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Ribas-Maynou J, Benet J. Single and Double Strand Sperm DNA Damage: Different Reproductive Effects on Male Fertility. Genes (Basel) 2019; 10:E105. [PMID: 30708937 PMCID: PMC6410262 DOI: 10.3390/genes10020105] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 01/21/2019] [Accepted: 01/29/2019] [Indexed: 12/22/2022] Open
Abstract
Reproductive diseases have become a growing worldwide problem and male factor plays an important role in the reproductive diagnosis, prognosis and design of assisted reproductive treatments. Sperm cell holds the mission of carrying the paternal genetic complement to the oocyte in order to contribute to an euploid zygote with proper DNA integrity. Sperm DNA fragmentation had been used for decades as a male fertility test, however, its usefulness have arisen multiple debates, especially around Intracytoplasmic Sperm Injection (ICSI) treatments. In the recent years, it has been described that different types of sperm DNA breaks (single and double strand DNA breaks) cause different clinical reproductive effects. On one hand, single-strand DNA breaks are present extensively as a multiple break points in all regions of the genome, are related to oxidative stress and cause a lack of clinical pregnancy or an increase of the conception time. On the other hand, double-strand DNA breaks are mainly localized and attached to the sperm nuclear matrix as a very few break points, are possibly related to a lack of DNA repair in meiosis and cause a higher risk of miscarriage, low embryo quality and higher risk of implantation failure in ICSI cycles. The present work also reviews different studies that may contribute in the understanding of sperm chromatin as well as treatments to prevent sperm DNA damage.
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Affiliation(s)
- Jordi Ribas-Maynou
- Unitat de Biologia Cel·lular i Genètica Mèdica, Departament de Biologia Cel·lular, Fisiologia i Immunologia, Facultat de Medicina, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain.
| | - Jordi Benet
- Unitat de Biologia Cel·lular i Genètica Mèdica, Departament de Biologia Cel·lular, Fisiologia i Immunologia, Facultat de Medicina, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain.
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Simon L, Emery B, Carrell DT. Sperm DNA Fragmentation: Consequences for Reproduction. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1166:87-105. [DOI: 10.1007/978-3-030-21664-1_6] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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53
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Tello-Mora P, Hernández-Cadena L, Pedraza J, López-Bayghen E, Quintanilla-Vega B. Acrosome reaction and chromatin integrity as additional parameters of semen analysis to predict fertilization and blastocyst rates. Reprod Biol Endocrinol 2018; 16:102. [PMID: 30340492 PMCID: PMC6195742 DOI: 10.1186/s12958-018-0408-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 09/11/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Traditional semen parameters have shown little to none predictive value for fertilization and blastocyst viability for a successful pregnancy. Therefore, the purpose of this study was to explore the usefulness of incorporating the acrosome reaction (AR) and chromatin integrity to conventional semen analysis to individually predict the fertile potential of sperm samples. METHODS A cross-sectional study was conducted in 69 participants undergoing IVF using oocyte donation. Semen samples were collected and evaluated for: AR [spontaneous (sAR) and induced (iAR)] by flow cytometry using anti-CD46-FITC, Acrosome Response to an Ionophore Challenge (ARIC), chromatin integrity by Sperm Chromatin Structure Assay (DNA Fragmentation Index-%DFI and High DNA Stainability-%HDS), WHO semen analysis, fertilization and blastocyst rates. RESULTS The participant age was 40.0 ± 6.1 years (66% were normozoospermic). Sperm morphology, sAR, iAR, and ARIC were associated with the fertilization (β = 3.56, R2 = 0.054; β = - 5.92, R2 = 0.276; β = 1.83, R2 = 0.150; and β = 2.10, R2 = 0.270, respectively, p < 0.05). A logit model was developed to calculate the probability of fertilization (≥ 60%) for each participant, using the sperm morphology and ARIC as independent variables, followed by ROC analysis to determine a cutoff probability of 0.65 (specificity = 80.6%, sensitivity = 63.2%). %DFI was inversely associated with the viable blastocyst rate (β = - 1.77, R2 = 0.057, p = 0.003), by the logit model and ROC analysis, a cutoff probability of 0.70 (specificity = 80.6%, sensitivity = 72.3%) was obtained to predict blastocyst viability (≥ 40%). There was no difference in the results with normozoospermic samples (n = 46). CONCLUSIONS The incorporation of ARIC and %DFI allowed to obtain predictive models for high fertilization and blastocyst rates in an individualized way, being promising tools to improve the diagnosis of male fertility potential for research or assisted reproduction, even in men with unknown infertility.
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Affiliation(s)
- Pamela Tello-Mora
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del IPN, Av. IPN 2508, 07360, Ciudad de México, México
| | - Leticia Hernández-Cadena
- Instituto Nacional de Salud Pública, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, México
| | - Jeimy Pedraza
- Laboratorio de Investigación y Diagnóstico Molecular, Instituto de Infertilidad y Genética, Ingenes México, Carretera México-Toluca No. 5420, 05320, Ciudad de México, México
| | - Esther López-Bayghen
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del IPN, Av. IPN 2508, 07360, Ciudad de México, México
| | - Betzabet Quintanilla-Vega
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del IPN, Av. IPN 2508, 07360, Ciudad de México, México.
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54
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Esbert M, Pacheco A, Soares SR, Amorós D, Florensa M, Ballesteros A, Meseguer M. High sperm DNA fragmentation delays human embryo kinetics when oocytes from young and healthy donors are microinjected. Andrology 2018; 6:697-706. [PMID: 30259705 DOI: 10.1111/andr.12551] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 08/06/2018] [Accepted: 08/16/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Time-lapse monitoring (TLM) technology has been implemented in the clinical setting for the culture and selection of human embryos. Many studies have assessed the association between sperm DNA fragmentation (sDNAf) and clinical outcomes after ART, but little is known about the influence of sDNA on embryo morphokinetics. OBJECTIVES The objective of this retrospective study, which includes 971 embryos from 135 consecutive ICSI cycles (56 cases with own oocytes, 79 with oocytes from young and healthy donors), was to assess if sDNAf has an impact on embryo morphokinetics. MATERIALS AND METHODS Samples used to perform ICSI were analyzed by the flow cytometry TUNEL assay, and embryo development was assessed through an EmbyoScope® system. The association between sDNAf and the timings of cell cleavage was analyzed by categorizing the first variable into quartiles: ≤6.50%; 6.51-10.70%; 10.71-20.15%; >20.15%. RESULTS In cases where sDNAf was above 20.15% (the upper quartile), embryos derived from donated oocytes (n = 644) showed significantly slower divisions. Such association was not observed in embryos obtained from the patients' own oocytes (n = 327). The embryo cleavage pattern (either normal, direct from 1 to 3 blastomeres, direct from 1 to 4 blastomeres, incomplete, reversed or asynchronous) was independent of the sDNAf level. Blastocyst arrival rate was 63.0% and the rate of good quality embryos (transferred and frozen embryos divided by the number of zygotes) was 45.49%. Neither parameter was related to the levels of sDNAf. DISCUSSION According to our results, the association between high sDNAf and donated oocytes led to delayed cell division. To our knowledge, this is the first study suggesting that sDNAf can delay human embryo cleavage timings when oocytes from donors are inseminated. CONCLUSIONS This finding may indicate that, in the presence of increased DNA damage, time is needed before the first embryonic cell division for the activation of the optimal DNA repairing machinery in higher quality oocytes.
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55
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Relationship between sperm progressive motility and DNA integrity in fertile and infertile men. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2018. [DOI: 10.1016/j.mefs.2017.12.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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56
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Ilgın S, Aydoğan-Kılıç G, Baysal M, Kılıç V, Ardıç M, Uçarcan Ş, Atlı Ö. Toxic Effects of Trazodone on Male Reproductive System via Disrupting Hypothalamic-Pituitary-Testicular Axis and Inducing Testicular Oxidative Stress. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:7196142. [PMID: 30151072 PMCID: PMC6087606 DOI: 10.1155/2018/7196142] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 06/03/2018] [Indexed: 01/02/2023]
Abstract
Depression and anxiety are recognized as public health problems. Epidemiological studies have shown that depression and anxiety often occur during reproductive ages between 20 and 60 years of age in males. Trazodone is one of the most frequently prescribed drugs in the treatment of depression and anxiety. Drugs used in repeated doses also play a role in the etiology of infertility. In our study, it was aimed to identify the possible toxic effects of trazodone on male rats and elucidate the underlying mechanisms. Vehicle or trazodone (5, 10, and 20 mg/kg/day) was administered to rats for 28 consecutive days (n = 8 per group). At the end of that period, sperm concentration, motility, morphology, and DNA damage were determined and testicular morphology was assessed histopathologically in rats. Additionally, we investigated hormonal status by determining serum testosterone, FSH, and LH levels and oxidative stress by determining glutathione and malondialdehyde levels in testicular tissue to elucidate mechanisms of possible reproductive toxicity. According to our results, sperm concentration, sperm motility, and normal sperm morphology were decreased; sperm DNA damage was increased in trazodone-administered groups. Degenerative findings on the testicular structure were observed after trazodone administration in rats. Additionally, serum FSH, LH, and testosterone levels were elevated in the trazodone-administered groups. Increased MDA levels were the signs of enhanced oxidative stress after trazodone administration in testis tissues. Thus, we concluded that trazodone induced reproductive toxicity in male rats; this reproductive toxicity was accompanied by oxidative stress and hormonal changes, which are considered as important causes of reproductive disorders.
