Practical Guide in Andrology and Embryology Gita Ganguly Mukherjee, Gautam Khastgir, Ratna Chattopadhyay
INDEX
Page numbers followed by, f refer to figure, fc refer to flow chart, and t refer to table.
A
Acetaldehyde 172
Acetyl carnitine 110
Acetyl co-A succinate 4
Acid phosphatase 3
Acridine orange test 28
Acrolein 84
Acrosomal
cap 3
sac containing enzymes 3
status 74
Acrosome 3, 72
body 21
forms 3
reaction 25, 26, 68, 76, 80, 81
Adenoma, pituitary 121
Adenosine triphosphate 4
efflux of 76
Adriamycin 161, 338
Adult spermatozoa, anatomical segments of 2
Advanced sperm selection techniques 64, 65
Agrocranin 259
Air fluid method 267
demerits of 268
merits of 268
Air handling systems 182, 204
Air purification system 182f
Air quality 194, 196, 215
equipment 181f
Alanine 261
higher secretion of 398
Albumin 85
Alcohol consumption 100
Alpha fibers 4
Altruistic surrogacy 380
Amenorrhea 337
American Society for Reproductive Medicine 39, 49, 189, 255, 313, 378, 381
American Urological Association 45
Amino acid 231, 310, 398
depletion/appearance 262f
profile 398
serine 398
transportation 231
turnover 261
Androgen binding
globulin 14
transports testosterone 14
protein 15
Anejaculation 152, 153
Aneuploid 309
embryos 313
Aneuploidy 30, 360, 361, 363, 364, 399
screening 386
Angiotensin converting enzyme gene 3
Aniline blue test 28
Animal house laboratory, benefits of 368
Annexin V
binding buffer 102
conjugated paramagnetic microbeads 68
glass wool filtration 70
Anorgasmia 149
Anthocyanins 112, 113
Antidepressants 154
Anti-mullerian hormone 337
Antioxidant 85, 107, 110, 112, 122
therapy 29
Antisperm antibody 23, 62
Antral follicle count 290, 337
Antral follicular development 230
Anucleate fragmentation, percentage of 240
Aplastic anemia 340
Apolipoprotein A1 397
Apoptosis 83, 101
pathway of 101
Arginine 110
Array comparative genomic hybridization 361
Arsenic 119
ART laboratory
basic components of 173
troubleshooting in 208
Artificial insemination utilizing human sperm 158
Artificial manipulation 282
Assisted hatching 134, 277, 278, 280, 282
methods of 279
technology 134
using partial zona dissection, technique of 279
Assisted Human Reproduction Act 189
Assisted reproductive technology 24, 36, 44, 103, 107, 128, 165, 171, 192, 208, 222, 238, 255, 271, 279, 291, 308, 320, 326, 337, 359, 367, 385, 386, 388f
cycles 166
laboratory 189
aim of 385
predicting success of 52
procedures 128
process of 376
utilization 191
Assisted reproductive treatment 64
Assisted zona drilling 281
Astaxanthin 112
Asthenospermia 41, 62, 160
Asthenozooserpmia 20, 37, 61
Asynchrony 132
ATPase enzyme 4
Autoimmune disease 340
Autosomal gene mutations 39
Axonemal
defects 37
structure 109
Azoospermia 36, 39, 41, 49, 118, 153, 160162, 165
complete 51
factor region 41, 49
kinds of 165
nonobstructive 40, 41, 45, 132, 165, 389
obstructive 48fc, 49, 165
permanent 161, 162
temporary 161
B
Bacteriological incubator 57
Basal serum follicle-stimulating hormone 39
Basement membrane 12
Beckwith-Wiedemann syndrome 136
Behcet's disease 340
Benchtop incubator 177, 199f, 203f
Benzene 172
Beta-blocking drugs 155
Binocular compound phase contrast microscope 57
Birefringence 392
Birth weight
low 330, 331
very low 331
Blastocyst 173, 175, 241, 248, 277, 396
biopsies 363
cryofreezing, advantages of 321
cryopreservation 314
culture 307, 364
damage 282
development 240, 257, 309
course of 196
enhancement of 313
formation 226, 279
prediction of 248
hatching of 281
in vitro 308
inner cell mass 321
morphological assessment of 311
morphology of 312
prediction 250
splits 312
stage 220, 240, 256, 263, 272, 309, 311, 320, 399
embryos 272
morphology 240
transfer 309, 313
transfer 258, 273, 389
method 313
vitrification 314, 315f
Blastomere 213, 272, 278, 360
Blastomeric synchrony 260
Blastulation rates 190
Bleomycin 161, 338
Blood 183
clots 209
flow studies 151
vessels 150
Body
fluids 183
mass index 113, 290
myopathy, heredity inclusion of 137
Bone marrow transplantation 340
Bowel malignancy 340
Breast cancer 340
Busulfan 161, 338
C
Cadmium 119
Calcium oscillation 6, 289
Canadian Fertility and Andrology Society 189
Cancer 33, 99, 164
cell transmission, Risks of 339
treatment 33, 337
advancement in 336
Carbendazim 118
Carbohydrate 277
metabolism, products of 261
Carbon dioxide 202f
sensors 202f
Carboplatin 338
Cardiac disorder 137
Carmustine 338
Carnitines 85
Carotenoids 85
Catalase 85
Cells
biology 221
concentration 328
cryopreserved 158
dehydration of 159
free deoxyribonucleic acid, content of 396
solidification of 318
type 360
Cellular debris, presence of 58
Central nervous system tumors 161
Centrifuges 179
Cervical carcinoma 340
Cesarean delivery 274
Chemotaxis 7
Chemotherapeutic drugs, low-risk 338
Chemotherapy 99, 336, 339
drugs in 338t
Chlorambucil 161, 338
Chlortetracycline staining 26
Chromatin status, abnormal 288
Chromium 119
Chromosomal
aberrations 360
detection of 361
abnormalities 40, 135
analysis 40, 308
aneuploidy rate 160
material, gain of 361
Chromosome 13, 18 and 21, trisomies of 360
gain of 360
segregation 9
set of 360
Churg-Strauss syndrome 340
Cisplatin 161, 338
Cleavage rates 190, 226
Cleavage stage
embryos 175
cryopreservation of 327
morphology 240
Clinical pregnancy rates 226
Clomiphene 389
Clomipramine 153
Cold shock injury 159
Combined oral contraceptives, number of 209
Comparative genomic hybridization 329, 361
Completely immotile sperm 131
Computer-assisted sperm analysis 26
Conventional cryopreservation methods 317
Copper 77
Cortex tissue 343
Cortical granule 289
Crohn's disease 296
Cryobank 175
Cryo-devices 175
Cryoinjury 302
Cryopreservation 101, 166, 175, 278, 295, 311, 317, 372
cycles 180
method 306, 317
protocols 302, 363
techniques 326
theory of 158
unit 173, 174
description and function 174
location and relationships 175
Cryopreserved ovarian
cortex, reimplantation of 351
tissue, transplant of 354
Cryoprotectants 159, 302, 314
concentration of 301, 306, 318
nonpenetrating 159
toxicity 302
type of 318
Cryostorage vessels 205
Cryptorchidism 44, 107
Culture media, role of 370
Cumulative live birth rate 194
Cumulus cells 209, 210, 228, 231, 232
apoptosis, prevention of 234
coordinate follicular 230
oocyte communication 229f
role of 230
small amount of 210
Cumulus expansion 395
enabling factor signal 234
Cumulus oocyte 209
communication 230f
complex 209, 229, 230, 289, 290
denudation of 210
Cumulus oophorus
cells 130
complex 388
Cyclic adenosine monophosphate 230
inhibits 231
Cyclic guanosine monophosphate 230
Cyclophosphamide 161, 338
