Spermatology defects in patients with male infertility associated with fibrous sheath dysplasia of the sperm flagellum

Dysplasia of the fibrous sheath (DFS) is a specific structural abnormality of sperm, which is characterized by disorganization of the transverse ribs and vertical columns of the fibrous membrane and leads to impaired motility and morphology of sperm, impaired male fertility. The purpose of this work was a comprehensive spermiological study of patients with infertility associated with DFS. Material and methods. Twenty-six unrelated patients with male infertility were examined, in whom, according to the results of transmission electron microscopy of spermatozoa (TEM), a high content of gametes with DFO was detected (group I – 50-79%, n=14; group II – 80-100%, n=12). Standard semen examination was performed according to WHO laboratory manual (2010). Results . Total asthenozoospermia was detected in 11 (42%) patients and total teratozoospermia in 21 (81%) patients.Increased content of spermatozoa with spontaneous acrosome reaction in 85% of patients with DFS and incomplete chromatin condensation in 38% were detected. Heterogeneous defects of axoneme structure were found in 88% of samples. In 42% of cases, dysplastic changes in the fibrous sheath were combined with the absence of the central pair of microtubules of the axoneme of the sperm flagellum. Conclusion . In patients with severe dysplasia of the fibrous sheath, a decrease in motile and morphologically normal sperm, combined with their reduced concentration (oligoasthenoteratozoospermia), was revealed. DFS is often combined with an increased content of sperm with a reacted acrosome and heterogeneous defects in the axoneme structure, including primary ciliary dyskinesia. In patients with high percentage DFS, severe decrease in sperm motility and morphology was found, in most in combination with their reduced concentration (oligoastenotheratozoospermia). An increased percentage of gametes with a reacted acrosome and heterogeneous defects in the axoneme structures characteristic of primary ciliary dyskinesia also was revealed.