CEDIE   05498
CENTRO DE INVESTIGACIONES ENDOCRINOLOGICAS "DR. CESAR BERGADA"
Unidad Ejecutora - UE
artículos
Título:
Tales of the tail and sperm head aches: changing concepts on the prognostic significance of sperm pathologies affecting the head, neck and tail
Autor/es:
CHEMES H E,; ALVAREZ SEDÓ, C
Revista:
ASIAN JOURNAL OF ANDROLOGY
Editorial:
NATURE PUBLISHING GROUP
Referencias:
Lugar: Londres; Año: 2011
ISSN:
1008-682X
Resumen:
This article presents an update on the variable prognostic significance of different sperm pathologies in patients with severe male factor infertility due to morphology and motility disorders. Severe asthenozoospermia was a leading cause of infertility because spermatozoa could not reach the oocyte and penetrate normally. Identifying structural causes of sperm immotility was of great concern before ICSI, since sperm immotility was the limiting factor in the treatment of these patients. Microinjection of in situ motile spermatozoa, in vitro stimulation of motility or identification of immotile but live spermatozoa assured good fertilization and pregnancy rates, provided injected spermatozoa were viable. The recognition of genetic phenotypes in severe asthenozoospermia assures that patients are adequately informed on the risks involved. The one sperm characteristic that remains seriously affecting fertility prognosis is teratozoospermia, primarily sperm head and neck anomalies. Of particular importance are defects of chromatin condensation and acrosomal hypoplasia, the two most common abnormalities in severe teratozoospermia. Besides its obvious academic interest, the correct ultrastructural diagnosis of sperm pathologies helps to decide on the best therapeutic choice in view of the development of microscopic methods to select the best spermatozoon for microinjection and the likely introduction of new better ones in the future. In the present article we will review the differential roles played by individual sperm components in normal fertilization and early embryo development and explore how current ART have modified our concepts on the prognostic significance of sperm pathologies affecting the head, neck, mid piece and tail.