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Affiliation(s)
- Sinem Ilgın
- Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Anadolu University, Eskisehir, Turkey
| | - Gözde Aydoğan-Kılıç
- Faculty of Science, Department of Biology, Anadolu University, Eskisehir, Turkey
| | - Merve Baysal
- Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Anadolu University, Eskisehir, Turkey
| | - Volkan Kılıç
- Faculty of Science, Department of Biology, Anadolu University, Eskisehir, Turkey
| | - Mina Ardıç
- Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Anadolu University, Eskisehir, Turkey
| | - Şeyda Uçarcan
- Faculty of Science, Department of Biology, Anadolu University, Eskisehir, Turkey
| | - Özlem Atlı
- Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Anadolu University, Eskisehir, Turkey
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Ziarati N, Tavalaee M, Bahadorani M, Nasr Esfahani MH. Clinical outcomes of magnetic activated sperm sorting in infertile men candidate for ICSI. HUM FERTIL 2018; 22:118-125. [DOI: 10.1080/14647273.2018.1424354] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Niloofar Ziarati
- Department of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
- Department of Biology, Falavarjan Branch, Islamic Azad University, Isfahan, Iran
| | - Marziyeh Tavalaee
- Department of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Mehrnoosh Bahadorani
- Department of Biology, Falavarjan Branch, Islamic Azad University, Isfahan, Iran
| | - Mohammad Hossein Nasr Esfahani
- Department of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
- Isfahan Fertility and Infertility Center, Isfahan, Iran
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Panner Selvam MK, Agarwal A. A systematic review on sperm DNA fragmentation in male factor infertility: Laboratory assessment. Arab J Urol 2018; 16:65-76. [PMID: 29713537 PMCID: PMC5922187 DOI: 10.1016/j.aju.2017.12.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 11/26/2017] [Accepted: 12/02/2017] [Indexed: 02/04/2023] Open
Abstract
Objective To review sperm DNA fragmentation (SDF) testing as an important sperm function test in addition to conventional semen analysis. High SDF is negatively associated with semen quality, the fertilisation process, embryo quality, and pregnancy outcome. Over recent decades, different SDF assays have been developed and reviewed extensively to assess their applicability and accuracy as advanced sperm function tests. Amongst them, the standardisation of the terminal deoxynucleotidyl transferased UTP nick-end labelling (TUNEL) assay with a bench top flow cytometer in clinical practice deserves special mention with a threshold value of 16.8% to differentiate infertile men with DNA damage from fertile men. Materials and methods A systematic literature search was performed through the PubMed, Medline, and ScienceDirect databases using the keywords ‘sperm DNA fragmentation’ and ‘laboratory assessment’. Non-English articles were excluded and studies related to humans were only included. Results Of the 618 identified, 87 studies (original research and reviews) and in addition eight book chapters meeting the selection criteria were included in this review. In all, 366 articles were rejected in the preliminary screening and a further 165 articles related to non-human subjects were excluded. Conclusion There are pros and cons to all the available SDF assays. TUNEL is a reliable technique with greater accuracy and as an additional diagnostic test in Andrology laboratories along with basic semen analysis can predict fertility outcome, and thus direct the choice of an assisted reproductive technology procedure for infertile couples. Also, the TUNEL assay can be used as a prognostic test and results are beneficial in deciding personalised treatment for infertile men.
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Key Words
- AO, acridine orange
- ART, assisted reproductive technology
- CMA3, chromomysin A3
- DFI, DNA fragmentation index
- DNA damage
- FITC, Fluorescein isothiocyanate
- ICSI, intracytoplasmic sperm injection
- IUI, intrauterine insemination
- IVF, in vitro fertilisation
- PI, propidium iodide
- ROS, reactive oxygen species
- SCD, sperm chromatin dispersion
- SCSA, sperm chromatin structure assay
- SDF, sperm DNA fragmentation
- Sperm DNA fragmentation (SDF)
- Sperm DNA fragmentation (SDF) assay
- TUNEL, terminal deoxynucleotidyl transferased UTP nick-end labelling
- TdT, terminal deoxynucleotidyl transferase
- Terminal deoxynucleotidyl transferased UTP nick-end labelling (TUNEL)
- dUTP, 2′-deoxyuridine 5′-triphosphate
- dsDNA, double-stranded DNA
- ssDNA, single-strand DNA
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Affiliation(s)
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
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59
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Colacurci N, De Leo V, Ruvolo G, Piomboni P, Caprio F, Pivonello R, Papaleo E, La Verde E, Depalo R, Lispi M, Longobardi S, Paoli D, Pallotti F, Lombardo F. Recombinant FSH Improves Sperm DNA Damage in Male Infertility: A Phase II Clinical Trial. Front Endocrinol (Lausanne) 2018; 9:383. [PMID: 30042737 PMCID: PMC6048873 DOI: 10.3389/fendo.2018.00383] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 06/22/2018] [Indexed: 11/13/2022] Open
Abstract
UNLABELLED Background and objectives: Male infertility is a global health dilemma and Follicle-Stimulating Hormone (FSH) administration has shown promising results. Several studies showed that infertile men with normal semen parameters have low levels of DNA damage while infertile men with abnormal semen parameters have more damage at the DNA level. Sperm DNA damage may affect the reproductive outcome and has been associated with failure in the achievement of competent embryos and pregnancy fulfillment. The aim of this study was to evaluate whether the administration of recombinant FSH (Gonal-f® PEN 900 IU) could improve sperm DNA fragmentation in men with infertility. The secondary endpoints of this study were to evaluate the FSH effects on sperm parameters and hormonal assets. Methods: A longitudinal, prospective, multicenter, open-label clinical trial was carried out. Infertile couples were recruited from six Italian Reproductive Medical Centers and 115 infertile men were enrolled for this study. All participants were treated with subcutaneous injections of Gonal-f® 150 IU every other day, within a 3 month-time frame. The semen samples were examined in accordance to the 2010 World Health Organization criteria. Sperm DNA Fragmentation (DFI) was determined by fluorescence microscopy using terminal deoxynucleotidyl transferase-mediated d-UTP Nick-end Labeling (TUNEL) assay. Statistical analysis was performed using both the t-test for paired samples and the Wilcoxon signed-rank test. Results: FSH administration improved DFI in 67% of patients, with an average decrease of 35.4% compared to the baseline. This improvement is more evident in men with basal DFI lower than 17% and in those with FSH basal levels between 2.16 and 4.27 IU/L. In addition, FSH enhanced the gonadal function, increasing the hormones AMH and Inhibin B and semen parameters. Limitation of these results are represented by the absence of a placebo group and of FSHR genotype stratification sub-analysis. Conclusion: Recombinant FSH 150 IU is well tolerated and effective in eliciting a significant DFI reduction as well as in improving gonadal function. TRIAL REGISTRATION EUDRACT Number 2010-020196-23. Registred 14 April 2011.
