Human Sperm Centrosome: From Current Evidence to Future Perspectives—A Systematic Review

Background: The sperm centrosome is a key organelle composed of two centrioles surrounded by pericentriolar material and is essential for sperm aster formation and first mitotic spindle formation after sperm entry into the oocyte, thereby supporting early embryonic development. Methods: This systematic review evaluated 83 publications published between 1986 and 2026 to provide an updated overview of the human sperm centrosome, including its structural organization, protein composition, role in reproductive success, and association with embryonic abnormalities. Results: The available evidence indicates that centrosome-associated proteins such as centrin, γ-tubulin, and pericentrin are critical for spindle assembly, microtubule nucleation, and centriole duplication, and that alterations in their expression or localization are associated with poor sperm quality and reduced fertilization potential. Centrosomal dysfunction has also been linked to fertilization failure despite intracytoplasmic sperm injection, abnormal embryo cleavage, and possible embryonic aneuploidy. Although diagnostic approaches have improved, targeted treatments remain limited. Conclusions: These findings highlight the clinical relevance of sperm centrosomal integrity and support the need for further research into its diagnostic and therapeutic implications.