Objective: To determine the integrity of the sperm plasma membrane, mitochondria, and DNA, which are essential for accurate transmission of genetic material to offspring, and to quantify possible apoptosis and investigate any relationship between these parameters in ejaculated sperm from men with or without varicoceles. Design: Retrospective study. Setting: University teaching hospital. Patient(s): Twenty-five patients with varicocele and 10 normal, fertile controls. Intervention(s): Apoptosis-related phenotype activations including the plasma membrane translocation of phosphatidylserine, mitochondrial dysfunction, and nuclear DNA damage, were assessed by using the annexin-V/propidium iodide double staining assay, 3,3'-dihexloxacarbocyanine iodide staining assay, and single-cell gel electrophoresis assay (comet assay). Main Outcome Measure(s): Apoptosis-related phenotype. Result(s): Patients with varicocele had statistically significantly more annexin V live sperm cells and nuclear DNA fragmentation than did the control men. In contrast, their numbers of 3,3′-dihexloxacarbocyanine iodide live cells were statistically significantly less than those in control men. Conclusion(s): The increased externalization of phosphatidylserine, mitochondrial dysfunction, and nuclear DNA damage occurred in the sperm of men with varicoceles, suggesting that certain apoptotic mechanisms may relate to the condition of varicocele, originating in the mitochondria of spermatocytes and then functioning within the nucleus of the cell.
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