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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.