Table 2 Suggested additional analyses performed for ART decision
Sperm phenotype | Large head with irregular shape and multiple flagella | Large head with a regular shape | |||
|---|---|---|---|---|---|
Light microscopy |
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| |||
Sperm head measurement (200 cells, CASMA) | Determination of the percentage of spermatozoa with a large head and the percentage with a normal-sized head | Determination of the percentage of spermatozoa with a large head | |||
FISH analysis on raw semen (with X/Y/18 probes) Photo 3 |
| 100 % aneuploidy, Donor sperm or adoption | <100 % aneuploidy | A normal percentage of spermatozoa with abnormal chromosome content | An elevated percentage of spermatozoa with abnormal chromosome content |
FISH analysis of selected spermatozoa with a normal-sized head Photo 4 |
| / | Percentage of aneuploid spermatozoa Low sperm aneuploidy? | / | Percentage of aneuploid spermatozoa Low sperm aneuploidy? |
AURKC screening | Mutation detected: stop ART with patient’s sperm | Optional | |||
Chromatin condensation rate in whole sperm | / | / | Within the normal range | Not within the normal range | |
Chromatin condensation assay on spermatozoa with a normal-sized head (sperm measurement + aniline blue staining | / | / | / | Chromatin condensation rate for spermatozoa with a normal-sized head | |
Genetic counselling | Decision on ART according to the results of an aneuploidy assessment, AURKC mutation screening and the couple’s history of fertility/infertility | Decision on ART according to the sperm chromatin condensation rate, the FISH result on whole sperm and (in some cases) the percentage of spermatozoa with a normal-sized head and the couple’s history of fertility/infertility | |||
(Photo 1)
(Photo 2)
