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Vol. 37. Issue 2.
Pages 100-105 (February 2013)
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Vol. 37. Issue 2.
Pages 100-105 (February 2013)
Original article
DOI: 10.1016/j.acuroe.2011.11.012
Diagnosis of male infertility: A need of functional and chromatin evaluation
Diagnóstico de infertilidad masculina: necesidad de valoraciones funcionales y cromatínicas
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G. Curti??
Corresponding author
giannicurti@gmail.com

Corresponding author.
, M. Cánepa, L. Cantú, J.M. Montes
Laboratorio Fertilab, Montevideo, Uruguay
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Tables (3)
Table 1. Seminal parameters evaluated with their corresponding reference ranges. The values are expressed as median±standard error (n=110).
Table 2. Parameters altered depending on the group of patients analyzed. The table shows the parameters not considered by the 2010 WHO manual.7 The values correspond to the percentage of samples of the total in each group.
Table 3. Seminal parameters studied in groups A, B, and control, and comparisons between groups. The values of the variables are expressed as median±standard error. The comparisons were performed using the one-way ANOVA test; the p values are shown.
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Abstract
Objectives

To evaluate the incidence of functional and chromatin alterations on spermatozoids in patients grouped according to normality of standard semen parameters based on the 5th edition of the World Health Organization (WHO) guidelines. To identify and correlate the most frequently altered characteristics in the normal standard semen parameters sub-population.

Materials and methods

A prospective study was performed. It evaluated standard semen parameters (volume, sperm concentration, motility and morphology, round cells, peroxidase-positive cells) according to WHO guidelines, as well as functional tests (24h survival, hypoosmotic swelling test, modified stress test), and additional assays (aniline blue, nitroblue-tetrazolium, TUNEL) in 110 semen samples from patients and 6 from fertile donors (control). Based on standard semen parameters values, patients were divided into two groups (A: all standard parameters normal; B: one altered standard parameter at least).

Results

At least one of the variables analyzed was altered in 96.61% of the samples. Groups A and B showed statistically significant differences in all the complementary tests. At least one of the complementary tests were altered in 93.68% of the samples in group A, and the most frequently affected variable was sperm DNA fragmentation (16.95%).

Conclusions

Performing a more in-depth seminal study within the routine functional and chromatin assays provides a more precise diagnosis of male infertility. The WHO standards should be considered as a primary approach.

Keywords:
Sperm DNA fragmentation
Terminal deoxynucleotidyl transferase dUTP nick end labeling
Nitroblue tetrazolium
Sperm function tests
Resumen
Objetivos

Estudiar la incidencia de alteraciones funcionales y cromatínicas en espermatozoides de pacientes, agrupados según normalidad de los parámetros seminales estándar en función de la quinta edición del manual de la Organización Mundial de la Salud (OMS). Identificar y correlacionar las características alteradas con mayor frecuencia en la subpoblación normal para los parámetros estándar.

Materiales y métodos

Estudio prospectivo en el que se evaluaron en muestras de semen de 110 pacientes y 6 donantes fértiles (control), los parámetros seminales estándar (volumen, concentración, motilidad, morfología, células redondas, células peroxidasa-positivas) según las directrices de la OMS, así como test complementarios funcionales (sobrevida 24 horas, test hipo-osmótico, test de estrés modificado) y adicionales (azul de anilina, nitroblue-tetrazolium, TUNEL). Según el resultado de los análisis estándar los pacientes se dividieron en dos grupos (A: todos los parámetros estándar normales; B: al menos uno de los parámetros estándar alterado).

Resultados

El 96,61% de las muestras presentó alterada al menos una de las variables analizadas. Los grupos A y B mostraron diferencia estadísticamente significativa en todos los test complementarios. En el grupo A el 93,68% de las muestras presentó al menos un test complementario alterado, y la variable afectada con mayor frecuencia fue la fragmentación del ADN espermático (16,95%).

Conclusiones

La profundización en el estudio seminal, introduciendo en la rutina ensayos funcionales y cromatínicos, redunda en un diagnóstico más afinado de la infertilidad del varón. Los parámetros de la OMS deben considerarse como un abordaje primario.

Palabras clave:
Fragmentación del ADN espermático
Terminal deoxynucleotidyl transferase dUTP nick end labeling
Nitroblue Tetrazolium
Pruebas funcionales espermáticos

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