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Affiliation(s)
- Nicola Colacurci
- Department of Gynecological, Obstetrics and Reproduction Sciences, II University of Naples, Naples, Italy
| | - Vincenzo De Leo
- Department of Molecular and Developmental Medicine, Centre for Couple Sterility, University of Siena, Siena, Italy
| | - Giovanni Ruvolo
- Obstetrics and Gynecology, Casa di Cura Candela, Palermo, Italy
| | - Paola Piomboni
- Department of Molecular and Developmental Medicine, Centre for Couple Sterility, University of Siena, Siena, Italy
| | - Francesca Caprio
- Department of Gynecological, Obstetrics and Reproduction Sciences, II University of Naples, Naples, Italy
| | - Rosario Pivonello
- Department of Endocrinology, University of Naples “Federico II”, Naples, Italy
| | - Enrico Papaleo
- Operating Unit of Gynecology and Obstetrics, DIMER Center of Natality Sciences, IRCCS San Raffaele of Milan, Milan, Italy
| | - Eugenio La Verde
- Department of Gynecological, Obstetrics and Reproduction Sciences, II University of Naples, Naples, Italy
| | - Raffaella Depalo
- Pathophysiology Center of Human Reproduction and Freezing Gametes, Ospedale Policlinico Consorziale of Bari, Bari, Italy
| | | | | | - Donatella Paoli
- Laboratory of Seminology- Sperm Bank “Loredana Gandini”, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
- *Correspondence: Donatella Paoli
| | - Francesco Pallotti
- Laboratory of Seminology- Sperm Bank “Loredana Gandini”, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Francesco Lombardo
- Laboratory of Seminology- Sperm Bank “Loredana Gandini”, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
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60
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Choi HY, Kim SK, Kim SH, Choi YM, Jee BC. Impact of sperm DNA fragmentation on clinical in vitro fertilization outcomes. Clin Exp Reprod Med 2017; 44:224-231. [PMID: 29376020 PMCID: PMC5783920 DOI: 10.5653/cerm.2017.44.4.224] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 10/26/2017] [Indexed: 12/04/2022] Open
Abstract
Objective We studied the association between sperm DNA fragmentation (SDF) and several clinical in vitro fertilization outcomes. Methods We retrospectively analyzed 169 consecutive fresh IVF cycles. Semen was collected on the day of oocyte retrieval, and we assessed standard semen parameters and the SDF level (by terminal deoxynucleotidyl transferase dUTP nick-end labeling). Poor ovarian response (POR) was defined as the collection of three or fewer mature oocytes. Oocytes were inseminated by the conventional method or intracytoplasmic sperm injection. Results SDF did not affect the fertilization or pregnancy rate, but did have a significant effect on the miscarriage rate. In the miscarriage group (n=10), the SDF level was significantly higher (23.9% vs. 14.1%) and number of mature oocytes was significantly lower (4.3 vs. 7.6) than in the live birth group (n=45). Multiple regression analysis showed that SDF was an independent predictor of miscarriage (odds ratio, 1.051; 95% confidence interval, 1.001–1.104). The cutoffs for the SDF level and number of mature oocytes that could predict miscarriage were >13% and ≤3, respectively. In the low-SDF group (≤13%), the miscarriage rate was similar in POR patients and those with a normal ovarian response (NOR; 14.2% vs. 4.3%). In the high-SDF group (>13%), the miscarriage rate was significantly higher in the POR group than in the NOR group (60.0% vs. 13.3%, p=0.045). Conclusion Our study demonstrated that a high SDF level (>13%) was associated with a high miscarriage rate, and that it mainly contributed to miscarriage in the POR group. The results suggest that SDF measurements should be considered in couples with POR in order to predict the prognosis of the pregnancy.
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Affiliation(s)
- Hwa Young Choi
- Department of Obstetrics and Gynecology, Maria Fertility Hospital, Seoul, Korea.,Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Seul Ki Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.,Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Seok Hyun Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.,Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea
| | - Young Min Choi
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.,Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea
| | - Byung Chul Jee
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.,Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
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61
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Rui BR, Angrimani D, Bicudo LC, Losano J, Nichi M, Pereira R. A fast, low-cost and efficient method for the diagnosis of sperm DNA fragmentation in several species. Reprod Domest Anim 2017; 53:171-175. [PMID: 29086436 DOI: 10.1111/rda.13087] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 08/30/2017] [Indexed: 01/29/2023]
Abstract
Sperm DNA fragmentation is a condition that interferes directly in the reproductive efficiency. Currently, there are several methods for assessing the sperm DNA integrity, such as Alkaline Comet, TUNEL and Sperm Chromatin Structure Assay. However, many of these techniques are laborious and require high-precision equipment. Thus, the development of new techniques can optimize the evaluation of sperm DNA damage. Therefore, the aim of this study was to standardize the toluidine blue (TB) stain technique for the analysis of DNA fragmentation of dog, cat, bull, stallion and ram spermatozoa. For this purpose, we used six animals of each specie (n = 30), in reproductive age. Sperm was collected by different methods according to the particularities of each species, and such samples were divided into two aliquots: a sperm sample was kept at 5°C (considered as intact sperm DNA), and the remaining samples were submitted to the induction of DNA fragmentation by exposure to ultraviolet light for 4 hr. Samples were then mixed with the intact sample to obtain known and progressive proportions of sperm with fragmented DNA (0%, 25%, 50%, 75% and 100%). Semen smears were performed and subjected to staining with TB. Blue-stained spermatozoa were considered to have DNA fragmentation. We observed high linear regression coefficients between the expected proportion of damaged DNA and the results of TB for dog, cat, ram, bull and stallion samples. In conclusion, TB stain was considered a fast and effective technique for the study of spermatozoa DNA in several species.
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Affiliation(s)
- B R Rui
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Dsr Angrimani
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - L C Bicudo
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Jda Losano
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - M Nichi
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Rjg Pereira
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
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62
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Simon L, Emery BR, Carrell DT. Review: Diagnosis and impact of sperm DNA alterations in assisted reproduction. Best Pract Res Clin Obstet Gynaecol 2017; 44:38-56. [DOI: 10.1016/j.bpobgyn.2017.07.003] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 07/11/2017] [Accepted: 07/24/2017] [Indexed: 01/31/2023]
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63
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Chi HJ, Kim SG, Kim YY, Park JY, Yoo CS, Park IH, Sun HG, Kim JW, Lee KH, Park HD. ICSI significantly improved the pregnancy rate of patients with a high sperm DNA fragmentation index. Clin Exp Reprod Med 2017; 44:132-140. [PMID: 29026719 PMCID: PMC5636925 DOI: 10.5653/cerm.2017.44.3.132] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Revised: 06/16/2017] [Accepted: 06/05/2017] [Indexed: 12/19/2022] Open
Abstract
Objective Correlations between semen parameters and sperm DNA fragmentation index (DFI) were investigated to identify characteristics of sperm without DNA damage that could be used in selecting sperm for intracytoplasmic sperm injection (ICSI). Pregnancy outcomes were compared to determine whether in vitro fertilization (IVF) or ICSI is a better choice for patients who have sperm with a high-DFI. Methods Semen analysis was carried out in 388 patients who visited our IVF center for the first time to investigate correlations between sperm DFI and semen parameters. In addition, 1,102 IVF cycles in 867 patients were carried out in the present study; 921 cycles in the low-DFI group (DFI <30%) and 181 cycles in the high-DFI group (DFI ≥30%). Both the low- and high-DFI groups were subdivided into IVF and ICSI cycle groups. Results Sperm DFI showed significant inverse correlations with sperm motility (r=−0.435, p<0.001) and morphology (r=−0.153, p<0.05). Sperm DFI also showed significant correlations with rapid motility (r=−0.436, p<0.001), and the kinetic parameters of average-path velocity (r=−0.403) and linearity (r=−0.412). Although there was no significant difference in the pregnancy rates between IVF (48.6%) and ICSI (44.8%) in the low-DFI group, the pregnancy rate of ICSI cycles (44.8%, p<0.05) was significantly higher than IVF cycles (25.0%) in the high-DFI group. No significant difference was observed in the abortion rates between the low-DFI (52 of 921, 5.6%) and high-DFI groups (7 of 181, 3.8%). Conclusion ICSI is a better choice than IVF for improving the pregnancy outcomes of patients who have sperm with a high DFI.