Cysteines 85
Cystic fibrosis transmembrane conductance regulator 48, 136
gene mutation testing 49, 52
Cytarabine 338
Cytochrome C reduction 109
Cytogenetic
abnormalities 360
analysis, conventional 362
disease 336
Cytokinesis 249
Cytoplasmic
droplets 7
factors 289
inclusions 291
maturation 210
syngamy 6
Cytoskeleton 213
Cytotoxic therapy 339
Cytoxan 338
D
Dacarbazine 161, 338
Dactinomycin 338
Daunorubicin 338
Dehydration, stages of 315f
Density gradient 61
technique 61f
Deoxyribonucleic acid 132, 176
bind 362
breakage, presence of 90
damage 22, 82, 89, 97
defects, type of 95
eukaryotic 1
fragmentation 25, 27, 89
amount of 98
index 29, 94, 97, 98
levels of 98, 100
initiation of 289
microarrays 362
strands 9
Depolymerization 320
Desire disorders 155
Diabetes, medical history of 18
Dichlorodiphenyltrichloroethane 118
Dietary substance 107
Dimethyl sulfoxide 159, 302, 342
Diploid spermatogonial cell 8
Donor
age 378
cycles 296
evaluation of 377f
gametes, ART guidelines for 379
insemination, indications for 377
oocytes 227
semen insemination 165
thalassemia screening of 378
types of 377
Double density gradient centrifugation 101
Double embryo transfer 270
Doxorubicin 338
Duchenne muscular dystrophy 137
E
Earle's balanced salt solution 58
Echotip soft catheter 266
Ectopic pregnancy 191
Egg
banking 379
commercial 378, 379
donation 376, 378
donors 383
fusion 277
hyperstimulation 383
ploitation 382
Ejaculate volume 20
Ejaculation
control 156
deficiency in 153
delayed 149
premature 18, 149, 151, 152, 152f
retarded 152, 153
retrograde 389
Ejaculatory
disorders 44, 152
disturbances 152
dysfunction 166
Elective single embryo transfer 270, 271, 326
criteria for 271
outcome of 272
Electron transport system 82
Electronegatively charged sperm 68
Electrophoretic system 65, 66t
Embryo 166, 173, 226, 238, 277, 309, 317, 319, 331, 337
assessment of 390
biopsy 390
cryopreservation 131, 300, 320, 322, 326, 332
indications 300
culture 261, 372
and transfer 171
developments of 220
differs 321
donation 227, 377
endometrium asynchrony 320
endoplasmic reticulum 368
freezing 296, 391
techniques of 301
glue 266
implantable 238, 307
in vitro 308, 394
loading 266, 267
metabolome, assessment of 261
mitochondrion membrane potential 368
morphokinetic markers 243
morphology 398
assessment, conventional 238
preimplantation 363, 365
quality 214
biomarker of 397
rate of 323
respiration rate of 359
secretome 259
selection, noninvasive method of 255
spent media 260
stage of 318
toxicity 172
transfer 179, 208, 216, 266, 270, 279, 289, 307, 326, 386, 390
technique 266
utilization rate 190
vitrification protocol 302, 303f
Embryogenesis 54, 310t, 360
Embryonic death 282
Endocrine
control 15
disruptors 118
indicators 350
Endometrial development, advancement in 328
Endometrioma 387
Endometriosis 112
severe 340
symptomatic 319
Endometrium 111, 309
Environmental sensors 205
carbon dioxide 205
differential pressure 205
liquid nitrogen 205
oxygen 205
relative humidity 205
room pressure 205
temperature 205
Eosin nigrosin suspension 25
Eosinophilic granulomatosis 340
Epididymal sperm 131
aspirations 386
percutaneous 389
Epididymal spermatozoa 15
Epididymides 37
Erectile dysfunction 151, 154, 154f, 155, 156
tests for diagnosing for 151
Estradiol 339
Estrogen receptors 15
Ethylene glycol 302
Ethylenediaminetetraacetic acid 310
Etoposide 161
Euploid 51
embryos 329
risk of 322
European Academy of Andrology 45, 49
European Society for Human Reproduction and Embryology 39, 189
Ewing's sarcoma 340
Exocytosis 289
Extracellular
fragments 280
ice crystal formation 301, 314
pH 198
solution 318
tissue matrix 352
Extra-testicular factors 99
F
Facility
management system 205
monitoring systems 205
Female fertility, preservation of 337
Female germ cells, number of 336t
Female infertility 112
causes for 111
idiopathic 111
Female reproductive tract 111
Fertile controls 76
Fertility
impaired 162
preservation 162, 164
group 160
restoration 339
treatment 164
group 163
Fertilization 94, 132, 212, 226
abnormal 212
artificial 24
failure 212, 288, 290fc, 391, 392
low 290fc
morphological assessment of 7f
oocyte in 231
process of 288
rate 72, 146, 190, 211, 371
scoring for 171
total failed 213
Fetal heartbeat 190
Fibroid 387
Fibrous tail sheath 4
Fimbria 309
Fludarabine 338
Fluid-only method 267
demerits of 267
merits of 267
Fluorescent in situ hybridization 30, 137, 360, 390
Fluoxetine 153
Folic acid 110, 113
Follicle
culture 353
rupture 221
somatic cells of 395
stimulating hormone 14, 135, 212, 337
serum 21, 45
Follicular
development 351, 395
fluid 183, 397, 398
phases 353
Folliculogenesis 349
Formaldehyde 172
Fourier transform infrared spectroscopy 262
Fragile X permutation 296
Fresh embryo transfer 305, 332
Fresh in vitro fertilization embryos 330
Fresh oocyte donation 379
Frozen
cycles 327
embryo 136, 330
transfer 326, 331, 331t
oocytes 320
thawed blastocysts 321
thawed embryo 273
thawed ovarian tissue, transplantation of 350
transfer 389
G
Galactose, monosaccharides like 302
Galactosemia 340
Gametes 317, 395
cryopreservation of 326
deficiency of 107
donation 107
intracellular regions of 215
Gametogenesis 360
Gap junction plays 229
Gas cylinders 176f
Gemcitabine 338
Genetic 53
causes 155
defects, vertical transmission of 52
disease 159, 322, 336
information 4
role of 44
screening 331, 378
selection 322
test, advanced 107
Genitourinary infections 44
Genomic 395, 399
Germ cells 13, 160, 161
Germinal angiotensin-converting enzyme 3
Gestational sac 305
development 190
Glass wool filtration 70, 70t
Globozoospermia 38, 291
Glutathione 110, 111
reductase 85
Glyceraldehydes-3-phosphate dehydrogenase 82
Glycoproteins 277
Gonadotoxic
cancer treatment 353
chemotherapy 354
treatment 339
Gonadotropic therapy 161
Gonadotropin 121
releasing hormone 121, 329, 337
Graduated embryo scoring system 241
Granulomatosis 340
Granulosa 228
cell 130, 209, 228
Gynecomastia 19
H
Haber-Weiss reaction 77
Halo test 93
Hatching process 277
Heating surface 180f
Heavy metal toxicity 119
Hematologic disease 159, 162
Hemochromatosis 121
Hemorrhage, antepartum 330
Hemospermia 36
Hepa system 181
Hepatitis
B antigen 377, 378
C 377
virus 378
Heterogeneous gonadal disorder 336
Heterotopic transplantation 350
High efficiency particulate air 182, 204, 388
High performance liquid chromatography 261, 398
Hindering normal testicular function 160
Histone 54
octamers 2
replacement of 89
Hodgkin's disease 160, 161, 340
Hodgkin's lymphoma 341
Homocysteine metabolism, disordered 368
Hormonal
diseases 44
manipulation 122
