Background: Sperm head vacuoles are easily detectable in human spermatozoa under the electron microscope. A sperm head vacuole is considered abnormal when it exceeds 20% of the head's cross-sectional area. The authors report a rare case of primary spermatozoa deformity with 100% vacuolated head and evaluate the correlation between presence of head vacuoles/nucleus vacuoles and abnormal transformation of nucleoprotamine types, defects of nucleoprotamine, and gene disorders of chromatin/chromosome/spermatogenesis.
Methods: A 43-year-old male patient with infertility came to the Reproduction Health Center, Hebei, China. Semen was examined in accordance with the WHO criteria, and the spermatozoa were counted. Two hundred spermatozoa were observed both under light microscope and the electronic microscope.
Results: About 50% of the spermatozoa had head deformities. In the intact spermatozoa, the heads were 100% vacuolated. Under ultrastructural observation, abnormalities were observed and two major types of spermatozoa were detected. In the head of those incompletely mature spermatozoa, four kinds of the nucleus vacuoles were observed.
Conclusion: Abnormal spermatozoa with head vacuoles account for the patient infertility.