Theriogenology 57 (2002) 1493±1501 Capacitation and acrosomal exocytosis are enhanced by incubation of stallion spermatozoa in a commercial semen extender Angela C. Pommer, Jennifer J. Linfor, Stuart A. Meyers* Sperm Biology Laboratory, Department of Anatomy, Physiology, and Cell Biology, School of Veterinary Medicine, University of California, One Shields Avn., Davis, CA 95616, USA Received 19 December 2000; accepted 31 August 2001 Abstract Preserved stallion semen often has decreased spermatozoal motility and fertility that can vary signi®cantly between individual stallions. It is not known whether the medium used for extending equine sperm contributes to these decreases by inducing premature capacitation during storage. If spermatozoa undergo capacitation or acrosome reaction prior to insemination, this could result in a diminished capacity to penetrate the cumulus mass and fertilize the egg. We hypothesized that skim milk-based semen extenders, similar to those used in cooled storage, stabilize sperm membranes and prolong sperm motility and longevity. However, this could decrease the ef®ciency of sperm to undergo subsequent capacitation in vivo. This study was designed to evaluate the effects from two media on sperm function. Spermatozoal motility was analyzed, intracellular calcium was measured, and the ability of sperm to undergo acrosome reaction was compared after incubation in a skim milk extender (SME) and Tyrode's medium containing albumin, lactate, and pyruvate (TALP) at 37 8C. Results suggest that the SME facilitated capacitation as detected by an increase in both intracellular calcium and acrosome reactions, and a decrease in motility, as compared to TALP. Our data support a shortened functional lifespan for equine sperm in skim milk extender, which indicates that further re®nements in cooled semen preservation are required to improve fertility of transported equine semen. # 2002 Elsevier Science Inc. All rights reserved. Keywords: Spermatozoa; Stallion; Capacitation; Acrosome; Extender 1. Introduction It has been demonstrated that sperm must be able to access the female upper genital tract, enter the uterine tubes, bind to oviductal epithelium, capacitate, and undergo the acrosome * Corresponding author. Tel.: 1-530-752-9511; fax: 1-530-752-7690. E-mail address: [email protected] (S.A. Meyers). 0093-691X/02/$ ± see front matter # 2002 Elsevier Science Inc. All rights reserved. PII: S 0 0 9 3 - 6 9 1 X ( 0 2 ) 0 0 6 5 9 - 3 1494 A.C. Pommer et al. / Theriogenology 57 (2002) 1493±1501 reaction in order to fertilize an egg [1]. Capacitation of sperm has been described as a complex of poorly de®ned cellular events that occur in situ within the female reproductive tract that are obligatory for the acrosome reaction and fertilization to progress [1±3]. Capacitation involves sperm plasma membrane events that lead to an increased cellular calcium in¯ux, fusion and vesiculation of the plasma and outer acrosomal membranes, and loss of the acrosomal protein matrix in a process termed the acrosome reaction, an exocytotic event [1]. When acrosomal exocytosis occurs, sperm release hydrolytic enzymes and proteases including hyaluronidase and acrosin, respectively, which allow the sperm to digest their way through the cumulus extracellular matrix (ECM) and zona pellucida surrounding the egg. If sperm prematurely capacitate or acrosome react, they could have a diminished capacity to penetrate the cumulus mass and fertilize the egg. Stored semen often has decreased spermatozoal motility and fertility that can vary signi®cantly between individual stallions [4,5]. Preserving sperm function following cooled or frozen storage is essential to maintain optimum fertility. Bovine and equine sperm have been demonstrated to exhibit signs of premature capacitation associated with cryopreservation [6,7]; however, the mechanism of the action is undetermined. It is plausible, therefore, that cell longevity is compromised by premature capacitation-related changes associated with storage of sperm in different media. If so, sperm would then display a decreased ability to fertilize oocytes at the natural site of fertilization in the oviductal ampulla following insemination. This study was designed to compare the ability of sperm to undergo acrosome reactions after induction of capacitation by incubating the sperm for 3 h at 37 8C in two different media. This temperature (37 8C) was selected in order to approximate the intra-uterine environment. The two media utilized were a commercial skim milk-based semen extender (SME) and Tyrode's medium containing albumin, lactate, and pyruvate (TALP), a chemically de®ned medium used to induce sperm capacitation in vitro [8,9]. We hypothesized that skim milk-based semen extenders stabilize sperm membranes and prolong sperm motility and longevity but, as such, render the sperm ineffective at undergoing subsequent capacitation in vivo. The results of this study will be used to modify semen storage methods. 