Fragmentación del ADN espermático empleando el método de TUNEL

Chenlo, Patricia Haydee; Curi, Susana Mercedes; Pugliese, Mercedes Norma; Ariagno, Julia Irene; Sardi-Segovia, M.; Furlan, M.J.; Repetto, Herberto Ernesto; Zeitler, E.; Cohen, Myra; Mendeluk, Gabriela Ruth

doi:10.1016/j.acuro.2014.02.022

Cited by 22 publications

(10 citation statements)

References 14 publications

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“…In contrast, if the prevalence is high (e.g., men with risk factors for SDF), the PPV will be high provided a highly specific cutoff value is chosen. As a matter of fact, it has been shown that the PPV of TUNEL concerning pregnancy in ART is only moderate whereas that of SCD is low despite the high sensitivity (77–85%) and specificity (89–91%) of both tests ( 83 , 166 , 236 , 237 ).…”

Section: Discussionmentioning

confidence: 99%

A Strengths-Weaknesses-Opportunities-Threats (SWOT) analysis on the clinical utility of sperm DNA fragmentation testing in specific male infertility scenarios

Esteves¹,

Agarwal

Cho

et al. 2017

Transl. Androl. Urol.

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BackgroundSperm DNA fragmentation (SDF) is recognized as a leading cause of male infertility because it can impair the paternal genome through distinct pathophysiological mechanisms. Current evidence supports SDF as a major factor in the pathophysiology of several conditions, including varicocele, unexplained infertility, assisted reproductive technology failure, and environmental lifestyle factors, although the mechanisms involved have not been fully described yet. Measurement of the levels of DNA fragmentation in semen provides valuable information on the integrity of paternal chromatin and may guide therapeutic strategies. A recently published clinical practice guideline (CPG) highlighted how to use the information provided by SDF testing in daily practice, which triggered a series of commentaries by leading infertility experts. These commentaries contained an abundance of information and conflicting views about the clinical utility of SDF testing, which underline the complex nature of SDF.MethodsA search of papers published in response to the CPG entitled “Clinical utility of sperm DNA fragmentation testing: practice recommendations based on clinical scenarios” was performed within the Translational Andrology and Urology (TAU) website (http://tau.amegroups.com/). The start and end dates for the search were May 2017 and August 2017, respectively. Each commentary meeting our inclusion criteria was rated as “supportive without reservation”, “supportive with reservation”, “not supportive” or “neutral”. We recorded whether articles discussed either SDF characteristics as a laboratory test method or clinical scenarios, or both. Subsequently, we extracted the particulars from each commentary and utilized the ‘Strengths-Weaknesses-Opportunities-Threats’ (SWOT) analysis to understand the perceived advantages and drawbacks of SDF as a specialized sperm function method in clinical practice.ResultsFifty-eight fertility experts from six continents and twenty-two countries contributed commentaries. Overall, participants (87.9%; n=51) were supportive of the recommendations provided by the CPG on the utility of SDF testing based on clinical scenarios. The majority of participants made explicit remarks about both the clinical scenarios and SDF assays’ characteristics. Among ‘not supportive’ and ‘supportive with reservation’ participants, 75% (n=30/40) and 77.5% (n=31/40) expressed concerns related to technical limitations of SDF testing methods and clinical utility of the test in one or more clinical scenarios discussed in the CPG, respectively. The SWOT analysis revealed that the CPG provides a reasonable evidence-based proposal for integration of SDF testing in the routine daily practice. It also uncovered gaps of knowledge and threats limiting the widespread application of SDF in everyday practice, thus allowing the identification of opportunities to further refine SDF testing and its clinical utility.ConclusionsThe understanding of the role of SDF in male infertility requires an in-depth analysis of the multifactorial pat...

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Section: Discussionmentioning

confidence: 99%

A Strengths-Weaknesses-Opportunities-Threats (SWOT) analysis on the clinical utility of sperm DNA fragmentation testing in specific male infertility scenarios

Esteves¹,

Agarwal

Cho

et al. 2017

Transl. Androl. Urol.