treatment 121
Hormone analysis 21, 39
Human
chorionic gonadotropin 190, 122, 132, 210, 289, 390, 328
embryos 263, 320
follicular, biochemistry of 309
gametes 220
immunodeficiency virus 165
infertility therapy, flexibility in 317
leukocyte antigen 259, 397
oocyte 288, 320
cryopreservation of 319
placenta 371
preimplantation embryos 260
reproduction 220, 221
reproductive physiology, basics of 368
spermatozoa 1, 2f, 77
morphology of 3f
tubal fluid 59
Hyaluron-bound spermatozoa, selection of 392
Hyaluronic acid sperm binding test 71
Hyaluronidase 3
Hydrogen
peroxide 108
radicals 110
potential of 197, 202f
Hydrosalpinx 387
Hydroxyethyl 342
piperazineethanesulfonic acid 177
Hydroxyl ion 108
Hyperactivation 76, 80, 108
Hyperhomocysteinemia 368, 369, 371f, 372f
associated pregnancy loss, pathogenesis of 369
Hyperprolactinemia 155
Hypertension 330, 331
Hyperthermia, testicular 78
Hypogonadism 107
Hypoosmotic swelling test 25f
Hypotaurine 85
I
Idarubicin 338
Idiopathic infertility, medical management in 107
Ifosfamide 161, 338
Imipramine 153
Immature oocyte, retrieval of 353
Immotile cilia syndrome 37
Immotile sperms, selection of 70
Immunoassay techniques 397
Immunobead test 35
In situ hybridization 160
In vitro
activation 352
culture 188
conditions 278
fertilization 32, 64, 94, 98, 107, 128, 166, 171, 181, 182, 188, 197, 198, 199f, 205, 209, 220, 238, 255, 288, 290, 292, 300, 307, 317, 327, 359, 368, 385, 386
conventional 142
laboratory 171, 172f, 215
program 204
set up 180
workstation 179
manipulation 220
maturation 230, 337, 347f, 353
produced embryos, rate of 318
produced oocytes, rate of 318
Incubators 177f
temperature analyzer for 183f
types of 178f
Infectious disease 336
Infertile male, physical examination of 34
Infertility
causes for 108
identifying cause of 51
idiopathic 108
treating 107
Inflammatory bowel diseases 340
Inner cell mass 312, 312f
Insemination concentration/density 292
Institutional Animal Ethics Committee 367
Interferone gamma 397
International Committee for Monitoring Assisted Reproductive Technology 191
International Embryologist Society 320
International Index of Erectile Function 151
Intracellular
ice crystals 302
ice formation 296
pH 201
reactive oxygen species 76
stores 289
Intracranial pressure, risk of 383
Intracytoplasmic morphologically selected sperm injection 73, 134f, 142, 290392
technology 133
Intracytoplasmic sperm injection 8, 25, 49, 64, 92, 94, 98, 103, 128, 130, 130f, 132, 142, 149, 173, 198, 209, 210, 221, 239, 255, 288, 290, 296, 332, 359, 385, 386, 388
advantages of 131
consequences of 135
embryo transfer 305
evolution of 128
indications for 131
off-shoots of 137
physiological 29, 291
technique of 130
Intrauterine insemination 32, 56, 58, 64, 94, 98, 107, 387
Intravaginal ejaculatory latency time 152
Iron 77
Isochromosome 361
Isoprostanes 84
Itai itai disease 119
IVF set up, components of 173
J
Jaundice 36
Jumonji protein 260
K
Kallman syndrome 21
Karyotype 45
Kitazato ovarian cortex vitrification media 348f
Klinefelter's mosaics 51
Klinefelter's syndrome 19, 23, 40, 42, 45, 51
L
Laminar flow 57
Large-for-gestational age 327
Laser assisted
hatching 134f, 281
zona drilling 281
L-carnitine 110, 112, 113
Lead 119
Leigh syndrome 137
Lepidium 113
Leptin 259
Leukemia 160, 161, 340
Leukocytes 78, 278
peroxidase-positive 35
presence of 20
Leukocytospermia 21
presence of 83
Lidocaine 156
Lipid peroxidation 76, 82, 84, 109
Liquid nitrogen 158, 179, 304
Live birth 190, 351
rates 135, 323
Loading cortex bits 348f
Long chain fatty acids, role of 112
Luminol 84
Luteinizing hormone 12, 14, 39, 45, 119, 232
pituitary 329
serum 21
Lycopene 110, 111
Lymphoma 161
Lysins proteases 278
M
Magnesium 113
Magnetic activated
cell sorting 68, 69f, 97, 101, 103, 103f, 291
technique of 102f
cell storing 290
sperm sorting 104t
Magnetic cell sorting 68, 69f, 69t
Male gamete 1
Male infertility 39, 53, 107, 108, 117119
clinical evaluation of 44
etiology of 119
evaluation of 18, 19
genetics of 39
treatment of 121
Male reproductive oxidative stress
management of 85
prevention of 85
Male reproductive system 76
Male sexual dysfunction 149, 150f, 156
causes of 149
communication 156
education 156
hormones 156
mechanical aids 156
medical treatment 156
medications 156
psychological therapy 156
Malnutrition, malignancy-related 161
Malondialdehyde 82
Mammalian
embryos 188
oocytes 370
Mass
spectrometry 260, 397, 398
spectroscopy 261
Maternal
hyperhomocysteinemia, effect of 368
ribonucleic acid 289
transcript accumulation, deficiency in 213
Meiosis 10
phase of 9, 9f
Meiotic
competence failure 289
division 8
Melphalan 338
Membrane, inner acrosomal layers of 3
Mercury 119
Metabolomics 259, 260, 395, 398
analysis 272
Metaphase chromosome 362
Methotrexate 338
Methylation status 289
Methylcobalamin 110
Microbial contamination, level of 194
Microfluidic sperm cell sorter 70, 71f, 71t
Microinsemination sperm transfer 129
Micromanipulation 372
Micronutrients, role of 109
Microtesticular sperm extraction 132
Miscarriage 191, 369
Mitochondria 72
Mitochondrial
abnormalities 37
activity 359
capsule 79
level 77
Mitotic
chromosomes, deoxyribonucleic acid in 1
proliferation 8
Mixed gonadal dysgenesis 40
Modern reproductive medicine 255
Molecular cytogenetic method 362
Monogenic disorders 360
Monosomies 360, 362
Monozygotic twins 282, 313
formation of 282
Morphokinetic
embryo selection on basis of 259
evaluation 308
Morphological grading systems 242t
Morphology
conventional 248, 249t
embryo selection on basis of 256
Mosaic
samples, detection of 365
Turner syndrome 340
Motile
male reproductive cell 1
sperm organelle morphology examination 72
spermatozoa 35, 145
Motility 20, 80
enhancers 110
Multicellular embryos 322
Multiple gestations 323
risk of 270
Multiple pregnancy 191
rate 272, 309
Mural granulose cells 228
N
N-acetyl-cysteine 113
National Institute for Health and Care Excellence 313
Near infrared spectroscopy 398
Neck 4, 7
Necrozoospermia 37
characteristic of 37
Neonatal intensive care unit 331
Nerves 150
Neuroblastoma 340
Neurodegenerative disease 159
Neuropsychiatric disorders 52
Next generation sequencing 365, 396
Nicotinamide adenine dinucleotide 77
phosphate 77
Nitric oxide 108, 118
Nitroblue tetrazolium 109
Nitrous oxide 108
Nitroxyl ion 108
Non-apoptotic spermatozoa, selection of 68
Noncontact laser systems 281
Nonenzymatic antioxidants 85
Non-Hodgkin's disease 161, 340
Non-Hodgkin's lymphoma 160
Nonmalignant disease 163, 164
Nonmotile sperm cell 1
Normospermia 41
Normozoospermia 110
