Birefringence characteristics in sperm heads allow for the selection of reacted spermatozoa for intracytoplasmic sperm injection Luca Gianaroli, M.D.,

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Birefringence characteristics in sperm heads allow for the selection of reacted spermatozoa for intracytoplasmic sperm injection Luca Gianaroli, M.D., M. Cristina Magli, M.Sc., Anna P. Ferraretti, M.D., Andor Crippa, Ph.D., Michela Lappi, B.Sc., Serena Capitani, Ph.D., Baccio Baccetti, M.D. Fertility and Sterility Volume 93, Issue 3, Pages 807-813 (February 2010) DOI: 10.1016/j.fertnstert.2008.10.024 Copyright © 2010 American Society for Reproductive Medicine Terms and Conditions

Figure 1 An incident light beam passing through an object. In the case of an isotropic structure (A), no birefringence effect is observed because the light propagates at a single velocity without being polarized. When crossing an anisotropic structure (B), the incident light beam is refracted into two rays traveling at different velocities. The retardance of the slow ray relative to the fast ray generates the birefringence effect. Fertility and Sterility 2010 93, 807-813DOI: (10.1016/j.fertnstert.2008.10.024) Copyright © 2010 American Society for Reproductive Medicine Terms and Conditions

Figure 2 (A) The localization of birefringence in the postacrosomal region indicates that the acrosome reaction has already occurred. (B) The presence of birefringence in both compartments of the head, acrosome, and nucleus, identifies an intact acrosome in a nonreacted spermatozoon. The birefringence in the midpiece is clearly evident in B. Fertility and Sterility 2010 93, 807-813DOI: (10.1016/j.fertnstert.2008.10.024) Copyright © 2010 American Society for Reproductive Medicine Terms and Conditions

Figure 3 The pattern of birefringence is altered by the presence of a vacuole in the sperm head, whereas it is clearly visible in the midpiece. Fertility and Sterility 2010 93, 807-813DOI: (10.1016/j.fertnstert.2008.10.024) Copyright © 2010 American Society for Reproductive Medicine Terms and Conditions

Figure 4 Under polarized light, vacuoles are evident in reacted (A), nonreacted (B) and non-birefringent (C) spermatozoa. Fertility and Sterility 2010 93, 807-813DOI: (10.1016/j.fertnstert.2008.10.024) Copyright © 2010 American Society for Reproductive Medicine Terms and Conditions