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Affiliation(s)
- Hee-Jun Chi
- IVF Center, Mamapapa and Baby Clinic, Ulsan, Korea
| | - Seok-Gi Kim
- IVF Center, Mamapapa and Baby Clinic, Ulsan, Korea.,Department of Biotechnology, Daegu University, Daegu, Korea
| | | | | | | | - Il-Hae Park
- IVF Center, Mamapapa and Baby Clinic, Ulsan, Korea
| | - Hong-Gil Sun
- IVF Center, Mamapapa and Baby Clinic, Ulsan, Korea
| | - Jae-Won Kim
- IVF Center, Mamapapa and Baby Clinic, Ulsan, Korea
| | | | - Hum-Dai Park
- Department of Biotechnology, Daegu University, Daegu, Korea
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64
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Benagiano G, Paoli D, Lombardo F, Brosens JJ, Brosens IA. DNA fragmentation and the ultimate success of a pregnancy. Transl Androl Urol 2017; 6:S539-S543. [PMID: 29082175 PMCID: PMC5643643 DOI: 10.21037/tau.2017.03.46] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Affiliation(s)
| | - Donatella Paoli
- Department of Experimental Medicine, Laboratory of Seminology-Sperm Bank, Sapienza University of Rome, Rome, Italy
| | - Francesco Lombardo
- Department of Experimental Medicine, Laboratory of Seminology-Sperm Bank, Sapienza University of Rome, Rome, Italy
| | - Jan J Brosens
- Leuven Institute for Fertility and Embryology, Leuven, Belgium
| | - Ivo A Brosens
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, UK
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65
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Agarwal A, Cho CL, Esteves SC, Majzoub A. Sperm DNA fragmentation testing is on the right track. Transl Androl Urol 2017; 6:S389-S391. [PMID: 29082951 PMCID: PMC5643657 DOI: 10.21037/tau.2017.04.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, USA
| | - Chak-Lam Cho
- Division of Urology, Department of Surgery, Kwong Wah Hospital, Hong Kong, China
| | - Sandro C Esteves
- Androfert, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, SP, Brazil
| | - Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
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66
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Alasmari W. Importance of the assessment of intracellular Ca 2+ level as diagnostic tool of dysfunctional sperm. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2017. [DOI: 10.1016/j.mefs.2017.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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67
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Majzoub A, Agarwal A, Esteves SC. Elucidating the clinical indications of sperm DNA fragmentation in male infertility. Transl Androl Urol 2017; 6:S658-S660. [PMID: 29082950 PMCID: PMC5643654 DOI: 10.21037/tau.2017.03.24] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, Brazil
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68
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Cho CL, Agarwal A, Majzoub A, Esteves SC. Clinical utility of sperm DNA fragmentation testing: concise practice recommendations. Transl Androl Urol 2017; 6:S366-S373. [PMID: 29082146 PMCID: PMC5643614 DOI: 10.21037/tau.2017.07.28] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Sperm DNA integrity is generally acknowledged as an essential component for human reproduction. While the negative impact of high sperm DNA fragmentation (SDF) on outcomes of natural pregnancy and assisted reproductive technology (ART) is well known, the clinical indication of SDF testing is less well defined. A recent review on clinical utility of SDF testing highlighted the different SDF assays and clinical indications of SDF testing. This concise practice recommendations aim at summarizing the evidence and presenting to the readers the essence of the clinical utility of SDF testing based on the currently existing evidence. The potential role of SDF testing in varicocelectomy candidates, couples with recurrent pregnancy loss, patients with unexplained infertility, couples with failed assisted reproduction, and infertile men with exposure to modifiable lifestyle risk factors is illustrated. Recommendations from an expert panel on each clinical condition is presented, with levels of evidence.
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Affiliation(s)
- Chak-Lam Cho
- Division of Urology, Department of Surgery, Kwong Wah Hospital, Hong Kong, China
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
| | - Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, University of Campinas (UNICAMP), Campinas, SP, Brazil.,Division of Urology, University of Campinas (UNICAMP), Campinas, SP, Brazil.,Faculty of Health, Department of Clinical Medicine, Aarhus University, Denmark
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69
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Kumaresan A, Johannisson A, Nordqvist S, Kårehed K, Åkerud H, Lindgren KE, Morrell JM. Relationship of DNA integrity to HRG C633T SNP and ART outcome in infertile couples. Reproduction 2017; 153:865-876. [PMID: 28356499 DOI: 10.1530/rep-17-0058] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/17/2017] [Accepted: 03/29/2017] [Indexed: 11/08/2022]
Abstract
The status of sperm DNA fragmentation, protamine deficiency, free thiols and disulphide bonds in colloid-selected samples and its relationship to ART outcome or HRG C633T SNP is not known. The objective of this study was to determine these relationships in spermatozoa from men with male factor or unknown factor infertility (n = 118) undergoing in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI). Sperm DNA integrity was analysed by flow cytometry using three fluorescent probes (acridine orange, monobromobimane and chromomycin A3). Principal component analysis (PCA) was used to identify the parameters that most influenced fertility. The relationships of sperm DNA integrity with seminal parameters, HRG C633T SNP and ART outcome were established using ANOVA and t-test. Sperm concentration and yield after preparation accounted for 27% of the total variance; sperm DNA integrity (%DFI and disulphide bonds) accounted for 16% of the variance in men from infertile couples. Sperm %DFI was significantly higher (P < 0.05) in older men than in younger men. A significant difference (P < 0.01) was observed in %DFI between smokers and non-smokers. Sperm %DFI was significantly higher (P < 0.01) in male factor infertility compared to either female factor or unknown factor infertility while free thiols were significantly higher (P < 0.01) in unknown infertility factor. No significant difference was observed between IVF success/failure in any of the seminal parameters studied. There was a tendency for protamine deficiency to be higher and disulphide concentration to be lower in men with HRG 633T. Such assessments may provide additional useful information about the prognosis for ART outcome, although more research is needed before clinical guidelines can be provided.
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Affiliation(s)
- Arumugam Kumaresan
- Department of Clinical Sciences/Division of ReproductionSwedish University of Agricultural Sciences, Uppsala, Sweden.,Theriogenology LaboratoryAnimal Reproduction, Gynaecology & Obstetrics, National Dairy Research Institute, Karnal, Haryana, India
| | - Anders Johannisson
- Department of Clinical Sciences/Division of ReproductionSwedish University of Agricultural Sciences, Uppsala, Sweden
| | - Sarah Nordqvist
- Department of GeneticsImmunology and Pathology, and Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Karin Kårehed
- Department of GeneticsImmunology and Pathology, and Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Helena Åkerud
- Department of GeneticsImmunology and Pathology, Uppsala University, Uppsala, Sweden
| | - Karin E Lindgren
- Department of GeneticsImmunology and Pathology, and Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Jane M Morrell
- Department of Clinical Sciences/Division of ReproductionSwedish University of Agricultural Sciences, Uppsala, Sweden
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70
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Simon L, Zini A, Dyachenko A, Ciampi A, Carrell DT. A systematic review and meta-analysis to determine the effect of sperm DNA damage on in vitro fertilization and intracytoplasmic sperm injection outcome. Asian J Androl 2017; 19:80-90. [PMID: 27345006 PMCID: PMC5227680 DOI: 10.4103/1008-682x.182822] [Citation(s) in RCA: 129] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Sperm DNA damage is prevalent among infertile men and is known to influence natural reproduction. However, the impact of sperm DNA damage on assisted reproduction outcomes remains controversial. Here, we conducted a meta-analysis of studies on sperm DNA damage (assessed by SCSA, TUNEL, SCD, or Comet assay) and clinical pregnancy after IVF and/or ICSI treatment from MEDLINE, EMBASE, and PUBMED database searches for this analysis. We identified 41 articles (with a total of 56 studies) including 16 IVF studies, 24 ICSI studies, and 16 mixed (IVF + ICSI) studies. These studies measured DNA damage (by one of four assays: 23 SCSA, 18 TUNEL, 8 SCD, and 7 Comet) and included a total of 8068 treatment cycles (3734 IVF, 2282 ICSI, and 2052 mixed IVF + ICSI). The combined OR of 1.68 (95% CI: 1.49–1.89; P < 0.0001) indicates that sperm DNA damage affects clinical pregnancy following IVF and/or ICSI treatment. In addition, the combined OR estimates of IVF (16 estimates, OR = 1.65; 95% CI: 1.34–2.04; P < 0.0001), ICSI (24 estimates, OR = 1.31; 95% CI: 1.08–1.59; P = 0.0068), and mixed IVF + ICSI studies (16 estimates, OR = 2.37; 95% CI: 1.89–2.97; P < 0.0001) were also statistically significant. There is sufficient evidence in the existing literature suggesting that sperm DNA damage has a negative effect on clinical pregnancy following IVF and/or ICSI treatment.
