Clinical value of DNA fragmentation evaluation tests under ART treatments

Abstract

Male reproductive health has been under scrutiny recently. Many studies in the literature have concluded that semen quality is declining and that the incidence of testicular cancers is increasing. The reason for this change has been attributed to damage in sperm chromatin. During in vivo reproduction, the natural selection process ensures that only a spermatozoon with normal genomic material can fertilize an oocyte. However, the assisted reproduction technique (ART) is our selection process, leading to the possibility that abnormal spermatozoa could be used to fertilize an oocyte. We could avoid this by quantifying the amount and type of genomic damage in sperm using well-accepted laboratory methods. The sperm deoxyribonucleic acid (DNA) integrity is important for success of natural or assisted fertilization as well as normal development of the embryo, fetus and child. Intra cytoplasmic sperm injection (ICSI) is bypassing natural sperm selection mechanisms, which increases the risk of transmitting damaged DNA. The significance of required investigations and multiple techniques is that they could evaluate DNA defects in human spermatozoa. The ability of these techniques to accurately estimate sperm DNA damage depends on many technical and biological aspects. The aim of this review is to evaluate the most commonly used methods. Received: 10 October, 2012 Accepted: 30 November, 2012 Erkek üreme sağlığıyla ilgili son zamanlardaki çalışmalar semen kalitesi ve sıklığı artan testiküler kanser vakaları üzerinde yoğunlaşmaktadır. Normal üreme şartlarında spermlerin doğal seleksiyonu söz konusu olmakta ve normal genetik yapıdaki spermlerle oositlerin fertilizasyonu gerçekleşmektedir. Ancak yardımcı üreme teknikleri ile gerçek-leştirilen tedavilerde sperm seçimi semen kalitesine bağlı olarak da anormal spermlerle geçekleştirilebilmektedir. Bu durumlarda kabul görmüş birtakım laboratuvar testleri uygulayarak hasarlı genetik yapıdaki spermlerden korunabilmek mümkün olabilmektedir. Sperm deoksiribonükleik asid (DNA) bütünlüğü; doğal ve yardımcı yöntem-lerle fertilizasyonun başarısı aynı zamanda embriyo, fetüs ve çocuğun normal gelişimi için önemlidir. İntrasitoplazmik sperm enjeksiyonunda (ICSI) doğal sperm seçim mekanizmaları devre dışı kalmakta, bu da hasarlı DNA'nın transfer riskini artırmaktadır. Bu derlemede sperm DNA fragmantasyonu oranı belirlemede en sık kullanılan testler değer-lendirilmektedir. (J Turkish-German Gynecol Assoc 2012; 13: 270-4)

Effect of sperm DNA fragmentation on embryo development: clinical and biological aspects

“…During the course of natural selection, effective conception can only occur following the fertilization of an oocyte by sperm with intact DNA. However, assisted reproductive technologies have increased the possibility of anomalous spermatozoa being used to fertilize oocytes ( Tavukçuoğlu et al , 2012 ). Sperm DNA fragmentation is an important parameter of sperm quality that can be used to assess sperm nuclear integrity, which itself plays an important role in fertilization and embryo development ( Bungum et al , 2007 ).…”

Effect of sperm DNA fragmentation on clinical outcomes for Chinese couples undergoing in vitro fertilization or intracytoplasmic sperm injection

“…However, assisted reproductive technology has increased the possibility that abnormal spermatozoons can be used to fertilize oocytes. 29 Sperm DNA fragmentation is an important parameter of sperm quality and can be used to assess sperm nuclear integrity which plays an important role in fertilization and embryo development. 10 Although sperm DNA fragmentation using the Halosperm® kit has been developed as a diagnostic test of male infertility, its correlation with the outcomes of IVF/ICSI has not been established.…”

A systematic review and meta-analysis to determine the effect of sperm DNA damage on in vitro fertilization and intracytoplasmic sperm injection outcome

“…The ability of these assays to accurately measure the level of DNA damage depends on the technical and biological aspects of each test 24. The alkaline Comet assay may be used to study single- or double-strand DNA breaks and measures the migration of the DNA fragments in the electric field.…”