Defective sperm decondensation: A cause for fertilization failure
The study aimed to evaluate the role of chromatin packaging (CMA3 staining), sperm morphology during sperm-zona binding, sperm decondensation and the presence of polar bodies in oocytes that failed in vitro fertilization (IVF). The percentage CMA3 staining categorized the data into three groups, <44%, n=10; ≥44-59%, n=10; and ≥60%, n=29. Morphology groups were ≤4% (n=11); >4-14% (n=19); and >14% (n=19). One hundred and seventy-two oocytes that failed IVF were evaluated for sperm-zona binding, ooplasma penetration and sperm decondensation. Odds ratio analyses indicated that being in the ≥60% CMA3 staining group resulted in a 15.6 fold increase in the risk of decondensation failure, relative to CMA3 staining of <44%. For morphology, there was a 2.17 fold decrease in the risk of fertilization failure in the morphology group with >4-14% normal cells, while it increased 2.45 fold for the morphology group with ≤4% normal cells. Using CMA3 fluorescence to discriminate, 51% of the oocytes in the group with elevated CMA3 fluorescence had no sperm in the ooplasma compared to 32% and 16% penetration failure in the CMA3 staining groups ≥44-59% and <44%, respectively. Sperm chromatin packaging quality and sperm morphology assessments are useful clinical indicators of human fertilization failure. Immunofluorescence techniques could be used to provide a clear diagnosis of failed fertilization.