Past Issue

Volume 5, Number 3, Oct-Dec 2011, Pages: 122-127

Flow Cytometry: A Novel Approach for Indirect Assessment of Protamine Deficiency by CMA3 Staining, Taking into Account the Presence of M540 or Apoptotic Bodies

Zohreh Fathi, M.Sc, 1, 2, Marziyeh Tavalaee, M.Sc, 1, Abbas Kiani, M.Sc, 1, Mohammad Reza Deemeh, M.Sc, 1, 3, Mehrdad Modaresi, Ph.D, 4, Mohammad Hossein Nasr-Esfahani, Ph.D, 1, 3, 5, *,
Department of Reproduction and Development, Reproductive Biomedicine Center, Royan Institute for Animal Biotechnology, ACECR, Isfahan, Iran
Payame Noor University, Isfahan, Iran
Isfahan Fertility and Infertility Center, Isfahan, Iran
Islamic Azad University-Khorasgan Branch, Isfahan, Iran
Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
* Corresponding Addresses: P.O.Box: 8158968433 Department of Reproduction and Development Reproductive Biomedicine Center Royan Institute for Animal Biotechnology ACECR Isfahan Iran & Department of Embryology Reproductive Biomedicine Center Royan Institute for Reproductive Biomedicine ACECR Tehran Iran



Chromomycin A3 (CMA3) staining, either by the slide method or fluorescence microscopy, is widely used for indirect assessment of protamine deficiency in a semen sample. Flow cytometry is the most suitable tool to improve assessment accuracy, both in terms of statistical analysis and for prevention of observer variation. This study provides a simple procedure to account for merocyanine 540 (M540) or apoptotic bodies, which result in underestimation of the percentage of CMA3 positivity, by using propidium iodide (PI) staining. Therefore, this study aims to evaluate the percentage of CMA3 by PI staining to exclude M540 bodies that prevent underestimation of CMA3 staining.

Materials and Methods

This study is an experimental study. Semen samples collected from 104 infertile men who referred to the Andrology Unit of the Isfahan Fertility and Infertility Center were initially assessed according to World Health Organization (WHO) criteria. Samples were washed twice with Ham’s. Each sample was divided into two portions, a control and the other processed for density gradient centrifugation (DGC). Each portion was assessed for CMA3 staining by both the slide and flow cytometry methods. Coefficients of correlation and student t-test were carried out using the Statistical Package for the Social Studies (SPSS 11.5).


Detection of CMA3 staining was more appropriate with fluorescence detector 3 (FL-3) rather than fluorescence detector 2 (FL-2) in the evaluation of protamine deficiency to exclude M540 bodies.


This study, for the first time, provides the basis for assessment of CMA3 staining for flow cytometry. However, since the maximum excitation for CMA3 is not covered by the 488 nm laser, we recommend further experimentation using a flow cytometer with optimal excitation.