Novel sperm preparation technique 97
Nuclear
cap 3
magnetic resonance 261, 398
syngamy 6
Nucleolar precursor bodies 6, 239
Nucleotides 231
Nucleus 3
elongation of 11
Nutraceutical, types of 107
O
Obesity 99, 155
Oligoasthenospermia 131
Oligoasthenoteratospermia 108
severe 131
Oligoasthenoteratozoospermia 133
Oligoasthenozoospermia 22
Oligospermia 41, 62, 118, 120
severe 41
Oligozoospermia 20, 37, 49, 136, 160, 163, 165
idiopathic 110
severe 159, 160, 161, 163, 164
Oncofertility 167
Oncotesticular sperm extraction 162
Oncovin 161
Oocyte 130, 131, 166, 173, 175, 198, 208, 210, 221, 231, 293, 297, 317, 319, 331, 337, 363
absence of 209
accumulation of 328
activation 289
assisted 392
analysis of 399
assessment of 390
chromosome 130
collection 387
cryopreservation 295297, 317319, 332, 336, 339, 354
indications 295
program 295
safety of 319
cumulus
complex 231
gap junction 235
insight 228, 234
relationship 230
cytoplasm of 130f, 319, 321
cytoplasmic components 132
denudation of 210
donation of 319
Donation Program 319
donor 377, 378
early denudation of 221
factors 288, 289
freezing 296, 297, 337
advantages of 297
techniques of 296
grading of 238
granulosa cell complexes 371
immature 209, 221, 347f, 353
in vitro maturation of 210
inactivation 212
incidence of 291
insemination of 171
karyotype 399
manipulation of 386
maturation 395
morphological scoring of 394
number of 340
nutrition and metabolism 230
paracrine signaling 233
postmature 209
rate of 323
retrieval 171, 208, 239
role of 233
secreted factors 233
Oophorectomy
bilateral 340
unilateral 340
Oophoropexy 337
Ooplasm 94
Optimum testicular temperature 120
Orphan embryos 306
Orthotopic reimplantation 350
Osmotic stress 159
Ovarian
activity, refurbishment of 351
cortex
bits 344f
cryopreservation, indications for 339
preservation, future of 352
site of 351fc
slow freezing of 343f
transplantation of 349
failure, premature 336, 337, 378
follicles 337
follicular microenvironment 228
folliculogenesis 228
function 350
graft 350
hyperstimulation 64, 319
syndrome 191, 323, 328, 329, 331, 382, 391
controlled 320
insufficiency, premature 336
reserve 340
specimen 343f
stimulation 319
controlled 327
influence laboratory performance 388
stroma 343
tissue 344f, 349
autotransplantation of 354
banking, guidelines for 339
collection of 342
cryobanked 339
cryopreservation 337, 341, 342, 353, 354
cryopreserved 351, 353
for slow freezing, preparation of 343t
freezing 336
grafting 350, 351
heterotopic transplantation of 350
transplantation of 351
tumor, benign 340
vascular transplantation 352
Ovulation
hormones for 107
hyperstimulation protocols, controlled 270, 300
Ovum penetration test 25
Oxidative stress 76, 80f, 108, 368
effects of 76
embryo selection on basis of 263
role of 111
Oxygen consumption 255, 399
embryo selection on basis of 260
Oxygen derivatives 108
Ozone 108
P
Paraplegia 132
Paroxetine 153
Partial zona dissection 129
Passive microbial air monitoring 204
Pediatric cancer 162
Pemphigus vulgaris 340
Penile implants 156f
Pentoxifylline 85
Perinatal mortality 330
Peroxynitrite 108
Pesticides 118
Peyronie's disease 154
Phenylpropanolamine 153
Phimosis 19
Phosphate buffer saline 59
Phospholipase A2, deactivation of 81
Phospholipid phosphatidylserine 68, 97
Phosphorylates mitogen-activated protein kinase 81
Phosphotyrosine phosphatase 81
Piezo electric pulse 281
Piezo technology 281
Piperazineethanesulfonic acid 209, 342
Plasma membrane 3
Plastic industry toxin 18
Platelet activating factor 259
Polar bodies 360
Polyangiitis 340
Polyaromatic hydrocarbon 120
Polychlorinated biphenyl 18
Polycystic kidney disease 37
Polycystic ovarian syndrome 112, 319, 326
Polymerase chain reaction 360, 395
Polymorphisms 44
Polyp 387
Polyploidy 360, 361
Polyunsaturated fatty acids 76, 109, 120
Polyvinyl alcohol 302
Polyvinylpyrrolidone 130
polymers like 302
Poor semen quality, incidence of 160
Postacrosomal lamina 72
Posthumous sperm cryopreservation 164
Postovum pickup 293
Postvitrification 227
Postwarm excellent morphology 305
Postzygotic chromosomal abnormalities 213
Potential malignant cell contamination 351
Prednisone 161
Pregnancy
biochemical 226
multiple 271, 307
optimum 268
rates 32, 181, 268, 271, 314, 364
spontaneous 350
Preimplantation genetic
diagnosis 48, 50, 137, 173, 191, 292, 311, 322, 359, 385, 390
screening 48, 250, 292, 296, 311, 322, 329, 386, 390
testing 137
Premature menopause, risk of 340
Primordial germ cells 98
Procarbazine 161
Progesterone 331
elevated 330
Pronuclear
scoring 239
stage transfers 239
Pronuclei 212, 256
Propanediol 302
Prophylactic salpingo-oophorectomy 296
Prostaglandin endoperoxide synthase 232
Protamine 6, 11, 89
Protein
carbonyl groups 399
hormone human chorionic gonadotropin 397
kinase A, activates 80
morphogenetic 233
peroxidation 399
tyrosine kinase, activate 81
Proteolytic enzymes 11
Proteomics 259, 272, 395, 396
Pubertal mumps orchitis 18
Puberty, onset of 19
Pycnogenol 113
Q
Qualitative real time polymerase chain reaction 396
Quarantine period 379
R
Radiotherapy 99, 336
Raman spectroscopy 398
Randomized controlled trials 112, 327
Reactive nitrogen species 108
Reactive oxygen species 30, 76, 77, 83, 89, 108, 119, 176
effects of 79, 108
exogenous sources of 78
measurement of 109
presence of 99
types of 108
Real-time motile sperm organelle morphology examination 72
Reciprocal translocations 361, 362
Recurrent early pregnancy loss 29
Refractory male infertility problems 159
Rehydration 318
Remote monitoring systems 205t
Reproductive
cells 171
disorders 117
endocrinology 221
function 339
Resting cell 8
Resuscitation, cardiopulmonary 256
Resveratrol 123
Reticuloendothelial system 12
Retrograde ejaculation 152, 153
management of 153
Rheumatic disease 159
Rheumatoid arthritis 340
Ribonucleic acid 231, 259
microarray 234
molecules 395
Ribosome 231
Ringer's lactate 59
Robertsonian translocations 40, 361, 365
ROSNI-round spermatid nuclear injection 12
Round spermatid injection 132
S
Salazopyrin 36
Sarcoidosis 121
Sarcomas 160
Scar tissue 154
Schermann's discoveries 158
Second meiotic division 9
Secretomics 395, 396
Selenium 110, 111, 113
Semen 58, 183
analysis 19, 35, 56
normal 377
routine 83
banking 158, 159
benefits 159
reason 159
cryopreservation of 391
deoxyribonucleic acid fragmentation in 109
parameters 22, 162
analysis of 83
quality 167
volume 35
Seminal
elastase measurement 83
fluid
different parameters of 20t
parameters 20
fructose 35
neutral glucosidase 35
oxidation-reduction potential 84
oxidative stress, evaluation of 83
plasma 78
zinc 35