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Affiliation(s)
- Luke Simon
- Department of Surgery (Urology), University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Armand Zini
- Division of Urology, Department of Surgery, St. Mary's Hospital Center, St. Mary's Hospital, 3830 Lacombe Avenue, Montreal, Quebec H3T 1M5, Canada
| | - Alina Dyachenko
- Division of Urology, Department of Surgery, St. Mary's Hospital Center, St. Mary's Hospital, 3830 Lacombe Avenue, Montreal, Quebec H3T 1M5, Canada
| | - Antonio Ciampi
- Division of Urology, Department of Surgery, St. Mary's Hospital Center, St. Mary's Hospital, 3830 Lacombe Avenue, Montreal, Quebec H3T 1M5, Canada
| | - Douglas T Carrell
- Department of Surgery (Urology), University of Utah School of Medicine, Salt Lake City, UT, USA.,Department of Human Genetics, University of Utah School of Medicine, Salt Lake City, UT, USA.,Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT, USA
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71
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Chi HJ, Kwak SJ, Kim SG, Kim YY, Park JY, Yoo CS, Park IH, Sun HG, Kim JW, Lee KH. Efficient isolation of sperm with high DNA integrity and stable chromatin packaging by a combination of density-gradient centrifugation and magnetic-activated cell sorting. Clin Exp Reprod Med 2016; 43:199-206. [PMID: 28090458 PMCID: PMC5234288 DOI: 10.5653/cerm.2016.43.4.199] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 09/27/2016] [Accepted: 10/13/2016] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE This study was carried out to investigate the correlations of the sperm DNA fragmentation index (DFI) with semen parameters and apoptosis, and to investigate the effects of density-gradient centrifugation (DGC) and magnetic-activated cell sorting (MACS) on reducing the proportion of sperm with DNA fragmentation and protamine deficiency. METHODS Semen analysis and a sperm DNA fragmentation assay were performed to assess the correlations between semen parameters and the DFI in 458 semen samples. Sperm with progressive motility or non-apoptosis were isolated by DGC or MACS, respectively, in 29 normozoospermic semen samples. The effects of DGC or MACS alone and of DGC and MACS combined on reducing the amount of sperm in the sample with DNA fragmentation and protamine deficiency were investigated. RESULTS The sperm DFI showed a significant correlation (r=-0.347, p<0.001) with sperm motility and morphology (r=-0.114, p<0.05) but not with other semen parameters. The DFI (11.5%±2.0%) of semen samples was significantly reduced by DGC (8.1%±4.1%) or MACS alone (7.4%±3.9%) (p<0.05). The DFI was significantly further reduced by a combination of DGC and MACS (4.1%±1.3%, p<0.05). Moreover, the combination of DGC and MACS (1.6%±1.1%, p<0.05) significantly reduced the protamine deficiency rate of semen samples compared to DGC (4.4%±3.2%) or MACS alone (3.4%±2.2%). CONCLUSION The combination of DGC and MACS may be an effective method to isolate high-quality sperm with progressive motility, non-apoptosis, high DNA integrity, and low protamine deficiency in clinical use.
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Affiliation(s)
- Hee-Jun Chi
- IVF Center, Mamapapa and Baby Clinic, Ulsan, Korea
| | - Su-Jin Kwak
- IVF Center, Mamapapa and Baby Clinic, Ulsan, Korea
| | - Seok-Gi Kim
- IVF Center, Mamapapa and Baby Clinic, Ulsan, Korea
| | | | | | | | - Il-Hae Park
- IVF Center, Mamapapa and Baby Clinic, Ulsan, Korea
| | - Hong-Gil Sun
- IVF Center, Mamapapa and Baby Clinic, Ulsan, Korea
| | - Jae-Won Kim
- IVF Center, Mamapapa and Baby Clinic, Ulsan, Korea
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72
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Champroux A, Torres-Carreira J, Gharagozloo P, Drevet JR, Kocer A. Mammalian sperm nuclear organization: resiliencies and vulnerabilities. Basic Clin Androl 2016; 26:17. [PMID: 28031843 PMCID: PMC5175393 DOI: 10.1186/s12610-016-0044-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 11/12/2016] [Indexed: 01/07/2023] Open
Abstract
Sperm cells are remarkably complex and highly specialized compared to somatic cells. Their function is to deliver to the oocyte the paternal genomic blueprint along with a pool of proteins and RNAs so a new generation can begin. Reproductive success, including optimal embryonic development and healthy offspring, greatly depends on the integrity of the sperm chromatin structure. It is now well documented that DNA damage in sperm is linked to reproductive failures both in natural and assisted conception (Assisted Reproductive Technologies [ART]). This manuscript reviews recent important findings concerning - the unusual organization of mammalian sperm chromatin and its impact on reproductive success when modified. This review is focused on sperm chromatin damage and their impact on embryonic development and transgenerational inheritance.
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Affiliation(s)
- A. Champroux
- GReD “Genetics, Reproduction & Development” Laboratory, UMR CNRS 6293, INSERM U1103, Clermont Université, BP60026 - TSA60026, 63178 Aubière cedex, France
| | - J. Torres-Carreira
- Centro Universitário Rio Preto, UNIRP, Rodovia Br153, Km 69, CEP15093-450 São José do Rio Preto, São Paulo Brazil
| | - P. Gharagozloo
- CellOxess LLC, 830 Bear Tavern Road, Ewing, NJ 08628 USA
| | - J. R. Drevet
- GReD “Genetics, Reproduction & Development” Laboratory, UMR CNRS 6293, INSERM U1103, Clermont Université, BP60026 - TSA60026, 63178 Aubière cedex, France
| | - A. Kocer
- GReD “Genetics, Reproduction & Development” Laboratory, UMR CNRS 6293, INSERM U1103, Clermont Université, BP60026 - TSA60026, 63178 Aubière cedex, France
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73
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Bach PV, Schlegel PN. Sperm DNA damage and its role in IVF and ICSI. Basic Clin Androl 2016; 26:15. [PMID: 27980786 PMCID: PMC5137216 DOI: 10.1186/s12610-016-0043-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 10/12/2016] [Indexed: 11/10/2022] Open
Abstract
While the semen analysis has traditionally been relied upon to differentiate fertile and infertile men, its utility has been questioned in the current era of assisted reproductive technologies. The desire for more sophisticated diagnostic and predictive tools has led to increased use of sperm DNA damage in the management of male infertility. Despite the availability of numerous assays to measure sperm DNA damage, our understanding of the etiology, measurement, and clinical implications of sperm DNA damage remains incomplete. While the current evidence is fraught with heterogeneity that complicates attempts at comparison and meta-analysis, there does appear to be a role for sperm DNA damage in the development and maintenance of pregnancy in the era of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). However, as noted by the American Society for Reproductive Medicine, the routine and widespread use of sperm DNA damage testing is not yet supported. Further studies are needed to standardize the measurement of sperm DNA damage and to clarify the exact role of sperm DNA damage within the myriad of other male and female factors contributing to reproductive outcomes in IVF and ICSI.
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Affiliation(s)
- Phil Vu Bach
- Department of Urology, Weill Cornell Medicine, 525 East 68th Street, Starr 900, New York, NY 10065 USA
| | - Peter N Schlegel
- Department of Urology, Weill Cornell Medicine, 525 East 68th Street, Starr 900, New York, NY 10065 USA
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74
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Agarwal A, Majzoub A, Esteves SC, Ko E, Ramasamy R, Zini A. Clinical utility of sperm DNA fragmentation testing: practice recommendations based on clinical scenarios. Transl Androl Urol 2016; 5:935-950. [PMID: 28078226 PMCID: PMC5182232 DOI: 10.21037/tau.2016.10.03] [Citation(s) in RCA: 260] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Sperm DNA fragmentation (SDF) has been generally acknowledged as a valuable tool for male fertility evaluation. While its detrimental implications on sperm function were extensively investigated, little is known about the actual indications for performing SDF analysis. This review delivers practice based recommendations on commonly encountered scenarios in the clinic. An illustrative description of the different SDF measurement techniques is presented. SDF testing is recommended in patients with clinical varicocele and borderline to normal semen parameters as it can better select varicocelectomy candidates. High SDF is also linked with recurrent spontaneous abortion (RSA) and can influence outcomes of different assisted reproductive techniques. Several studies have shown some benefit in using testicular sperm rather than ejaculated sperm in men with high SDF, oligozoospermia or recurrent in vitro fertilization (IVF) failure. Infertile men with evidence of exposure to pollutants can benefit from sperm DNA testing as it can help reinforce the importance of lifestyle modification (e.g., cessation of cigarette smoking, antioxidant therapy), predict fertility and monitor the patient’s response to intervention.
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Affiliation(s)
- Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ahmad Majzoub
- Department of Urology, Glickman Urological and kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, SP, Brazil
| | - Edmund Ko
- Department of Urology, Loma Linda University, Loma Linda, California, USA
| | | | - Armand Zini
- Department of Urology, McGill University, Montreal, Canada
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75
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Xue LT, Wang RX, He B, Mo WY, Huang L, Wang SK, Mao XB, Cheng JP, Huang YY, Liu R. Effect of sperm DNA fragmentation on clinical outcomes for Chinese couples undergoing in vitro fertilization or intracytoplasmic sperm injection. J Int Med Res 2016; 44:1283-1291. [PMID: 28322098 PMCID: PMC5536744 DOI: 10.1177/0300060516664240] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective To investigate the effect of sperm DNA fragmentation on the fertilization rate, embryo development and pregnancy outcome of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in a cohort of Chinese couples. Methods Infertile couples that had undergone assisted reproductive technology at our centre between January 2011 and December 2013 were included in this retrospective study. Fractions of prepared sperm samples were evaluated for sperm DNA fragmentation on the day of oocyte recovery. Results Of the 550 couples selected, 415 had undergone IVF and 135 ICSI. Sperm DNA fragmentation rate was significantly negatively correlated with the fertilization rate in the ICSI cycles but not the IVF cycles. No association was found between sperm DNA fragmentation and cleavage rate or good quality embryo formation rates in IVF or ICSI cycles. Receiver operating characteristic (ROC) curve analysis showed that the sperm DNA fragmentation rate was a statistically significant prognostic indicator of the clinical fertilization rate in ICSI cycles; a rate > 22.3% was associated with a lower fertilization rate following ICSI compared with a rate ≤ 22.3%. Conclusions High values of sperm DNA fragmentation were associated with a low fertilization rate following ICSI but were not associated with alterations in pregnancy or live birth rates in either ICSI or IVF in this cohort of Chinese couples.
