Table 2.
The relationship between the presence of vacuoles and DNA fragmentation/damage
| Number of patients | DNA damages assessment | Vacuolated spermatozoa | Spermatozoa used as “controls” | P | ||||
|---|---|---|---|---|---|---|---|---|
| Number and size of vacuoles | Presence of other potential abnormalities | Proportion of vacuolated spermatozoa with DNA damages (%) | Type of spermatozoa used as “controls” | Proportion of “control” spermatozoa with DNA damages (%) | ||||
| Franco 2008 [26] | 30 | AO TUNEL | At least one vacuole occupying > 50% of the sperm head area | Yes | DNA denaturation: 67.9 DNA fragmentation: 29.1 | Morphologically normal and vacuole-free | DNA denaturation: 33.1 DNA fragmentation: 15.9 | P<0.0001 P<0.0001 |
| Garolla 2008 [25] | 10 | AO TUNEL | At least one vacuole (size not specified) | No | DNA denaturation: 71.9 DNA fragmentation: 40.1 | Morphologically normal and vacuole-free | DNA denaturation: 5.3 DNA fragmentation: 9.3 | P<0.001 P<0.001 |
| Wilding 2011 [27] | 5 | TUNEL | Multiple vacuoles occupying each > 4% of the sperm head area | No | 14.4 | Morphologically normal with no more than one small vacuole | 4.2 | P=0.03 |
| Hammoud 2013 [28] | 8 | TUNEL | Multiple vacuoles (size not specified) | No | 15.9 a (for anterior vacuoles) 22.5 b (for posterior ones) | Morphologically normal and vacuole-free | 4.1a,b | a P<0.05 b P<0.001 |
| Cassuto 2012 [18] | 26 | TUNEL | At least one vacuole (size not specified) | Yes | 4.2 | Unselected spermatozoa (obtained after two-layer density centrifugation) | 3.7 | NS |
| Perdrix 2011 [19] | 20 | TUNEL | A single vacuole occupying > 13% of the sperm head area | Yes | 1.7 | Whole sperm | 8.6 | NS |
| Boitrelle 2011 [16] | 15 | TUNEL | A single vacuole occupying > 25% of the sperm head area | No | 1.3 | Morphologically normal and vacuole-free | 0.7 | NS |
| Watanabe 2011 [30] | 20 | TUNEL | A single vacuole with a diameter > 1.5 μm | No | 2.3 | Morphologically normal and vacuole-free | 0.0 | NS |
Studies (with sample sizes and methodological details) evaluating the relationship between the presence of vacuoles (or not) and DNA damages. AO: acridine orange test, TUNEL: the terminal deoxynucleotidyl transferase-mediated dUTP-nick end-labelling. P values in bold type are statistically significant. a: P obtained when proportion of ‘control’ spermatozoa DNA fragmentation rates were compared with DNA fragmentation rates of spermatozoa with anterior vacuoles. b: P obtained when proportion of ‘control’ spermatozoa DNA fragmentation rates were compared with DNA fragmentation rates of spermatozoa with posterior vacuoles.