fluid 21, 22t
Sequential embryo morphology assessment 241
Serotonin levels 155
Sertoli cells 13
Sex determining region 45
Sexual disorders 149
Sexual dysfunction 149, 150, 154
Sexual maturity 162
Sexually transmitted diseases 18
Sickle cell
anemia 340
appearance 312
Sildenafil 156
Single blastocyst transfer policy 309
Single cell 322
gel electrophoresis assay 28, 93
Single embryo transfer 238, 270
economic aspects of 274
Single gel electrophoresis 101f
Single human oocytes, genome of 399
Single nucleotide polymorphism 250, 399
Single static embryo evaluation 239
Singleton pregnancies 271, 274
Slow freezing 343, 346, 350t
equilibration procedure 345t
Slow frozen blastocyst transfer cycles 328
Small for gestational age 330, 331
Small noncoding ribonucleic acid 263
Smith classification 239
Society for Assisted Reproductive Technologies 189, 255, 270
Soft tissue tumors 160
Somatic cells 89
Sperm 1, 130f, 173, 227, 386
abnormalities 7, 8f
acrosome reacted 26
acrosomeless 131
agglutination 36
aneuploidy 25
assay 30
screening 30
banking, users of 159
birefringence 73, 74
capacitation 289
cell, uniflagellar 1
chromatin dispersion 93
method 28f
tests 28
chromatin structure assay 28, 93, 101, 109
concentration 20, 35
meticulous recording of 292
count, normal 118
cryopreservation 162, 163, 313
indications for 164t
protocol 166
techniques 24
demonstration of 153
deoxyribonucleic acid
damage 78, 92, 109, 291
fragmentation 89, 90, 92, 97, 98, 100, 105
in fertility, role of 94
integrity 29
donation 376, 377
donors 159
group 159
epigenetics 53
factors 291
function testing 24, 30
head protein, type of 6
immotile 70, 132
improper zona binding of 288
injection 73f
technique 142
untracytoplasmic 292
maturation 76, 109
membrane maturity 71
morphology 20, 35, 36, 145, 291
abnormal 160
normal 65
motility 20, 79, 91, 109, 118
normal 143f
nuclear annulus 2
nucleus 3
oocyte fusion 81
organelles 72
parameters 108, 389
plasma membrane 77
preparation 171, 387
laboratory 57
procedure 57
technique 56, 58, 293
proportion of 146
quality 160
samples, storage of 57
selection 66t
criterion 293
using zeta potential method 67f, 67t
seminopathy 56
straws 167
subzonal injection of 129
thawing 166
vacuolated 143f
visualized 134f
wash, normal 60f
Spermatic cord 85
Spermatid 3, 9
injection, elongated 132
Spermatium 1
Spermatocyte, secondary 8
Spermatogenesis 7, 12, 12f, 107
apoptotic functions of 99
effect of temperature on 13
endocrine control of 14, 14fc
process of 119
Spermatogonial stem cell 8
Spermatozoa 3, 25, 77, 77f, 144, 221, 278
acrosome reacted 73
aggressive immobilization of 211
apoptotic 101
different segments of 5
genetic testing of 53
globozoospermic 291
immature 78
motility of 13
Spermatozoal maturation 79
Spermatozoon 1
hyperactivated 81
Spermiation 38
Spermiogenesis 11
phase of 8, 11
Spermotogonia, types of 8
Sphingosine-1-phosphate, effects of 352
Spinal cord injury 37, 165
Sports nutrition 107
Standard operating procedure 185, 196, 323
Standardized Training Programs 192
Stereo zoom microscopes 178
Sterile cryovials 166
Steroid hormone 107
Steroid-resistant glomerulonephritis 340
Stimulation
protocols 328
quality of 389
Styrene 172
Subfertility, male factor 271
Sucrose 317
concentration 319
Sulfasalazine 36
Superovulation 328
Superoxide 108, 110
dismutase 77, 85, 111
level of 112
Sureview soft catheter 266
Surgical sperm extraction 122
Surrogacy 107, 227, 377, 380, 381, 383
ART guidelines for 381
commercial 380
gestational 380
indications for 380
screening genetic couple for 380
traditional 380
Surrogate 380
mothers 383
screening 380
Swim up
technique 60f
with centrifugation 59
without centrifugation 59
Systemic disease 121, 163
Systemic lupus erythematosus 340
T
Tenaculum traction 391
Teratozoospermia 38, 160
Terminal deoxynucleotidyl transferase 93
mediated deoxyuridine triphosphate nick end labelling 101f
Terratozoospermia 62
Test tube
baby 128
warmers 57
Testicular
biopsy 23
blood supply 163
cancer 117, 160, 161
risk of 52
failure 20, 39
injury 18
sperm 123, 131
aspiration 30, 45, 52, 132, 377, 386, 389, 391
extraction 386
steroidogenesis 119
temperature 89
tissue extraction 167
trauma 44
volume 19
Testis torsion 163
Testosterone 39
deficiency 155
serum 21
Thalassemia major 340
Thawed oocytes 319
Thawing 318, 346
method 176
protocol 304
Thermochemiluminescence 263
Thermochron
buttons distributed over 199f
devices 198, 199f
Thick zona pellucida, presence of 386
Thiobarbituric acid-reactive substances 399
Thrombosis 368
Toluene 172
Toluidine blue test 28
Top quality blastocysts, formation of 398
Total antioxidant capacity 84
Total fertilization failure 288
Total quality management system 323
Toxic chemicals 163
Toxic regimen 161
Toxins 118
Transcriptomics 395
technology 395
Transmembrane glycoprotein 83
Trehalose 302, 314
Trinucleotide expansions 365
Triple gas incubator 177
Triploid embryos 213
Trophectoderm 278, 309, 321
biopsies 396
Trophoblast cells, number of 398
Tunica albuginea 344f
Turner's syndrome 271, 296
Tyrode's acid 280
U
Ultra-high magnification sperm selection 143f
Ureaplasma urealyticum infection 83
Urethral orifice 19
Uterine
cavity 308
inadequate 331
receptivity and compatibility 307
transfer media 266
V
Vacuolar area 72
Vacuoles 145
Vaginal carcinoma 340
Varicocele 19, 44, 78, 85, 89, 98, 107
Vas deferens
congenital
bilateral absence of 49, 136
unilateral absence of 49
Veins, pampiniform plexus of 85
Venereal disease research laboratory 377
Vertical laminar flow hoods 177
Vinblastine 161, 338
Vincristine 161, 338
Vitality tests 25
Vitamin 113
B12 110
therapy, effect of 110
C 110, 113, 114
E 110, 111, 113, 114
deficiency 155
Vitrification 301, 305, 307, 314, 318, 327, 346
development of 314
freezing 350t
group 305
of blastocyst 314
preparation for 346f
protocol 349t
solution 303
technique 343
Volatile organic
chemical 388
compounds 172, 182, 194, 197, 204, 224
Vulvar carcinoma 340
W
Warming protocol 349t
Wegener's disease 340
Wegener's granulomatosis 340
White blood cells 21
Wilms’ tumor 340
World Health Organization 24, 107
X
X chromosome 296
XX karyotype 45
Y
Y chromosome 1, 23
microdeletions 41, 44, 49
Y microdeletions 39, 40, 42
Z
Zeta potential method 65, 67, 74
Zika virus 331
Zinc 109111, 113, 119
Zona
binding
assays 25
capacity 38
dissection, partial 279
dissolution 278
dissolves 280
drilling 129
fails 279
free hamster oocyte 129f
pellucida 25, 38, 81, 129, 277, 280, 282, 289, 390
specific proteins 277
thickness 278
Zygotes 212, 213, 238, 386
population of 314
transfer 239
×
Chapter Notes