2. Materials and methods 2.1. Chemicals and reagents Fluorescein-conjugated Pisum sativum agglutinin (PSA) was obtained from Vector Laboratories (Burlingame, CA). Ethidium homodimer-1, Fluo-3 AM, Live-Dead1 Sperm Viability Kit, and Pluronic F-127 were purchased from Molecular Probes (Eugene, OR). EZ Mixin-``Cool-Store/Transport'' equine semen extender containing amikacin was purchased from Animal Reproduction Systems (Chino, CA). Dulbecco's phosphate-buffered saline (DPBS) was obtained from Gibco BRL (Grand Island, NY). All other chemicals were obtained from Sigma Chemical Company (St. Louis, MO). A.C. Pommer et al. / Theriogenology 57 (2002) 1493±1501 1495 2.2. Animals and semen Semen was obtained from ®ve fertile stallions individually housed at the Veterinary Medical Teaching Hospital and the Animal Science Horse Barn located at the University of California, Davis. Stallions were maintained on a diet of mixed grass hay and Omolene 200, with fresh water ad libitum and daily exercise according to Institutional Animal Care and Use Committee protocols at the University of California. Semen was collected using an arti®cial vagina and a phantom mare. A nylon mesh ®lter was used to eliminate the gel fraction, and only allow the sperm-rich fraction of the ejaculate to enter into the collection bottle. Half of the gel-free semen was immediately diluted 1:1 (v/v) into SME (E-Z Mixin) and the other half was diluted 1:1 (v/v) into TALP capacitation medium [9]. Both media had been warmed to 37 8C prior to semen collection, and the diluted semen was transported to the laboratory within 5 min of collection. 2.3. Sperm processing for capacitation and acrosome reactions Upon arrival at the laboratory, the TALP semen sample was centrifuged at 100 g for 5 min to sediment debris. Sperm were capacitated as previously described [9]. Brie¯y, the supernatant (3 ml) was layered over two Percoll-TALP gradients, each consisting of an 84% lower layer and a 42% upper layer. After centrifugation at 300 g for 20 min the sperm pellets were collected and placed in 4 ml TALP. The sperm suspension was centrifuged for 10 min at 300 g and the resulting sperm pellet was resuspended in 1 ml TALP. The sperm concentration was determined using a hemacytometer and diluted to 20 106 /ml. The concentration of sperm in the SME was also determined and diluted to 20 106 /ml. One milliliter of each sperm suspension was divided into two siliconized microcentrifuge tubes. One tube of each served as a control, and acrosome reactions were induced in the other tube by using 1 mM calcium ionophore A23187. The samples were incubated for 3 h at 37 8C in a humidi®ed 95% air and 5% CO2 atmosphere incubator. A 10 ml aliquot was taken from each sample and placed on a warmed glass slide, coverslipped, and placed on a stage warmer (Minitube; Verona, WI). Total and progressive motility were estimated and recorded by a single observer using an Olympus BX-60 microscope with differential interference contrast optics at 0 h, and following the 3 h incubation period. After in vitro capacitation (3 h at 37 8C), sperm suspensions from all treatments were ®xed for 10 min in 2% paraformaldehyde and washed by centrifugation and resuspension with DPBS. The samples were permeablized using 95% ethanol ( 20 8C) for 10 min and then washed with DPBS. The samples were incubated for 10 min in DPBS containing 5% bovine serum albumin (BSA, blocking solution) and double labeled with ¯uorescein±PSA and ethidium homodimer-1 for 10 min in the dark. The cells were washed with, and resuspended in, 500 ml DPBS. A drop of a ¯uorescence enhancer was added (Vectashield1; Vector) to preserve cell ¯uorescence. Sperm cell samples were placed on glass microscope slides with coverslips and ¯uorescence of 200 cells was visualized using oil immersion at magni®cation 1000 with an Olympus