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Affiliation(s)
- Lin-Tao Xue
- 1 Center for Reproductive Medicine, First Hospital, Jilin University, Changchun, China.,2 Reproductive Medical and Genetic Centre, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Rui-Xue Wang
- 1 Center for Reproductive Medicine, First Hospital, Jilin University, Changchun, China
| | - Bing He
- 2 Reproductive Medical and Genetic Centre, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Wei-Ying Mo
- 2 Reproductive Medical and Genetic Centre, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Li Huang
- 2 Reproductive Medical and Genetic Centre, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Shi-Kai Wang
- 2 Reproductive Medical and Genetic Centre, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xian-Bao Mao
- 2 Reproductive Medical and Genetic Centre, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jun-Ping Cheng
- 2 Reproductive Medical and Genetic Centre, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Yue-Yue Huang
- 2 Reproductive Medical and Genetic Centre, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - RuiZhi Liu
- 1 Center for Reproductive Medicine, First Hospital, Jilin University, Changchun, China
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76
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Cissen M, Wely MV, Scholten I, Mansell S, Bruin JPD, Mol BW, Braat D, Repping S, Hamer G. Measuring Sperm DNA Fragmentation and Clinical Outcomes of Medically Assisted Reproduction: A Systematic Review and Meta-Analysis. PLoS One 2016; 11:e0165125. [PMID: 27832085 PMCID: PMC5104467 DOI: 10.1371/journal.pone.0165125] [Citation(s) in RCA: 204] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Sperm DNA fragmentation has been associated with reduced fertilization rates, embryo quality, pregnancy rates and increased miscarriage rates. Various methods exist to test sperm DNA fragmentation such as the sperm chromatin structure assay (SCSA), the sperm chromatin dispersion (SCD) test, the terminal deoxynucleotidyl transferase mediated deoxyuridine triphosphate nick end labelling (TUNEL) assay and the single cell gel electrophoresis (Comet) assay. We performed a systematic review and meta-analysis to assess the value of measuring sperm DNA fragmentation in predicting chance of ongoing pregnancy with IVF or ICSI. Out of 658 unique studies, 30 had extractable data and were thus included in the meta-analysis. Overall, the sperm DNA fragmentation tests had a reasonable to good sensitivity. A wide variety of other factors may also affect the IVF/ICSI outcome, reflected by limited to very low specificity. The constructed hierarchical summary receiver operating characteristic (HSROC) curve indicated a fair discriminatory capacity of the TUNEL assay (area under the curve (AUC) of 0.71; 95% CI 0.66 to 0.74) and Comet assay (AUC of 0.73; 95% CI 0.19 to 0.97). The SCSA and the SCD test had poor predictive capacity. Importantly, for the TUNEL assay, SCD test and Comet assay, meta-regression showed no differences in predictive value between IVF and ICSI. For the SCSA meta-regression indicated the predictive values for IVF and ICSI were different. The present review suggests that current sperm DNA fragmentation tests have limited capacity to predict the chance of pregnancy in the context of MAR. Furthermore, sperm DNA fragmentation tests have little or no difference in predictive value between IVF and ICSI. At this moment, there is insufficient evidence to recommend the routine use of sperm DNA fragmentation tests in couples undergoing MAR both for the prediction of pregnancy and for the choice of treatment. Given the significant limitations of the evidence and the methodological weakness and design of the included studies, we do urge for further research on the predictive value of sperm DNA fragmentation for the chance of pregnancy after MAR, also in comparison with other predictors of pregnancy after MAR.
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Affiliation(s)
- Maartje Cissen
- Department of Obstetrics & Gynaecology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - Madelon van Wely
- Center for Reproductive Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Irma Scholten
- Center for Reproductive Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Steven Mansell
- Department of Molecular and Cell Biology, University of California, Berkeley, California, United States of America
| | - Jan Peter de Bruin
- Department of Obstetrics & Gynaecology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - Ben Willem Mol
- The Robinson Institute/School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia
| | - Didi Braat
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sjoerd Repping
- Center for Reproductive Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Geert Hamer
- Center for Reproductive Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Witt KD, Beresford L, Bhattacharya S, Brian K, Coomarasamy A, Cutting R, Hooper R, Kirkman-Brown J, Khalaf Y, Lewis SE, Pacey A, Pavitt S, West R, Miller D, Cutting R. Hyaluronic Acid Binding Sperm Selection for assisted reproduction treatment (HABSelect): study protocol for a multicentre randomised controlled trial. BMJ Open 2016; 6:e012609. [PMID: 27855103 PMCID: PMC5073628 DOI: 10.1136/bmjopen-2016-012609] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION The selection of a sperm with good genomic integrity is an important consideration for improving intracytoplasmic sperm injection (ICSI) outcome. Current convention selects sperm by vigour and morphology, but preliminary evidence suggests selection based on hyaluronic acid binding may be beneficial. The aim of the Hyaluronic Acid Binding Sperm Selection (HABSelect) trial is to determine the efficacy of hyaluronic acid (HA)-selection of sperm versus conventionally selected sperm prior to ICSI on live birth rate (LBR). The mechanistic aim is to assess whether and how the chromatin state of HA-selected sperm corresponds with clinical outcomes-clinical pregnancy rate (CPR), LBR and pregnancy loss (PL). METHODS AND ANALYSIS Couples attending UK Centres will be approached, eligibility screening performed and informed consent sought. Randomisation will occur within 24 hours prior to ICSI treatment. Participants will be randomly allocated 1:1 to the intervention arm (physiological intracytoplasmic sperm injection, PICSI) versus the control arm using conventional methods (ICSI). The primary clinical outcome is LBR ≥37 weeks' gestation with the mechanistic study determining LBR's relationship with sperm DNA integrity. Secondary outcomes will determine this for CPR and PL. Only embryologists performing the procedure will be aware of the treatment allocation. Steps will be taken to militate against biases arising from embryologists being non-blinded. Randomisation will use a minimisation algorithm to balance for key prognostic variables. The trial is powered to detect a 5% difference (24-29%: p=0.05) in LBR ≥37 weeks' gestation. Selected residual sperm samples will be tested by one or more assays of DNA integrity. ETHICS AND DISSEMINATION HABSelect is a UK NIHR-EME funded study (reg no 11/14/34; IRAS REF. 13/YH/0162). The trial was designed in partnership with patient and public involvement to help maximise patient benefits. Trial findings will be reported as per CONSORT guidelines and will be made available in lay language via the trial web site (http://www.habselect.org.uk/). TRIAL REGISTRATION NUMBER ISRCTN99214271; Pre-results.
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Affiliation(s)
- K D Witt
- Department: Centre for Primary Care & Public Health, Queen Mary University of London, London, UK
| | - L Beresford
- Department: Centre for Primary Care & Public Health, Queen Mary University of London, London, UK
| | - S Bhattacharya
- School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK
| | - K Brian
- Charity Registration No. 1099960 (InfertilityNetworkUK), London, UK
| | - A Coomarasamy
- Centre for Human Reproductive Science, University of Birmingham, Birmingham Women's Fertility Centre, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Rachel Cutting
- Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, UK
| | - R Hooper
- Department: Centre for Primary Care & Public Health, Queen Mary University of London, London, UK
| | - J Kirkman-Brown
- Centre for Human Reproductive Science, University of Birmingham, Birmingham Women's Fertility Centre, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - Y Khalaf
- Assisted Conception Unit, Guy's and St Thomas's Hospital, London, UK
| | - S E Lewis
- Queen's University Belfast, Institute of Pathology, Belfast, UK
| | - A Pacey
- Department of Human Metabolism, University of Sheffield, Sheffield, UK
| | - S Pavitt
- Dental Translational and Clinical Research Unit, School of Dentistry, University of Leeds, Leeds, UK
| | - R West
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - D Miller
- Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, UK
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Hu MH, Liu SY, Wang N, Wu Y, Jin F. Impact of DNA mismatch repair system alterations on human fertility and related treatments. J Zhejiang Univ Sci B 2016; 17:10-20. [PMID: 26739522 DOI: 10.1631/jzus.b1500162] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
DNA mismatch repair (MMR) is one of the biological pathways, which plays a critical role in DNA homeostasis, primarily by repairing base-pair mismatches and insertion/deletion loops that occur during DNA replication. MMR also takes part in other metabolic pathways and regulates cell cycle arrest. Defects in MMR are associated with genomic instability, predisposition to certain types of cancers and resistance to certain therapeutic drugs. Moreover, genetic and epigenetic alterations in the MMR system demonstrate a significant relationship with human fertility and related treatments, which helps us to understand the etiology and susceptibility of human infertility. Alterations in the MMR system may also influence the health of offspring conceived by assisted reproductive technology in humans. However, further studies are needed to explore the specific mechanisms by which the MMR system may affect human infertility. This review addresses the physiological mechanisms of the MMR system and associations between alterations of the MMR system and human fertility and related treatments, and potential effects on the next generation.
