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Table 2 Suggested additional analyses performed for ART decision

From: Is intracouple assisted reproductive technology an option for men with large-headed spermatozoa? A literature review and a decision guide proposal

Sperm phenotype Large head with irregular shape and multiple flagella Large head with a regular shape
Light microscopy (Photo 1) (Photo 2)
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
  1. Decision on ART according to sperm phenotype, light microscopy examination, FISH analysis, AURC screening, chromatine condensation