BX-60 ¯uorescence microscope using a ¯uorescein ®lter with excitation at wavelength 480/30 and emission at wavelength 535/40. Viability 1496 A.C. Pommer et al. / Theriogenology 57 (2002) 1493±1501 was determined in duplicate cell suspensions in all treatments by observing 200 cells using the Live-Dead1 Sperm Viability Kit that utilizes Sybr1-14 and propidium iodide ¯uorescence stains for differential labeling. Sperm cells were not simultaneously evaluated for viability and acrosomal status because the ¯uorescence spectral overlap of the ethidium homodimer and propidium iodide in the two methods would have interfered with detection of cell viability in acrosome-reacted cells. Consequently, the viability status of individual acrosome-reacted or -intact cells could not be determined. 2.4. Calcium measurements Separate aliquots of sperm, processed as described above, were analyzed for intracellular calcium. Cells in either SME or TALP, at a concentration of 20 106 /ml, were placed into siliconized microcentrifuge tubes (500 ml per tube, two tubes per treatment) and incubated at 37 8C in 5% CO2 in air for 1.5 or 3 h. The calcium indicator Fluo-3 AM (5 mM) containing 0.1% Pluronic F-127 in dimethyl sulfoxide (®nal concentrations) was loaded into cells for the last 30 min of incubation. After incubation, excess dye was removed from cells by centrifugation and resuspended in fresh medium to the original 500 ml volume. For calcium measurements, 1 ml (2 500 ml) of cell suspension was placed in a methacrylate cuvette (Fisher; Pittsburgh, PA) containing a micro stir bar and read in a Hitachi F-2000 spectro¯uorometer. The ¯uorescence response level was 1 s, with an excitation of 488 nm and an emission of 530 nm. The bandpass widths for both excitation and emission were 10 nm. Samples were maintained at 37 8C in a Lauda heating circulator water bath, which also controlled the temperature of the magnetic stirring turret in the spectro¯uorometer. For both the 1.5 and 3 h incubations, Fluo-3 ¯uorescence intensity was determined for a minimum of 60 s (base line) before treatment with 1 mM (®nal concentration) calcium ionophore A23187. Changes in intracellular calcium ([Ca2]i) were monitored for 10 0:5 min, due to sample variation. Maximum ¯uorescence was obtained by adding 1 mM digitonin, and minimum ¯uorescence was obtained by subsequent addition of either 50 mM EGTA/50 mM Tris or 12.5 mM EGTA/12.5 mM Tris to SME and TALP samples, respectively. All values are listed at ®nal, working concentrations. The measurements described above were used to calculate [Ca2]i with the equation Ca2 i K d F F min / (F max F), where Kd is the dissociation constant of Fluo-3, F the ¯uorescence intensity, Fmin the minimum Fluo-3 ¯uorescence, and Fmax is the maximum Fluo-3 ¯uorescence [10]. The Kd used for Fluo-3 was 316 nM [11,12]. To ensure there were no effects from medium on cellular uptake of Fluo-3 AM, cells were incubated and loaded in SME or TALP as described above and evaluated on the spectro¯uorometer in either the same media used for loading or the opposite media. Cellfree and dye-free media was also read on the spectro¯uorometer under the same experimental conditions and the optical densities of the two media observed. 2.5. Statistical analysis Data were analyzed using ANOVA techniques with Minitab1 statistical software (Minitab Inc., State College, PA). A two-way analysis of variance was used to evaluate A.C. Pommer et al. / Theriogenology 57 (2002) 1493±1501 1497 media and stallion or treatment and stallion. Changes in [Ca2]i were analyzed using oneway ANOVA to compare differences between media. 3. Results 3.1. Acrosome reactions Baseline acrosomal status (e.g. without ionophore treatment) was not different between sperm samples incubated for 3 h in TALP or SME media. Induction of acrosome reactions using calcium ionophore (1 mM) during the 3 h incubation period resulted in a greater percentage of acrosome reacted cells (P < 0:05) when compared to cells incubated in their respective medium containing no ionophore (Fig. 1). The ionophore-treated SME cells had a signi®cantly greater percentage of acrosome reactions than the ionophore-treated TALP cells (P < 0:05) as detected by ¯uoresceinated lectin staining. There were no signi®cant differences between stallions in response to calcium ionophore and no stallion by ionophore treatment interaction was detected. 