Sperm nuclear abnormalities in patients with globozoospermia have not been
well characterized and may lead to the high rates of fertilization failure
and Embryo loss reported in patients with this form of teratozoospermia. Th
is study used transmission electron microscopy (TEM), the sperm chromatin s
tructure assay (SCSA), and single cell gel eletrophoresis assay (COMET) to
assess if globozoospermia is associated with sperm chromatin structure abno
rmalities, DNA fragmentation, or both. The flow cytometric SCSA measures ab
normal chromatin structure based on the susceptibility of sperm nuclear DNA
to acid-induced denaturation in situ. COMET measures DNA fragmentation in
individual sperm nuclei based upon gel electrophoretic patterns. Although s
perm concentration (113 million/mL) and motility (66%) were normal in the p
atient, there was complete acrosome deficiency. TEM and SCSA data confirmed
light microscopic examination that showed that sperm populations included
a mixture of round and elongated sperm heads. Even though 100% of sperm had
abnormal head morphology, only 13% demonstrated DNA denaturation (COMP alp
ha (t))(1) which is below our threshold of 15% COMPalphat, and consistent w
ith high-fertility patients. Of interest, 13% of the sperm were also positi
ve in the COMET assay, supporting our previous observations that SCSA-posit
ive cells are also positive for DNA fragmentation. It was unexpected but of
great interest that a human sperm population with 100% sperm morphology ab
normalities had a chromatin integrity at the molecular level that is equiva
lent to sperm populations shown in previous studies to be highly fertile. T
hese data are the first reported using SCSA and COMET assays to evaluate a
patient with globozoospermia and support previous reports that intracytopla
smic sperm injection of globozoospermia may result in fertility/pregnancy.
Lower success rates seen in some patients may be due to unrelated factors.