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The Male Gamete: A Unique CellCHAPTER 1

BN Chakravarty,
Arati Biswas,
Shovandeb Kalapahar
 
INTRODUCTION
Sperm is the motile male reproductive cell, which is highly specialized cell in human body. The term spermatozoon is derived from the ancient Greek word “sperma” (meaning seed) and “zoon” (meaning living being) and more commonly known as a sperm cell. It is the haploid male gamete cell.
There are three types of cells in our body, e.g. somatic cells, stem cells, and germ cells.
Spermatogonia are the immature germ cells. They divide several times during the process of spermatogenesis. The spermatogenic process is directed by genes located on the Y chromosome and takes around 70 days to complete from the spermatocyte stage.12−21 more days are required for the transport of sperm from the testis through the epididymis to ejaculatory duct.
A uniflagellar sperm cell that is motile is referred to as a spermatozoon, whereas a nonmotile sperm cell is referred to as a spermatium.
Human spermatozoa have some unique characteristics which are summarized below:
  • Sperm cell is the smallest cells in the body in terms of volume
  • These cells (adult sperm cells) do not grow or divide
  • The sperm cells are the most polarized cells; head in front and tail at the rear part of the body
  • They fulfill their function outside the body, in different individuals, e.g. in female genital tract
  • Unlike somatic cells, the sperm head has a large nucleus but lacks large cytoplasm. Nucleus constitutes 65% of spermatozoa head
  • The sperm cells are unique among mammals for presence of plenty of abnormal forms of spermatozoa in the ejaculate.
Most tightly compacted eukaryotic DNA that is present in mammalian sperm, at least sixfold more highly condensed than the DNA in mitotic chromosomes.1 To achieve this high degree of packaging, sperm DNA interacts with protamines to form linear, side-by-side arrays of chromatin.2
zoom view
Fig. 1: Human spermatozoa.
This differs markedly from the builder DNA packaging of somatic cell nuclei and mitotic chromosomes, in which the DNA is coiled around histone octamers to form nucleosomes. In addition to the sperm nuclear matrix, sperm nuclei contain a unique structure termed the sperm nuclear annulus to which the entire complement of DNA appears to be anchored.
The centromeres are located centrally and telomeres peripherally. Folding of chromosomal p- and q-arms are flexible (Fig. 1). This specific chromosomal arrangement may be responsible for increased frequency of abnormal sperm shape and increased frequency of aneuploidy.
  • It has been observed that sex chromosome and G-group (chromosome 21 and 22) are more susceptible to nondisjunction during spermatogenesis.
  • Morphologically abnormal sperms (large head, round head, etc.) have either numerical or structural abnormalities of chromosomes.
 
ANATOMICAL SEGMENTS OF ADULT SPERMATOZOA (FIG. 2)
A mature human sperm cell has got the following parts—head, neck, and tail. Tail is again divided into—middle piece, principal piece, and end piece.
 
Head
It is oval in shape consisting of large nucleus and a dome-shaped acrosome present on the nucleus. In humans, sperm cells consists of a flat, disk-shaped head which is 5 µm in length and 3 µm in width and a tail 50 µm long.2 The tail flagellates, which propels the sperm cell (at about 1−3 mm/minute in humans) by whipping in an elliptical cone.3 The spermatozoon is characterized by a minimum of cytoplasm and the most densely packed DNA. The coverings of the sperm head from outside are:3
zoom view
Fig. 2: Morphology of human spermatozoa.
  • Plasma membrane
  • Outer and inner acrosomal layers of membrane
  • Acrosomal sac containing enzymes
  • Nuclear cap
  • Nucleus.
 
Acrosome
This is found at the anterior tip of the sperm (derived from Greek term “akron” meaning extremity and “soma” meaning body). The acrosome forms a cap like structure called the acrosomal cap. This occupies the space between anterior half of the nucleus and the plasma membrane of the sperm tip. The acrosome arises from the golgi complex during spermatogenesis. The acrosome itself is bounded by a unit membrane. It consists of a number of hydrolytic enzymes such as acid phosphatase, hyaluronidase, and others. These enzymes help in tissue lysis (dissolving) and this facilitates the penetration of the sperm into the egg membrane. The enzymes are proteolytic and help in dissolving the egg membrane.
The membranes of late spermatids and spermatozoa contain a special small form of angiotensin-converting enzyme called germinal angiotensin-converting enzyme. The function of this enzyme in the sperms is unknown, although male mice in which the function of the angiotensin-converting enzyme gene has been disrupted have reduced fertility.
 
Sperm Nucleus
The nucleus occupies most of the available space of the sperm head. It is the shape of the nucleus that ultimately decides the shape of the sperm head. Structurally it is enveloped by a nuclear membrane. Sometimes, however the posterior part of nuclear membrane (towards the body of the sperm) is 4somewhat depressed to accommodate the proximal centriole. The nucleus consists of DNA as well as basic proteins. There is no nucleolus.
Function: Nucleus contain genetic information and half number of chromosomes. The acrosome releases a hyaluronidase enzyme which destroys the hyaluronic acid of the ovum and enters into the ovum.
 
Neck
It contains centrioles which are proximal centriole and distal centriole.
Function: Distal centriole gives rise to axial filament of the sperm which runs up to the end of the tail. Centrioles help the zygotic division by forming the first mitotic spindle. The posterior or the distal centriole is responsible for the formation of the microtubules of the sperm tail.
 
Tail
 
Middle Piece (Figs. 3A and B)
It is tubular structure in which mitochondria are spirally arranged. It has a pair of longitudinal fibers called beta fibers, surrounded by a ring of nine pairs of longitudinal fibers called alpha fibers. In human sperms, the alpha fibers of axial filament are accompanied on the outside by nine, much thicker fibers called gamma fibers or coarse fibers. The alpha, beta, and gamma fibers are the sites of various enzymes.
Alpha fibers have ATPase enzyme, while beta fibers have acetyl co-A succinate. These fibers are anchored to the distal centrioles. The fibers are surrounded by the mitochondria. Very often the mitochondria are fused together and form a spiral sheet that surrounds the axonemal fibers. Around the periphery of midpiece of the sperm is found a thin sheet of cytoplasm mainly composed of microtubules. This layer is called manchette.
Function: Middle piece is called power house of sperm because it gives energy to the sperm to traverse through the female genital tract.
 
Principal Piece
The principal piece which constitutes most of the length of tail consists of the central core made up of axial filaments with a 9+2 arrangement (2 central, 9 peripheral). The tail fibers are attached to each other by arms containing the protein dynein, which is an ATPase. Hydrolysis of ATP (adenosine triphosphate) in the adjacent mitochondria provides the energy for sperm motility, which is produced by a sliding action between the fibers in the sperm tail.
Surrounding this core is a fibrous tail sheath which often appears as semicircular ribs oriented at right angles to the long axis of the filament. Sometimes, they appear as helical coils. In human beings, two of the gamma fibers are fused with the surrounding ribs to form anterior and posterior columns extending throughout the length of the principle piece.5
zoom view
Figs. 3A and B: Morphological anatomy of midpiece, principal piece, and end piece.
This arrangement divides the principal piece into two functional compartments—one having three gamma fibers and the other containing four. This symmetry is thought to help in a more powerful stroke of the tail in one direction. This is called the power stroke. The end piece is a small tapering portion of the tail containing only the axial filament covered with cytoplasm and plasma membrane.
 
