credibility of chromomycin a3 staining in prediction of fertility

background: chromomycin a3 (cma3) staining has been used to assess protamine deficiency. the aim of this study was to determine credibility of cma3 along with semen parameters for assessment of fertility potential. materials and methods: semen analysis and cma3 staining were carried out on 234 fertile and 178 subfertile individuals. semen analysis was assessed according to who criteria. protamine deficiency was assessed by cma3 staining. results: means, range of variables, coefficients of correlation and receiver operating characteristic (roc) analyses of semen parameters and protamine deficiency were determined. mean values of three main sperm parameters and the percentage of sperm with negative cma3 were significantly different between fertile and sub fertile groups. the results of cma3 assessment showed significant correlation with sperm density, percentage of motility and normal morphology in the total population, while in the subfertile group the results of cma3 showed significant correlation with sperm density and normal morphology. however in fertile men, the only significant correlation was observed between sperm with negative cma3 and normal morphology. roc analyses revealed that cma3 staining has a higher potential to predict fertility status, compared to semen parameters. conclusion: assessment of protamine deficiency could be considered as one of the complementary tests along with semen analysis for assessment of fertility.