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Table 2 The relationship between the presence of vacuoles and DNA fragmentation/damage

From: The nature of human sperm head vacuoles: a systematic literature review

 

Number of patients

DNA damages assessment

Vacuolated spermatozoa

Spermatozoa used as “controls”

P

   

Number and size of vacuoles

Presence of other potential abnormalities

Proportion of vacuolated spermatozoa with DNA damages (%)

Type of spermatozoa used as “controls”

Proportion of “control” spermatozoa with DNA damages (%)

 

Franco 2008 [26]

30

AO TUNEL

At least one vacuole occupying > 50% of the sperm head area

Yes

DNA denaturation: 67.9 DNA fragmentation: 29.1

Morphologically normal and vacuole-free

DNA denaturation: 33.1 DNA fragmentation: 15.9

P<0.0001 P<0.0001

Garolla 2008 [25]

10

AO TUNEL

At least one vacuole (size not specified)

No

DNA denaturation: 71.9 DNA fragmentation: 40.1

Morphologically normal and vacuole-free

DNA denaturation: 5.3 DNA fragmentation: 9.3

P<0.001 P<0.001

Wilding 2011 [27]

5

TUNEL

Multiple vacuoles occupying each > 4% of the sperm head area

No

14.4

Morphologically normal with no more than one small vacuole

4.2

P=0.03

Hammoud 2013 [28]

8

TUNEL

Multiple vacuoles (size not specified)

No

15.9 a (for anterior vacuoles) 22.5 b (for posterior ones)

Morphologically normal and vacuole-free

4.1a,b

a P<0.05 b P<0.001

Cassuto 2012 [18]

26

TUNEL

At least one vacuole (size not specified)

Yes

4.2

Unselected spermatozoa (obtained after two-layer density centrifugation)

3.7

NS

Perdrix 2011 [19]

20

TUNEL

A single vacuole occupying > 13% of the sperm head area

Yes

1.7

Whole sperm

8.6

NS

Boitrelle 2011 [16]

15

TUNEL

A single vacuole occupying > 25% of the sperm head area

No

1.3

Morphologically normal and vacuole-free

0.7

NS

Watanabe 2011 [30]

20

TUNEL

A single vacuole with a diameter > 1.5 μm

No

2.3

Morphologically normal and vacuole-free

0.0

NS

  1. Studies (with sample sizes and methodological details) evaluating the relationship between the presence of vacuoles (or not) and DNA damages. AO: acridine orange test, TUNEL: the terminal deoxynucleotidyl transferase-mediated dUTP-nick end-labelling. P values in bold type are statistically significant. a: P obtained when proportion of ‘control’ spermatozoa DNA fragmentation rates were compared with DNA fragmentation rates of spermatozoa with anterior vacuoles. b: P obtained when proportion of ‘control’ spermatozoa DNA fragmentation rates were compared with DNA fragmentation rates of spermatozoa with posterior vacuoles.