End Piece
This the terminal end of tail. Length is about 5 µm.
Sperms have no cytoplasmic organelles such as ribosomes and endoplasmic reticulum. There is no stored food in the sperm.4
 
MOLECULAR FUNCTIONS OF DIFFERENT SEGMENTS OF SPERMATOZOA
 
Functions of the Head
The plasma membrane which constitutes the outer coat of the head consists of a very unstable fatty acid which is known as polyunsaturated fatty acid (PUFA). 6PUFA has both helpful and unwanted functions in reproduction. The helpful function consists of facilitating fusion and disintegration of plasma and acrosin membrane leading to exocytosis of the enzyme acrosin. This happens when the sperm head comes in contact with zona pellucida at the time of fertilization. This procedure is known as “acrosome reaction” and “zona penetration” which allows the sperm head to enter into the perivitelline space.
Due to presence of PUFA (unstable fatty acid) excessive fluidity of plasma membrane is seen that is very specialized character of sperm. These may be responsible for premature disintegration and exocytosis of acrosome. This may happen when many leukocytes are present in seminal plasma, or due to presence of plenty of immature sperm cells, varicocele, and excessive centrifugation.
Under normal conditions, cytoplasmic syngamy occurs when the sperm head after zona penetration comes in contact with oocyte oolemma (outer coating of oocyte cytoplasm). Cytoplasmic syngamy has two important molecular events: (a) calcium oscillation, (b) cortical reaction. This happens due to oocyte activation through sperm head contact with oolemma.
 
Calcium Oscillation
Calcium oscillation occurs due to calcium influx from cytoplasmic organelles (rich in calcium stores). The primary effect of calcium oscillation within oocyte cytoplasm is removal of inhibitory factor for completion of meiosis-II which gets initiated with meiosis-I of oogenesis (during intrauterine life). In other words calcium oscillation induces maturation promoting factor (MPF) within oocyte cytoplasm, which is necessary for release of second polar body (completion of meiosis-II). Following meiosis-II, the oocyte nucleus is converted into a spindle (containing half of the genetic material) and forms the female pronucleus). Before the female pronucleus is formed, calcium oscillation also helps in formation of male pronucleus. This is an interesting step. The male pronucleus is formed primarily by removal of nuclear cap of the sperm head, replacement of the special type of sperm head protein—protamine by histone migrating from the oocyte nucleus. This is followed by assembly of a new nuclear envelop—formation of male pronucleus. Pronuclear chromatin condenses to form nucleolar precursor body (NPB). These are also known as nucleoli. Arrangement and synchrony of male pronuclear nucleoli with regard to nucleoli of the female pronucleus are significant markers of good or bad pronuclei (normal or abnormal fertilization)(Fig. 4).7
 
Function of Centriole in Sperm Neck
This helps in apposition of two pronuclei (male and female) by forming microtubules. The last stage of fertilization namely “nuclear syngamy” is completed by these microtubules.
zoom view
Fig. 4: Morphological assessment of fertilization through nucleolar arrangement in pronuclei.
 
Function of Tail
This helps the sperm to swim in the female genital tract. It is the main part of sperm that helps in movement through the female genital tract. The ability to move forward (progressive motility), which is acquired in the epididymis, involves activation of a unique protein called CatSper, which is localized to the principal piece of the sperm tail. This protein appears to be a Ca2+ ion channel that permits cAMP-generalized Ca2+ influx. In addition, spermatozoa express olfactory receptors, and ovaries produce odorant-like molecules. Recent evidence indicates that these molecules and their receptors interact, fostering movement of the spermatozoa towards the ovary (chemotaxis).
 
EXAMPLES OF SPERM ABNORMALITIES (FIG. 5)
  • Head: Defects in shape and size—like large, small, tapering, pyriform, amorphous, and vacuolated (more than 20% of head surface is occupied by vacuoles). There may also be double head or combination defect.
  • Neck and midpiece abnormalities: This consists of absence, non-inserted, fractured, bent and thin midpiece.
  • Tail abnormalities: Tail abnormalities include short, multiple, hair pin, broken, coiled, and tail with terminal droplets.
  • Cytoplasmic droplets in the head: Cytoplasmic content of the sperm head is much less than the nuclear DNA content. Cytoplasmic area greater than one-third of the area of the normal sperm head are considered abnormal.
 
SPERMATOGENESIS
This can be discussed under two broad headings:
  1. Molecular consideration
  2. Anatomic consideration.
8
zoom view
Fig. 5: Sperm abnormalities.
 
Molecular Consideration
The origin of adult spermatozoa from spermatogonial germ cell passes through three molecular phases:
  1. Mitotic proliferation: Duplication of chromosomal DNA followed by cell division, to maintain pool of stem cells. Proliferation and differentiation of diploid spermatogonial germ cell occurs in this phase.
  2. Meiotic division:
    • Duplication of chromosomal DNA, two cell divisions, results in haploid spermatogonia, to halve chromosome number.
    • Genetic diversity.
  3. Phase of spermiogenesis (cytodifferentiation): This phase consists of a series of changes involving development of nuclear DNA, acrosomal cap, tail, and ultimately resulting in development of an adult spermatozoa.
These events collectively, approximately continue for 70 days. Within this long period there may be numerous opportunities for introduction of damage to the genome of male gamete. This knowledge provides the practical information that while performing intracytoplasmic sperm injection (ICSI) with spermatid or secondary spermatocyte, there may be a risk of injecting a damaged spermatocyte. This may lead to failure of fertilization or development of an abnormal embryo.
 
Proliferation and Differentiation of Diploid Spermatogonial Cell
In the testis, the spermatogonial stem cells proliferate and differentiate producing three types of spermotogonia:
  1. Population identical to spermatogonial stem cell (resting cell) and these do not differentiate towards adult spermatogonial cell.9
  2. Population trying to differentiate towards adult spermatogonial cell—they are the precursors of future adult spermatozoa.
  3. Cells that are likely to undergo apoptosis.
During this phase, the spermotagonial cells are diploid, i.e. they contain two chromosomes each, and two chromatids (DNA strands) in each chromosome.
 
Phase of Meiosis
During this phase, the diploid proliferating and differentiating stem cells are converted to haploid gamete. This is a critical and unique event of genetic recombination. Primary spermatocyte (spermotogonial stem cells) with DNA content equivalent to two chromatids in two chromosomes replicate into four distinct chromatids (DNA strands) initiating meiosis (Fig. 6).
Chromosome segregation and crossing over of genes amongst DNA strands occurs during this phase. Crossing over is critical in gametogenesis—may lead to genetic defect and structural anomaly of sperm. Because, during this phase of crossing over, there may be loss or defect in the genetic material.
After chromosomal pairing and crossing over—the first meiotic division is completed, i.e. two secondary spermatocytes are formed. There is one chromosome and two chromatids (DNA strands) in each secondary spermatocyte. Therefore, the DNA content in each secondary spermatocyte is still diploid.
The second meiotic division (Fig. 7) starts where there is separation of two DNA strands in each chromosome—resulting in formation of four spermatids, each spermtaocyte having a haploid number of chromosome and a haploid DNA.
zoom view
Fig. 6: Phases of meiosis.
10
zoom view
Fig. 7: Secondary meiotic division.
The diagrammatic representation of the entire process of spermatogenesis at molecular level is shown below.
zoom view
 
Possible Problems Arising during the Phase of Meiosis
For comprehensive meiotic division to occur, meiotic cell contains many novel proteins and enzymes. These are essential for chromosome and DNA alignment, DNA breakage, recombination and DNA repair. Occasionally DNA repair mechanism in the phase of meiosis may be defective; there may 11be anomalies in chromosomal segregation and pairing and crossing over of genetic material. These defects may lead to germ cell differentiation arrest at either primary or secondary spermatocyte level.
 
Phase of Spermiogenesis: Cytodifferentiation
During this phase, maturation of spermatozoa starts. From the stage of secondary spermatocyte a round-shaped spermatid forms followed by elongated spermatid and finally an adult spermatozoa develops.
During these transitional phases, the specific changes which occur consist of:
  • Elongation of nucleus and nuclear condensation
  • Appearance of acrosomal sac containing proteolytic enzymes
  • Formation of neck and differentiation of the terminal part into three distinct segments—midpiece, principal piece, and end piece. These changes occur during six different stages; the stages have been designated as SA-1 and 2, SB-1 and 2 and SC-1 and 2
  • Cytoplasmic reduction.
 