3.2. Sperm motility Total and progressive sperm motility was decreased at the end of the 3 h incubation at 37 8C in both SME and TALP medium (P < 0:05). At 3 h, both total and progressive motility were not different between sperm incubated in the two media. In both SME and TALP, total (Table 1) and progressive (Table 2) sperm motility after 3 h incubation was Fig. 1. Acrosome reactions following calcium ionophore (A23187) treatment. Percentage of acrosome reacted cells as detected using FITC-PSA after 3 h incubation of calcium ionophore-treated (1 mM) and -untreated (0 mM) sperm. Samples were incubated in either TALP or SME medium at 37 8C in humidi®ed 95% air and 5% CO2 atmosphere. Values are expressed as mean percents S:E:M:, n 5. Superscripts (a, b, c) denote signi®cance (P < 0:05) within and between media treatments. 1498 A.C. Pommer et al. / Theriogenology 57 (2002) 1493±1501 Table 1 Percentage of total motility at 0 h, and after 3 h incubation, of calcium ionophore-treated (1 mM) and -untreated (0 mM) sperm Medium Calcium ionophore (mM) 0h TALP TALP SME SME 0 1 0 1 91 91 82 82 3h 3 3 2 2 68 43 68 2 Decrease (%) 6 9 4 2,c 26 53 17 97 Samples were incubated in either TALP or SME medium at 37 8C in humidi®ed 95% air and 5% CO2 atmosphere. Values are expressed as mean S:E:M:, n 5. The symbol () in superscript denotes signi®cance (P < 0:05) between calcium ionophore treatments within medium. The symbol (c) in superscript denotes signi®cance (P < 0:05) between media. lower in ionophore-treated cells when compared to control cells, in their respective medium, without ionophore (P < 0:05). After the 3 h incubation with ionophore, there was signi®cantly lower total and progressive motility in the SME cells as compared to the TALP cells (P < 0:05). Although sperm motility declined to very low levels in ionophore-treated samples, the population viability percentages were not different between sperm treated with 1 mM ionophore and control vehicle only (78 3 and 83 1, respectively). 3.3. Intracellular calcium measurements Cells incubated in SME exhibited signi®cantly higher changes in intracellular calcium (P < 0:05), when challenged with calcium ionophore A23187, than cells incubated in TALP at both the 1.5 and 3 h time points (Table 3). Results from experiments to evaluate Fluo-3 AM cell loading (data not shown) indicated that neither TALP nor SME had an effect on loading of Fluo-3 AM dye in equine sperm. Calcium measurement and response of cells to ionophore were consistent with other experiments presented, regardless of the media in which they were loaded and evaluated. Results from cell-free media (not shown) con®rmed that the optical density of the SME was two-fold higher than that of TALP. Results are expressed as percent change in [Ca2]i from base line. Table 2 Percentage of progressive motility at 0 h, and after 3 h incubation, of calcium ionophore-treated (1 mM) and untreated (0 mM) sperm Medium Calcium ionophore (mM) 0h TALP TALP SME SME 0 1 0 1 87 87 77 77 3h 4 4 2 2 62 33 54 0 Decrease (%) 7 12 12 0c 29 62 30 100 Samples were incubated in either TALP or SME medium at 37 8C in humidi®ed 95% air and 5% CO2 atmosphere. Values are expressed as mean S:E:M:, n 5. The symbol () in superscript denotes signi®cance (P < 0:05) between calcium ionophore treatments within medium. The symbol (c) in superscript denotes signi®cance (P < 0:05) between media. A.C. Pommer et al. / Theriogenology 57 (2002) 1493±1501 1499 Table 3 Percent changes in intracellular calcium, from baseline, after 1.5 or 3 h of incubation of calcium ionophoretreated (1 mM) and -untreated (0 mM) sperm Media Time of incubation (h) Change (%) in [Ca2]i from baseline TALP TALP SME SME 1.5 3 1.5 3 205 232 348 347 24 20 25 33 Samples were incubated in either TALP or SME medium at 37 8C in humidi®ed 95% air and 5% CO2 atmosphere. Values are expressed as the means of ®ve replicates = S:E:M: The symbol () in superscript denotes signi®cance (P < 0:05) between the two media. 