Fertility testing and ICSI sperm selection by hyaluronic acid binding: Clinical and genetic aspects

Gabor Huszar, Attila Jakab, Denny Sakkas, Ciler Celik Ozenci, Sevil Cayli, Elena Delpiano, Sinan Ozkavukcu

Research output: Contribution to journalReview articlepeer-review

168 Citations (Scopus)


The testis-expressed chaperone protein, HspA2 (previously creatine kinase M isoform) was established as a measure of human sperm cellular maturity, function and fertility. The presence of HspA2 in the synaptonemal complex is likely to link low HspA2 expression and increased frequency of chromosomal aneuploidies in arrested-maturity spermatozoa. A relationship also exists between HspA2 expression in elongating spermatids and the associated spermatogenetic events, including plasma membrane remodelling and the formation of zona pellucida and hyaluronic acid (HA) binding sites. The HA receptor of mature spermatozoa, when coupled with HA-coated slides and/or Petri dishes, allows visual observation of sperm-HA binding, providing a basis for sperm maturity testing, a major improvement in semen evaluation, and selection of mature spermatozoa for intracytoplasmic sperm injection (ICSI). Thus, in HA-selected spermatozoa the frequency of chromosomal disomy and diploidy is reduced 4- to 6-fold compared with semen sperm fractions. This reduction is similar to the increase in numerical chromosomal aberrations in ICSI children. Combined studies of sperm shape and chromosome probes demonstrated that sperm morphology does not aid selection of haploid spermatozoa. The HA-mediated sperm selection is a novel and efficient technique that may alleviate potential problems related to ICSI fertilization with visually selected spermatozoa.

Original languageEnglish
Article number2697
Pages (from-to)650-663
Number of pages14
JournalReproductive BioMedicine Online
Issue number5
Publication statusPublished - May 2007


  • Biochemical markers
  • Chromosomal aneuploidies
  • DNA fragmentation
  • Hyaluronic acid binding
  • ICSI
  • Sperm maturity

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology
  • Developmental Biology


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