Association between ICSI Clinical Outcomes in Total Globozoospermia Due to DPY19L2 Deletion and Phospho-lipase C Zeta Sperm Marker involved in Oocyte Activation

Background: Globozoospermia is one of the main reported causes of fertilization failure after intracytoplasmic sperm in-jection (ICSI) which is characterized by the presence of 100% acrosomeless round headed spermatozoa in an ejaculate and can be overcome by artificial oocyte activation (AOA). Low ex-pression level of Phospholipase C zeta (PLCζ), which is one of the main sperm factors involved in oocyte activation, is mostly account for fertilization failure. Deletion of the DPY19L2 gene is reported as a causative genetic factor in over 70% of infer-tile men with globozoospermia. This study aimed to evaluating the expression of sperm PLCζ at RNA and protein levels in 32 DPY19L2 deletion-mediated globozoospermic men and report-ing the corresponding clinical outcomes following ICSI with AOA.Materials and Methods: Semen samples were obtained from 32 men with total globozoospermia (presenting with 100% round-headed spermatozoa) and 32 fertile men and the expres-sion of PLCζ at RNA (Real-time PCR) and protein levels (west-ern blot) was compared between them.Results: PLCζ expression (at RNA and protein levels) in glo-bozoospermic men was significantly lower compared to fertile men (P<0.05). Fertilization rate in globozoospermic couples following ICSI-AOA was significantly lower compared to fer-tile men (P<0.05). However, implantation (26.2%) and preg-nancy (53.8%) rates were not endangered by DPY19L2 dele-tion in these couples.Conclusion: ICSI-AOA Application in globozoospermic cou-ples improves the post-ICSI fertilization rate and results in sat-isfactory live birth frequency.

Keywords:

ICSI-AOA , Globozoospermia , Fertilization , PLCζ