4. Discussion Transport of cooled equine semen for use in arti®cial insemination most commonly involves dilution of the ejaculate in a nonfat dry skim milk-based semen extender containing an antibiotic supplement which is based on the formula originally published by Kenney and coworkers [13]. This type of extender contains glucose as an energy source for the sperm, as well as a variety of milk-based proteins and carbohydrates that assist in physiological buffering and cellular protection. Although pregnancy rates may be decreased when mares are inseminated with cooled, stored semen as compared to fresh, extended semen [14] there are inherent, and often signi®cant, stallion differences in the fertility of preserved sperm [15]. Reasons for this decreased fertility could include premature capacitation-like changes which would decrease sperm longevity by activation of cellular metabolic processes. In a previous study from our laboratory, we determined that cooled storage (4 8C, 24 h) and frozen storage ( 196 8C) of stallion sperm rendered acrosomal disruption to treated sperm [6]. In that study, sperm treated by a short exposure to the calcium ionophore, A23187, failed to undergo acrosome reaction following 2 h incubation under capacitating conditions. However, acrosomal damage was apparent whether the cells were treated with calcium ionophore or not. A higher percentage of incompletely stained acrosomes were observed in frozen sperm than in fresh sperm. Incompletely stained acrosomes were also observed more frequently in cooled, extended sperm at a greater concentration than for fresh extended sperm. Both media used in that study contained skim milk components. Therefore, we hypothesized that acrosomal function and intracellular calcium ¯ux may be compromised during cooled storage, although for some stallions, skim milk provides adequate protection to sperm cells regarding motility and fertility. We designed an experiment to compare a milk-based diluent with a conventional culture medium. Although the sperm incubated in TALP medium required washing and Percoll±gradient centrifugation to remove seminal plasma (treatments not required for SME-treated sperm), the study was designed to compare a de®ned incubation medium using a laboratory-based method with a commercial semen extender under ®eld conditions (immediate dilution of sperm in SME). This experiment was performed at 37 8C in order to evaluate sperm function under capacitating conditions. 1500 A.C. Pommer et al. / Theriogenology 57 (2002) 1493±1501 In the present study, total and progressive sperm motility signi®cantly declined over the 3 h incubation period for sperm in both media. Ionophore treatment induced a marked and signi®cant decrease in motility when compared to control cells. Furthermore, after 3 h incubation with ionophore, total and progressive motility was signi®cantly lower in SME incubated cells than TALP incubated cells. Ionophore certainly disrupts sperm membrane integrity and ¯oods the cell with calcium [16], which would negatively affect sperm motility and could account for motility differences between ionophore-treated and untreated sperm in the present study. The calcium ionophore, A23187, induced acrosome reactions at a higher rate than cells incubated in their respective control media alone. However, when ionophoretreated cells incubated in the two media were compared, there was signi®cantly higher percentage of acrosome-reacted cells in SME than in TALP. In addition, cells incubated in SME had signi®cantly higher percent changes in intracellular calcium when challenged with ionophore than cells incubated in TALP medium. This result was surprising in that we expected the capacitation medium, TALP, to support more capacitation-related cell functions such as acrosome reactions and increased intracellular calcium. The greater percent change in intracellular calcium could be due to the elevated calcium content in the milk-based extender, nearly six-fold higher than TALP. Clinical chemistry analysis determined total calcium content in SME at 30.6 mg/dl where as total calcium content in TALP was 5.7 mg/dl. Consequently, there was more calcium available in SME for passive or active cellular uptake; thus, a greater magnitude of intracellular calcium was able to enter the cells at initiation of the acrosome reaction. Since calcium in¯ux is a prerequisite for the acrosome reaction to occur [17,18], the cells in the SME would have elevated calcium similar to conditions associated with sperm capacitation. Cooled semen may not survive optimally in commercial skim milk extenders because of increased acrosome reactions, lowered motility, and increased intracellular calcium when compared to cells incubated in a capacitation medium. This suggests that the sperm are prematurely capacitating in the SME, and upon insemination in the mare may not fertilize