peanut agglutinin lectin staining. Recording of progesterone and ionomycin-induced intracellular calcium signals with a fluorescent probe. RESULTS: Mr. S and his brother have normal, conventional sperm parameters. Both brothers have had repeated intrauterine insemination failures and one fertilization failure after conventional in vitro fertilization. Mr. S obtained 2 healthy babies after intracytoplasmic sperm injection. Genetic analysis found a homozygote deletion of the STRC (stereocilin) gene (NM 153700: c.1-? 5328+?del) that removes the CATSPER 2 gene. Mutation of the STRC gene is known to be associated with hearing loss. Sperm functional tests revealed an inability of progesterone to activate intracellular calcium signaling and to induce acrosome reaction. CONCLUSION: We demonstrate the absence of a calcium signal and acrosome reaction after progesterone in our patient with a CATSPER 2 mutation. We emphasize the importance of the male medical interview and of the genetic investigation of hearing loss. We show that in vitro fertilization-intracytoplasmic sperm injection is necessary, even where normal sperm parameters are present

Pre- and Postnatal Dietary Exposure to a Pesticide Cocktail Disrupts Ovarian Functions in 8-Week-Old Female Mice

International audienceFemale infertility has a multifactorial origin, and exposure to contaminants, including pesticides, with endocrine-disrupting properties is considered to be involved in this reproductive disorder, especially when it occurs during early life. Pesticides are present in various facets of the environment, and consumers are exposed to a combination of multiple pesticide residues through food intake. The consequences of such exposure with respect to female fertility are not well known. Therefore, we aimed to assess the impact of pre- and postnatal dietary exposure to a pesticide mixture on folliculogenesis, a crucial process in female reproduction. Mice were exposed to the acceptable daily intake levels of six pesticides in a mixture (boscalid, captan, chlorpyrifos, thiacloprid, thiophanate and ziram) from foetal development until 8 weeks old. Female offspring presented with decreased body weight at weaning, which was maintained at 8 weeks old. This was accompanied by an abnormal ovarian ultrastructure, a drastic decrease in the number of corpora lutea and progesterone levels and an increase in ovary cell proliferation. In conclusion, this study shows that this pesticide mixture that can be commonly found in fruits in Europe, causing endocrine disruption in female mice with pre- and postnatal exposure by disturbing folliculogenesis, mainly in the luteinisation process