Clinical Guidelines for Sperm DNA Fragmentation (SDF) is Associated with Male Infertility from Reactive Oxygen Species (ROS)

Abstract

Sperm DNA fragmentation is common in infertile male. Besides, sperm DNA integrity is essential for fertilization and healthy offspring development. Numerous genetic and environmental elements are associated with impacting sperm DNA integrity negatively. Such as lifestyle, ageing, industrial toxins, and infection. The mechanisms behind SDF are many, but apoptosis and reactive oxygen species are considered the main SDF mechanisms. The management of male infertility has led to the desire for more advanced SDF diagnostic tools to diagnose sperm DNA. Numerous sperm DNA damage assays such as terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labelling (TUNEL) assay and in situ nick translation (ISNT) are available to enhance SDF diagnosing and ultimately to better SDF management. Clinical SDF can lead to a low pregnancy rate, defects in embryo development and impaired offspring health. Moreover, SDF can impact the effectiveness of assisted reproductive technology through transfer genetics impartment to the embryo b in vitro fertilization or intracytoplasmic sperm injection. SDF can be mange through lifestyle changing, treating existing infection in the male reproductive tract and reactive oxygen species.

Sperm DNA Fragmentation: causes, evaluation and management in male infertility

“…The ROS formed is regulated by antioxidants found in semen. During oxidative stress, there is an imbalance between ROS and antioxidants ( Zakaria et al ., 2021 ).…”

“…Sperm binding to the zona pellucida is controlled by low level ROS just like superoxide anion radicals uplift acrosome reaction and capacitation. OS and reduction in antioxidant capacity of spermatozoa were found to be associated with rise in the ROS ( Zakaria et al ., 2021 ). Various causes of ROS include infection, inflammation, leucocytes, smoking, alcohol, radiation, toxic chemicals, diseases of the male reproductive accessory gland, genital tract inflammation, varicocele, testicular torsion or cryptorchidism ( Wright et al ., 2014 ).…”

“…b) Apoptosis during epididymal sperm maturation (Gosálvez et al, 2015). c) Oxidative Stress (Zakaria et al, 2021) d) Varicocele, infections, inflammation of male genital tract, febrile illness, obesity, advanced age, environmental pollutants and toxins Agarwal et al, 2020). e) Drugs, chemotherapy and radiotherapy (Esteves et al, 2015b;González-Marín et al, 2012) SDF can be caused by different factors, which are divided into intrinsic and extrinsic categories.…”

“…In order to differentiate fertile and infertile men on the basis SDF level, a meta-analysis on 4000 men from 27 studies concluded that SDF threshold that can differentiate between fertile and infertile men was 20% ( Roque & Esteves, 2018 ). Many conditions such as varicocele, reactive oxygen species, lifestyle, genital infections, advanced paternal age, chemo-therapeutic drug of testicular cancer (bleomycin etoposide), radiotherapy, urogenital infection, and cigarettes have been associated with elevated SDF levels ( Osman et al ., 2015 ; González-Marín et al ., 2012 ; Esteves et al ., 2021 ; Zakaria et al ., 2021 ). SDF also results in impaired fertilization, sub-optimal embryo quality, reduced pregnancy rate and increased abortion during Invitro fertilization (IVF).…”