Molecular cytogenetic and genetic aspects of globozoospermia: a review.

Infertility is estimated to affect up to 15% of couples of reproductive age. Among the male factors, globozoospermia (also called round-headed sperm syndrome) is a rare type of teratozoospermia accounting for <0.1% of male infertility. Lack of acrosome, whose production is a postmeiotic event in spermatogenesis, and round sperm head are its main characteristics. The acrosomeless spermatozoon is unable to go through the zona pellucida and fuse with the oolemma of the oocyte, and fertilisation failures have been attributed to a deficiency in oocyte activation capacity, even when intracytoplasmic sperm injection (ICSI) is attempted. The pathogenesis of this anomaly is still unclear but genetic factors are likely to be involved. DNA fragmentation rate has been reported for 16 globozoospermic males, usually using the terminal uridine nick-end labelling (TUNEL) assay. Most of the patients had a DNA fragmentation index (DFI) higher than that in fertile men. The rate of aneuploidy for some specific chromosomes was increased in 12 among the 26 globozoospermic males reported in the literature. The same results (high DFI and aneuploidy rates) were observed in infertile males compared to fertile men, notably in those with oligoasthenozoospermia or teratozoospermia, independently of the origins. Mutations or deletions in three genes, SPATA16, PICK1 and DPY19L2, have been shown to be responsible for globozoospermia. Proteins coded by the first two genes localise to the Golgi apparatus and the proacrosomal granules that are transported in the acrosome. It is likely that other proteins involved in the acrosome formation remain to be identified.

[Azoospermia: management and results: a series of 90 cases]. / Azoospermie : prise en charge et résultats. À propos de 90 cas.

OBJECTIVE: To report our 15-year experience in managing azoospermic males at the Brest University Hospital. PATIENTS AND METHODS: From 1996 to 2010, 90 azoospermic males were followed: 41 with non-obstructive azoospermia (NOA) and 49 with obstructive azoospermia (OA). Surgical methods proposed for retrieving sperm were Microsurgical Epididymal Sperm Aspiration (MESA) for men with OA and microdissection Testicular Sperm Extraction (mTESE) for those with NOA. RESULTS: Spermatozoa were retrieved in 56.1% of the testicular biopsies for NOA. The embryo transfer rate per cycle for injection intracytoplasmique d'un spermatozoïde (ICSI) with epididymal spermatozoa (OA) was higher to that of ICSI with ejaculated spermatozoa (93.2% vs. 86.6%, P<0.05), but the rate was lower for ICSI with testicular sperm (NOA) (70.2% vs. 86.6%, P<0.01). The rate of clinical pregnancy per embryo transfer was 31.4% following ICSI with epididymal spermatozoa but it was of 24.2% with testicular sperm and 23.1% with ejaculated sperm. CONCLUSION: ICSI are usually difficult in NOA because they are done with very few spermatozoa. When spermatozoa are retrieved from surgical techniques, more than 50% of the OA couples and almost 30% of the NOA couples conceived at least one child.

[Neurological tolerance of lithium-psychotropic drugs association (author's transl)]. / Tolerance neurologique de l'association lithium-psychotropes. A partir de 265 cures associatives.

The authors have studied the neurological tolerance from the combination of lithium-psychotropic drugs from 265 associated cures carried out on 132 patients between 1971 and 1978. The risk of neurological inability to assimilate is not greater when haldol is combined with lithium by comparison with other combinations where it is not included. Only the presence of cerebral organicity presents a risk factor. The 117 associated cures were preceded by preliminary treatments during which either the lithium or the psychotropic drugs were used to the same extent during the treatment. This series seems to allow on one hand to demonstrate that the incidence of neurological signs is multiplied by two by the combination, on the other hand to note that the intensity of the neurotoxic effects increases.