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Affiliation(s)
- Min-hao Hu
- Key Laboratory of Reproductive Genetics (Zhejiang), Ministry of Education, and Centre of Reproductive Medicine, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Shu-yuan Liu
- Key Laboratory of Reproductive Genetics (Zhejiang), Ministry of Education, and Centre of Reproductive Medicine, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Ning Wang
- Key Laboratory of Reproductive Genetics (Zhejiang), Ministry of Education, and Centre of Reproductive Medicine, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Yan Wu
- Key Laboratory of Reproductive Genetics (Zhejiang), Ministry of Education, and Centre of Reproductive Medicine, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Fan Jin
- Key Laboratory of Reproductive Genetics (Zhejiang), Ministry of Education, and Centre of Reproductive Medicine, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
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79
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The important role of protamine in spermatogenesis and quality of sperm: A mini review. ASIAN PACIFIC JOURNAL OF REPRODUCTION 2016. [DOI: 10.1016/j.apjr.2016.07.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Uppangala S, Pudakalakatti S, D'souza F, Salian SR, Kalthur G, Kumar P, Atreya H, Adiga SK. Influence of sperm DNA damage on human preimplantation embryo metabolism. Reprod Biol 2016; 16:234-241. [PMID: 27492188 DOI: 10.1016/j.repbio.2016.07.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 07/22/2016] [Accepted: 07/23/2016] [Indexed: 12/15/2022]
Abstract
Understanding the embryo metabolic response to sperm induced specific abnormalities could help in developing the metabolic markers to prevent the transfer of embryos carrying sperm mediated defects. In this study, NMR based metabolic profiling of the embryo spent media was employed in 34 patients undergoing ICSI cycles. Processed ejaculates were tested for DNA damage using comet assay. Relative intensities of the metabolites from 74 embryo spent media samples from 34 patients and 23 medium controls were profiled using 1H NMR and compared between 'male-factor' and control groups. Relative intensities in the subgroups which are independent of patients with male factor or tubal factors, but related to the extent of sperm DNA damage were also compared. Sperm characteristics including DNA damage levels (Olive tail moment, OTM) were significantly different between 'male factor' and control groups (P<0.001-0.0001). Of the metabolites analyzed, glutamine intensity was significantly lower in 'male factor' group (P<0.01) whereas, pyruvate intensity was significantly lower in embryos derived from the processed sperm fraction having <1.0 OTM (P=0.003). In contrast glutamine and alanine intensities were significantly higher in the embryos derived from sperm population having OTM <1.0. (P=0.03 & 0.005 respectively). Pyruvate to alanine ratio was significantly lower in <1.0 OTM group (P<0.0001). This study indicates that increased level of sperm DNA damage in the processed ejaculate affects embryo metabolism which could be related to embryonic genetic integrity.
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Affiliation(s)
- Shubhashree Uppangala
- Division of Clinical Embryology, Kasturba Medical College, Manipal University, Manipal, India
| | | | - Fiona D'souza
- Division of Clinical Embryology, Kasturba Medical College, Manipal University, Manipal, India
| | - Sujith Raj Salian
- Division of Clinical Embryology, Kasturba Medical College, Manipal University, Manipal, India
| | - Guruprasad Kalthur
- Division of Clinical Embryology, Kasturba Medical College, Manipal University, Manipal, India
| | - Pratap Kumar
- Department of Obstetrics & Gynecology, Kasturba Medical College, Manipal University, Manipal, India
| | - Hanudatta Atreya
- NMR Research Centre, Indian Institute of Science, Bangalore, India; Solid State and Structural Chemistry Unit, Indian Institute of Science, Bangalore, India.
| | - Satish Kumar Adiga
- Division of Clinical Embryology, Kasturba Medical College, Manipal University, Manipal, India.
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81
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Simon L, Aston KI, Emery BR, Hotaling J, Carrell DT. Sperm DNA damage output parameters measured by the alkaline Comet assay and their importance. Andrologia 2016; 49. [DOI: 10.1111/and.12608] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2016] [Indexed: 01/10/2023] Open
Affiliation(s)
- L. Simon
- Andrology and IVF Laboratory; Department of Surgery (Urology); University of Utah; Salt Lake City UT USA
| | - K. I. Aston
- Andrology and IVF Laboratory; Department of Surgery (Urology); University of Utah; Salt Lake City UT USA
| | - B. R. Emery
- Andrology and IVF Laboratory; Department of Surgery (Urology); University of Utah; Salt Lake City UT USA
| | - J. Hotaling
- Andrology and IVF Laboratory; Department of Surgery (Urology); University of Utah; Salt Lake City UT USA
| | - D. T. Carrell
- Andrology and IVF Laboratory; Department of Surgery (Urology); University of Utah; Salt Lake City UT USA
- Department of Obstetrics and Gynecology; University of Utah; Salt Lake City UT USA
- Department of Human Genetics; University of Utah; Salt Lake City UT USA
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Muratori M, Tarozzi N, Cambi M, Boni L, Iorio AL, Passaro C, Luppino B, Nadalini M, Marchiani S, Tamburrino L, Forti G, Maggi M, Baldi E, Borini A. Variation of DNA Fragmentation Levels During Density Gradient Sperm Selection for Assisted Reproduction Techniques: A Possible New Male Predictive Parameter of Pregnancy? Medicine (Baltimore) 2016; 95:e3624. [PMID: 27196465 PMCID: PMC4902407 DOI: 10.1097/md.0000000000003624] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Predicting the outcome of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) is one main goal of the present research on assisted reproduction. To understand whether density gradient centrifugation (DGC), used to select sperm, can affect sperm DNA integrity and impact pregnancy rate (PR), we prospectively evaluated sperm DNA fragmentation (sDF) by TUNEL/PI, before and after DGC. sDF was studied in a cohort of 90 infertile couples the same day of IVF/ICSI treatment. After DGC, sDF increased in 41 samples (Group A, median sDF value: 29.25% [interquartile range, IQR: 16.01-41.63] in pre- and 60.40% [IQR: 32.92-93.53] in post-DGC) and decreased in 49 (Group B, median sDF value: 18.84% [IQR: 13.70-35.47] in pre- and 8.98% [IQR: 6.24-15.58] in post-DGC). PR was 17.1% and 34.4% in Group A and B, respectively (odds ratio [OR]: 2.58, 95% confidence interval [CI]: 0.95-7.04, P = 0.056). After adjustment for female factor, female and male age and female BMI, the estimated OR increased to 3.12 (95% CI: 1.05-9.27, P = 0.041). According to the subgroup analysis for presence/absence of female factor, heterogeneity in the association between the Group A and B and PR emerged (OR: 4.22, 95% CI: 1.16-15.30 and OR: 1.53, 95% CI: 0.23-10.40, respectively, for couples without, n = 59, and with, n = 31, female factor).This study provides the first evidence that the DGC procedure produces an increase in sDF in about half of the subjects undergoing IVF/ICSI, who then show a much lower probability of pregnancy, raising concerns about the safety of this selection procedure. Evaluation of sDF before and after DGC configures as a possible new prognostic parameter of pregnancy outcome in IVF/ICSI. Alternative sperm selection strategies are recommended for those subjects who undergo the damage after DGC.
