Abstract

Background: Teratoasthenozoospermia (TA) is a severe form of male infertility with no clear etiology. Objective: To compare the level of intracellular anion superoxide (O2–), heat shock protein A2 (HSPA2) and protamine deficiencies in ejaculated spermatozoa between teratoasthenozoospermic and normozoospermic men. Materials and Methods: In this case-control study, semen samples of 20 infertile men with TA (with normal morphology lower than 4 and total motility lower than 40) as the case group and 20 normozoospermic fertile men as the control group were evaluated for intracellular O2 – and HSPA2 by flow cytometry and protamine deficiency by Chromomycin A3 (CMA3) test. Results: The rate of CMA3+ spermatozoa in the case group was higher than controls (36.67±1.69 vs. 20.71±0.68, respectively, p=0.001). The percentages of HSPA2+ spermatozoa in the cases were significantly lower than controls (22.86±2.87 vs. 46.56±1.81, p=0.001). Also, intracellular O2 – levels in the case group were significantly higher than controls (33.69±1.43 vs. 16.35±2.7, p=0.001) and had positive correlations with sperm apoptosis (r=0.79, p=0.01) and CMA3– positive sperm (r=0.76, p=0.01), but negative correlations with normal morphology (r=-0.81, p=0.01) and motility (r=-0.81, p=0.01). There was no significant correlation between intracellular O2 – and HSPA2 in the case group (r=0.041, p=0.79). Conclusion: We suggest that the increase in intracellular O2 –, decrease in spermatozoa HSPA2+, and high percentages of spermatozoa with immature chromatin, might be considered as etiologies of infertility in TA patients.