Parvin Sabeti - Department of Anatomy, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
Fardin Amidi - Department Of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Seyed Mahdi Kalantar - Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Mohammad Ali Sedighi Gilani - Department of Urology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

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 betweenteratoasthenozoospermic 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 lowerthan 40% ) as the case group and 20 normozoospermic fertile men as the control group were evaluated for intracellular O2 – and HSPA2 by flow cytometry andprotamine deficiency by Chromomycin A3 (CMA3) test. Results: The rate of CMA3+ spermatozoa in the case group was higher than controls (p=0.001). The percentages of HSPA2+ spermatozoa in the cases weresignificantly lower than controls (p=0.001). Also, intracellular O2 – levels in the case group were significantly higher than controls (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 betweenintracellular 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.

Male infertility, Sperm chromatin, HSPA2, Protamine deficiency