View full text Add to dashboard Cite

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“…Latest data provide further support for the use of SDF testing in fertility assessment and prediction of natural pregnancy. Sensitivity of 80–85% and specificity of 85–90% were reported with the use of sperm chromatin dispersion (SCD) and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) assays ( 9 , 10 ). We concur with the authors that the correlation between high SDF and poor IUI outcomes is not without debate with several studies demonstrating strong correlation ( 11 , 12 ) while others failed to show such an association ( 13 ).…”

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confidence: 99%

Call for wider application of sperm DNA fragmentation test

Agarwal

Cho

Majzoub

et al. 2017

Transl. Androl. Urol.

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“…The SCSA, SCD and TUNEL tests have been recently standardized and/or validated ( 12 , 54 , 55 ). Emerging data is providing further support for the use of SDF testing as a fertility assessment tool and as a predictor of natural pregnancy with a sensitivity of 80–85% and a specificity of 85–90% reported with SCD and TUNEL assays ( 56 , 57 ). As for the outcome of ART, SDF testing with SCD accurately predicted pregnancy with a sensitivity of 86.2% and negative predictive value of 72.2% ( 58 ).…”

Section: Discussionmentioning

confidence: 96%

Sperm DNA fragmentation testing: a cross sectional survey on current practices of fertility specialists

Majzoub¹,

Agarwal²,

Cho³

et al. 2017

Transl. Androl. Urol.

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BackgroundSperm DNA fragmentation (SDF) testing has been recognized as a valuable tool in the evaluation of infertile men. Despite that, its routine use in clinical practice is still hampered by the lack of understanding of the specific clinical scenarios where SDF testing is most beneficial. The aim of this study was to investigate fertility specialists evaluation of infertility of SDF testing in the context of male infertility evaluation and assisted reproductive technology.MethodsA questionnaire was developed to survey the major aspects of SDF testing and was mailed to specialists with demonstrated clinical experience in the field of infertility. A total of 65 professionals were invited to answer issues related to the utility of SDF testing, the testing methods they used, were the SDF cut-off values, and the cost of testing and the perceived drawbacks of the test results. Specific clinical scenarios were presented to assess whether or not participants would recommend SDF testing. The frequency of responses was analyzed.ResultsForty-nine participants from 19 countries responded to the study questionnaire. SDF testing was commonly ordered by 39 (79.6%) respondents; while 10 (20.4%) did not order SDF testing during fertility evaluation. Terminal deoxynucleotidyl transferase nick end labelling (TUNEL) and sperm chromatin structure assay (SCSA) were most commonly utilized (30.6% for both), followed by sperm chromatin dispersion (SCD) (20.4%), single cell gel electrophoresis (Comet) (6.1%) and other methods (12.2%). SDF was most commonly requested in couples presenting with recurrent conventional in vitro fertilization (IVF) failure or pregnancy loss following conventional IVF (91.8%), followed by couples with recurrent first trimester natural pregnancy loss (NPL) and recurrent pregnancy loss (RPL) following intracytoplasmic sperm injection (ICSI) (85.7% for both). A 67.3% of respondents admitted that an SDF test result would affect their decision to utilize testicular instead of ejaculated sperm for ICSI. The reported mean ± standard deviation (SD) cost (USD) of SDF testing was 170.4±122.9. Cost (46.9%), poor validation (36.7%) and low precision (18.3%) were the most commonly reported drawbacks of SDF testing.ConclusionsSDF testing is utilized in the evaluation of infertility patients by a majority of fertility specialists under specific clinical scenarios. Shortcomings, such as the presence of several SDF testing methods with different cut-off values and the test charges were some of the reasons hampering the routine use of SDF in the evaluation of infertile men.

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Fragmentación del ADN espermático empleando el método de TUNEL

Cited by 22 publications

References 14 publications

A Strengths-Weaknesses-Opportunities-Threats (SWOT) analysis on the clinical utility of sperm DNA fragmentation testing in specific male infertility scenarios

A Strengths-Weaknesses-Opportunities-Threats (SWOT) analysis on the clinical utility of sperm DNA fragmentation testing in specific male infertility scenarios

Call for wider application of sperm DNA fragmentation test

Sperm DNA fragmentation testing: a cross sectional survey on current practices of fertility specialists

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