Electron microscopy and recent advances in human sperm pathology

Electron microscopy is a valuable tool in understanding not only the presence, but also the nature of sperm malformation causing human infertility. We have examined, in the past, patients affected by severe teratospermia concomitant with andrological pathologies such as varicocele, cryptorchidism, and infection. In particular we have demonstrated that, in the case of varicocele, a combination of different phenotypic defects typical of immature spermatozoa is present. This general study has carried out on 2000 infertile men presented during ten years to our laboratory for sperm analysis. The ejaculate of all of them was examined by electron microscopy, statistically evaluated by a formula created by us (J. of Andrology, 1995) and cytogenetically checked by fluorescence microscopy techniques.. First of all this study concerned the techniques of assisted reproduction, i.e. intracytoplasmic sperm injection (ICSI), partial zona disruption (PZD) and in vitro fertilization (IVF). The conclusion was that the evaluation of the sperm quality of males attempting artificial insemination must concern not only motility or staining characteristics, but mainly submicroscopical and molecular properties directly connected with the successes of the procedure. Moreover the effect of follicle stimulating hormone (FSH) treatment on human sperm quality has been evaluated by our group testing the ultrastructure and the function of spermatozoa before and after the therapy. Using the sperm as an andrological monitor, it was evident that the therapeutic effect of FSH depends on the type of sperm affections. In particular phenotypic defects as apoptosis and immaturity can be corrected by FISH treatment.