Specific and Remarkable Changes during Spermiogenesis
  • Head nuclear protein consisting of histone is replaced by protamine, producing a tightly compacted nucleus. Protamine is a stronger DNA protein compared to histone. Unlike all other somatic cells of the body where histone is present with the DNA in the nucleus, spermatozoa is the only cell which contains protamine to offer compactness of the sperm head nuclear DNA.5,6
  • Chromatin condensation during spermiogenesis results in DNA occupying nearly 70% of the total volume of sperm nucleus (somatic cell—only 5%).710
  • The adverse effect of displacement of histone and replacement by protamine may result in haploid genome damage (after secondary spermatocyte, the sperm cell genome becomes haploid).
  • Repair capabilities during spermiogenesis phase is limited (unlike those during meiosis phase).
  • In addition to nuclear DNA structuring, axoneme, outer dense fiber and protein (dynein) in midpiece, principal piece and end piece develop.
  • Mitochondria develops on the sheath of midpiece as germ cell differentiation by spermiogenesis continues.
As a consequence of massive changes during spermiogenesis there may be tremendous load on “haploid” spermatozoa, leading to germ cell arrest or blockage—thereby causing infertility in many individuals.
Defects in synthesis of midpiece and tail mitochondria may result in structurally abnormal spermatozoa with poor motility. Also mutation in protein essential for compaction of sperm nuclear DNA may result in spermatozoa with abnormal head.111712
Minor genetic defects may not alter spermatozoa morphology but may lead to production of genetically defective spermatid. This will be a great concern for spermatid injection which is sometimes performed in the procedure of ICSI (ROSNI-round spermatid nuclear injection).
 
Difference of Initiation of Meiosis in the Male and Female Gamete
In female, meiosis starts at 12 weeks of intrauterine life, but remains arrested at meiosis-I. This is completed at puberty with onset of luteinizing hormone (LH) surge. In male, spermatogonial cells (the stem cells) remain at rest till puberty—meiosis and spermiogenesis start after puberty.
 
SPERMATOGENESIS—ANATOMICAL CONSIDERATION
Sperms develop and mature within seminiferous tubules. Seminiferous tubules consist of basement membrane and lumen (Fig. 8).
 
Basement Membrane
Basement membrane consist of two types of cells: Germ cells and Sertoli cells.
Sertoli cells are triangular-shaped cells with their apex projecting towards the lumen. The base of these triangular cells are situated peripherally. Apex of the Sertoli cells are interconnected by tight junction. This tightly interconnected apical junction forms “blood-testis barrier”. Blood-testis barrier when intact does not allow seminal antigens to pass into the systemic circulation (reticuloendothelial system) to produce self antibodies.
zoom view
Fig. 8: Microscopic picture in spermatogenesis.
13
Germs cells lie in between the Sertoli cells, they are precursors of adult spermatozoa.
 
Lumen
Interconnected Sertoli cells divide the lumen of seminiferous tubules into two compartments:
  1. Basal compartment
  2. Adluminal compartment.
 
Significance of Two Compartments
  • Basal compartment: In this compartment, maturation of early stages of spermatozoa occur. This compartment is in direct contact with interstitial cells containing Leydig cell, blood vessels, and lymphatics and therefore is directly exposed to immune phenomenon. But the tight interconnection of the apices of Sertoli cells, which forms the blood-testis barrier, prevents antigens to cross this barrier and prevents antibody formation. But when this blood-testis barrier is damaged as in infection, trauma, exposure to heat, and following vasectomy, antigens may crossover allowing antibodies to develop in reticuloendothelial system of the body. These antibodies then reenter the seminiferous tubules and damage the developing spermatozoa. Basement membrane contains myofibrils—which are under control of oxytocin. They help in forward sperm propulsion.
  • Adluminal compartment: Within the adluminal compartment, late stages of spermatozoal maturation continues. This is a sealed compartment and therefore not exposed to external or environmental trauma.
 
Final Maturation and Acquisition of Motility of Spermatozoa
This occurs through exposure of spermatozoa to many biochemical components while the sperm travels through the seminal pathway. The principal sites where the sperm acquires significant motility are—rete testis, epididymis, seminal vesicles, and prostate. The important biochemical constituents which provide additional sources of sperm vitality, motility, and integrity are—carnitine, acid glycerophosphate from epididymis, fructose and coagulase (from seminal vesicle), liquefying enzymes and acid phosphatase from prostate.
 
Effect of Temperature on Spermatogenesis
Spermatogenesis requires a temperature considerably lower than that of the interior of the body. The testes are normally maintained at a temperature of about 32°C. They are kept cool by air circulating around the scrotum and probably by heat exchange in a countercurrent fashion between the spermatic 14arteries and veins. When the testes are retained in the abdomen or when, they are held close to the body by tight cloth binders, degeneration of the tubular walls and sterility result. Hot baths (43−45°C for 30 minutes per day) and insulated athletic supporters reduce the sperm count in humans, in some cases by 90%. In addition, evidence suggests a seasonal effect in men, with sperm counts being greater in the winter regardless of the temperature to which the scrotum is exposed.
 
Endocrine Control of Spermatogenesis (Flowchart 1)
Just like ovulatory control, spermatogenesis has also an endocrine control with feedback mechanism between hypothalamic pituitary control from one side and testicular control from the other side. Follicle-stimulating hormone (FSH) is secreted from the pituitary which stimulates Sertoli cell within the seminiferous tubules and Sertoli cells in turn produce two factors:
  1. Inhibin which regulates the production of FSH from pituitary
  2. Androgen binding globulin (ABG).18
Androgen binding globulin transports testosterone produced by Leydig cells which exist outside the seminiferous tubules into the lumen of the seminiferous tubules allowing maturation of germ cells. LH also produced by pituitary stimulates Leydig cells to produce testosterone (5−10 mg per day). Testosterone on one side helps maturation of germ cells and on the other hand regulates production of pituitary LH through negative feedback mechanism. The stages from spermatogonia to spermatids appear to be androgen-independent. However, the maturation from spermatids to spermatozoa depends on androgen acting on the Sertoli cells in which the developing spermatozoa are embedded. FSH acts on the Sertoli cells to facilitate the last stages of spermatid maturation. In addition, it promotes the production of androgen-binding protein (ABP).18
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Flowchart 1: Endocrine control of spermatogenesis.(ABG: androgen binding globulin; FSH: follicle-stimulating hormone; LH: luteinizing hormone).
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In addition to endocrine control there are other paracrine procedures which help in spermatogenesis. These paracrine factors consist of— IGF-1, cytokines, proteins, and enzymes.19
The estrogen content of the fluid in the rete testis is high, and the walls of the rete contain numerous estrogen receptors (ER). In this region, fluid is reabsorbed and the spermatozoa are concentrated. If this does not occur, the sperm entering the epididymis are diluted in a large volume of fluid, and infertility results.
After production in seminiferous tubules under tight hormonal control, sperm have to pass through a long pathway to act in its final destination. Spermatozoa leaving the testes are not fully mobile. They continue their maturation and acquire motility during their passage through the epididymis. During its journey, it gets matured, motility as well as sperm becomes susceptible to different type of damage by free radicals.
Following the morphological transformation of nucleus in the testis, as spermatozoa transit through the epididymis, there occurs a stabilization of the chromatin through establishment of disulfide bond between the thiol rich protamines.20 Qualitative and quantitative modifications of the plasma membrane occurring in the lipidic composition21 and the absorption of specific proteins secreted by the epididymal epithelium result in changes of its electric charges. The lack of all this changes is associated with a decreased ability of epididymal spermatozoa to bind and penetrate the oocyte.22 Ejaculation of the spermatozoon involves contractions of the vas deferens mediated in part by P2X receptors for ATP and fertility is reduced in mice in which these receptors are knocked out.
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