the egg due to compromised function. Capacitation prior to insemination is detrimental because the sperm may have a diminished ability to reach the ovum, penetrate the cumulus cells, and bind to the zona pellucida. Our data support a shortened functional lifespan for equine sperm stored and shipped in skim milk extender, which indicates that improvements in semen preservation are required to improve fertility of transported semen for some stallions that display poor sperm function of preserved semen. Acknowledgements The authors gratefully acknowledge the assistance of Dr. Jan Roser, Department of Animal Science, College of Agriculture and Environmental Sciences, and Drs. Myrthe Wessel and Dierdra Carver, Ms. Julie Baumber and Dr. Barry A. Ball, Department of Population Health and Reproduction, School of Veterinary Medicine, for procurement of semen samples and scienti®c advice. This work was supported by a grant from the USDA (no. 98-35203-6584). A.C. Pommer et al. / Theriogenology 57 (2002) 1493±1501 1501 References [1] Yanagimachi R. Mammalian fertilization. In: Knobil E, Neill JD, editors. The physiology of reproduction. New York: Raven Press, 1994. p. 189±317. [2] Kopf G, Gerton G. The mammalian sperm acrosome and the acrosome reaction. In: Wassarman P, editor. Elements of mammalian fertilization. Boca Raton: CRC Press, 1991. p. 154±203. [3] Visconti P, Galantino-Homer H, Moore GD, Bailey JL, Ning X, Fornes M, Kopf GS. The molecular basis of sperm capacitation. J Androl 1998;19:242±8. [4] Bedford S, Graham JK, Amann RP, Squires EL, Pickett BW. Use of two freezing extenders to cool stallion spermatozoa to 5 8C with and without seminal plasma. Theriogenology 1995;43:939±53. [5] Bedford S, Jasko DJ, Graham JK, Amann RP, Squires EL, Pickett BW. Effect of seminal extenders containing egg yolk and glycerol on motion characteristics and fertility of stallion semen. Theriogenology 1995;43:955±67. [6] Bedford S, Varner D, Meyers S. Effects of cryopreservation on the acrosomal status of stallion spermatozoa. J Reprod Fertil 2000;(Suppl 56):133±40. [7] Cormier N, Sirard MA, Bailey JL. Premature capacitation of bovine spermatozoa is initiated by cryopreservation. J Androl 1997;18:461±8. [8] Meyers S, Liu I, Overstreet J, Drobnis E. Sperm-zona pellucida binding and zona-induced acrosome reactions in the horse: comparisons between fertile and subfertile males. Theriogenology 1996;46:1277± 88. [9] Meyers S, Overstreet J, Liu I, Drobnis E. Capacitation in vitro of stallion spermatozoaÐcomparison of progesterone-induced acrosome reactions in fertile and subfertile males. J Androl 1995;16:47±54. [10] Grynkiewicz G, Poenie M, Tsien RY. A new generation of Ca2 indicators with greatly improved ¯uorescence properties. J Biol Chem 1985;260:3440±50. [11] Bailey JL, Storey BT. Calcium in¯ux into mouse spermatozoa activated by solubilized mouse zona pellucida, monitored with the calcium ¯uorescent indicator, Fluo-3. Inhibition of the in¯ux by three inhibitors of the zona pellucida induced acrosome reaction: tyrphostin A48, pertussis toxin, and 3quinuclidinyl benzilate. Mol Reprod Dev 1994;39:297±308. [12] Minta A, Kao JPY, Tsien RY. Fluorescent indicators for cytosolic calcium based on rhodamine and ¯uorescein chromophores. J Biol Chem 1989;264:8171±8. [13] Kenney RM, Bergman RV, Cooper WL, Morse GW. Minimal contamination techniques for breeding mares: technique and preliminary ®ndings. Proc Amer Assoc Eq Pract 1975;21:327±36. [14] Varner DD, Blanchard T, Meyers PJ, Meyers SA. Fertilizing capacity of equine spermatozoa stored for 24 h at 5 or 20 8C. Theriogenology 1989;32:515±25. [15] Squires EL, Amann RP, McKinnon AO, Pickett BW. Fertility of equine spermatozoa cooled to 5 or 20 8C. Proc Inter Cong An Reprod Art Insem 1988;3:297±9. [16] Chan S, Fox E, Chan M, Tsoi W, Wang C, Tang L, Tang G, Ho P. The relationship between the human sperm hypoosmotic swelling test, routine semen analysis, and the human sperm zona-free hamster ovum penetration assay. Fertil Steril 1985;44:668±72. [17] Florman HM, Corron ME, Kim TDH, Babcock DF. Activation of voltage-dependent calcium channels of mammalian sperm is required for zona pellucida-induced acrosomal exocytosis. Dev Biol 1992;152:304± 14. [18] Thomas P, Meizel S. An in¯ux of extracellular calcium is required for initiation of the human sperm acrosome reaction induced by follicular ¯uid. Gam Res 1988;20:397±411.
© Copyright 2026 Paperzz