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Affiliation(s)
- Monica Muratori
- From the Department of Experimental, Clinical and Biomedical Sciences, Unit of Sexual Medicine and Andrology, Center of Excellence DeNothe, University of Florence (MM, MC, ALI, CP, BL, SM, LT, GF, MM, EB); Tecnobios Procreazione, Centre for Reproductive Health, Bologna (NT, MN, AB); and Clinical Trials Coordinating Center, AOU Careggi, Istituto Toscano Tumori, Florence (LB), Italy
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Magdi Y, Darwish E, Elbashir S, Ahmed Elawady M. Evaluation of DNA fragmentation in teratozoospermic infertile men compared with normozoospermic fertile men and its correlation with sperm morphology. ACTA ACUST UNITED AC 2015. [DOI: 10.1097/01.xha.0000475198.30247.53] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lukaszuk K, Wcislo M, Liss J, Stachowicz A, Jakiel G, Lukaszuk M, Pastuszek E, Woclawek-Potocka I, Galvao A, Bialobrzeska D. First Pregnancy, Somatic and Psychological Status of a 4-Year-Old Child Born following Annexin V TESA Sperm Separation. AJP Rep 2015; 5:e105-8. [PMID: 26495164 PMCID: PMC4603856 DOI: 10.1055/s-0035-1548726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 02/12/2015] [Indexed: 01/14/2023] Open
Abstract
Introduction Sperm DNA integrity is a crucial paternal factor affecting fertilization and pregnancy rates, as well as embryo development. Case The present case report describes the successful pregnancy after testicular sperm aspiration (TESA) combined with intracytoplasmic sperm injection (ICSI) (TESA-ICSI) in a couple where the male presented high sperm DNA fragmentation. In order to sort damaged sperm presenting DNA fragmentation, magnetic activated cell sorting (MACS) with annexin V microbeads (MACS Miltenyi Biotec, Teterow, Germany) was used. Conclusion The authors present the first description of a successful medical case using TESA-ICSI annexin V sperm sorting. Additionally, a follow-up of the child at the age of 4 years old was done.
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Affiliation(s)
- Krzysztof Lukaszuk
- INVICTA Fertility and Reproductive Centre, Gdańsk, Poland ; INVICTA Fertility and Reproductive Centre, Warsaw, Poland ; Department of Obstetrics and Gynecological Nursing, Medical University of Gdansk, Gdańsk, Poland ; Department of Obstetrics and Gynaecology, The Medical Center of Postgraduate Education, Warsaw, Poland
| | - Monika Wcislo
- INVICTA Fertility and Reproductive Centre, Warsaw, Poland
| | - Joanna Liss
- INVICTA Fertility and Reproductive Centre, Gdańsk, Poland
| | - Anna Stachowicz
- Department of Obstetrics and Gynaecology, The Medical Center of Postgraduate Education, Warsaw, Poland
| | - Grzegorz Jakiel
- Department of Obstetrics and Gynaecology, The Medical Center of Postgraduate Education, Warsaw, Poland
| | | | - Ewa Pastuszek
- INVICTA Fertility and Reproductive Centre, Gdańsk, Poland ; Department of Obstetrics and Gynecological Nursing, Medical University of Gdansk, Gdańsk, Poland
| | - Izabela Woclawek-Potocka
- Department of Reproductive Immunology and Pathology, Institute of Animal Reproduction and Food Research, Olsztyn, Poland
| | - Antonio Galvao
- Department of Reproductive Immunology and Pathology, Institute of Animal Reproduction and Food Research, Olsztyn, Poland
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Susilowati S, Triana IN, Malik A. The effects of insulin-like growth factor I (IGF-I) complex from seminal plasma on capacitation, membrane integrity and DNA fragmentation in goat spermatozoa. ASIAN PACIFIC JOURNAL OF REPRODUCTION 2015. [DOI: 10.1016/j.apjr.2015.06.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Razi M, Malekinejad H. Varicocele-Induced Infertility in Animal Models. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2015; 9:141-9. [PMID: 26246871 PMCID: PMC4518481 DOI: 10.22074/ijfs.2015.4234] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 03/10/2014] [Indexed: 01/05/2023]
Abstract
Varicocele is characterized by abnormal tortuosity and dilation of the veins of the pampiniform
plexus within the spermatic cord. Although several reports show the mechanisms
by which the varicocele exerts its infertility impact, the exact pathophysiology for
varicocele-induced inflammation and its relationship with testicular endocrine disruption
remain largely unknown. This review article will update previous findings by discussing
the pathophysiology of long term-induced varicocele in rats. Testicular endocrine
disruption in experimentally-induced varicocele, new findings related to biochemical
alterations in germinal epithelium, and sperm cells apoptosis are highlighted. Recent
observations show that varicocele down-regulates first and second maturation divisions,
results in Leydig and Sertoli cell inflammation, and increases immune cell infiltration in
the testes of the rat as an animal model. Ultimately, previous findings of our laboratory
have revealed that varicocele decreased sperm motility, viability and severe DNA damage.
Damage in sperm significantly lowers the animal’s fertility potential. Varicocele not
only exerts its pathologic impact by lowering the testicular antioxidant capacity but it
also down-regulates first and second maturation divisions by exerting biochemical alterations
such as reducing the intracytoplasmic carbohydrate ratio in germinal epithelium.
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Affiliation(s)
- Mazdak Razi
- Department of Histology, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Hassan Malekinejad
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran ; Department of Pharmacology and Toxicology, Faculty of Pharmacy, Urmia Medical University, Urmia, Iran Abstract
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Zhong HZ, Lv FT, Deng XL, Hu Y, Xie DN, Lin B, Mo ZN, Lin FQ. Evaluating γH2AX in spermatozoa from male infertility patients. Fertil Steril 2015; 104:574-81. [PMID: 26158906 DOI: 10.1016/j.fertnstert.2015.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 06/03/2015] [Accepted: 06/04/2015] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To investigate whether γH2AX levels were different in the spermatozoa of healthy men compared with infertility patients, and to assess the possible correlations between γH2AX and conventional semen parameters and double-stranded breaks (DSBs) identified with the use of comet assay. DESIGN Prospective study. SETTING Clinical laboratory. PATIENT(S) Semen from 100 male infertile patients and 100 healthy sperm donors. INTERVENTION(S) Human sperm samples were analyzed in terms of World Health Organization parameters. The γH2AX levels were detected by means of flow cytometry. DSBs of sperm were detected by means of comet assay. Morphology slides were made and the sperm morphology assessed according to strict criteria. MAIN OUTCOME MEASURE(S) Conventional semen analyses, γH2AX levels in sperm, DNA DSBs in sperm, and correlations among γH2AX, conventional semen analyses, and DSBs. RESULT(S) Concentration, viability, motility, and normal sperm morphology were significantly lower in male infertility patients compared with healthy men. Also, γH2AX levels and the number of DSBs were significantly higher in the sperm of infertile subjects compared with healthy men. γH2AX levels correlated negatively with conventional semen parameters and positively with DSBs. A threshold γH2AX level of 18.55% was identified as a cutoff value to discriminate infertile subjects from fertile control subjects with a specificity of 86.0% and a sensitivity of 83.0%. The positive and negative predictive values of the 18.55% γH2AX threshold were high: 87.7% and 85.5%, respectively. CONCLUSION(S) γH2AX levels were higher in the sperm of male infertility patients than in healthy men. γH2AX levels in sperm, as evaluated with the use of flow cytometry, might be a useful biomarker for evaluating DSBs in human spermatozoa.
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Affiliation(s)
- Hui-zhi Zhong
- First Affiliated Hospital of Guangxi Medical University, Guangxi, People's Republic of China
| | - Fu-tong Lv
- Research Center for Population and Family Planning of Guangxi Zhuang Autonomous Region, Guangxi, People's Republic of China
| | - Xue-lian Deng
- First Affiliated Hospital of Guangxi Medical University, Guangxi, People's Republic of China
| | - Ying Hu
- First Affiliated Hospital of Guangxi Medical University, Guangxi, People's Republic of China
| | - Dan-ni Xie
- Research Center for Population and Family Planning of Guangxi Zhuang Autonomous Region, Guangxi, People's Republic of China
| | - Bin Lin
- First Affiliated Hospital of Guangxi Medical University, Guangxi, People's Republic of China
| | - Zeng-nan Mo
- First Affiliated Hospital of Guangxi Medical University, Guangxi, People's Republic of China
| | - Fa-quan Lin
- First Affiliated Hospital of Guangxi Medical University, Guangxi, People's Republic of China.
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88
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Yang Q, Zhang N, Zhao F, Zhao W, Dai S, Liu J, Bukhari I, Xin H, Niu W, Sun Y. Processing of semen by density gradient centrifugation selects spermatozoa with longer telomeres for assisted reproduction techniques. Reprod Biomed Online 2015; 31:44-50. [DOI: 10.1016/j.rbmo.2015.02.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 02/11/2015] [Accepted: 02/24/2015] [Indexed: 11/17/2022]
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89
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Jin J, Pan C, Fei Q, Ni W, Yang X, Zhang L, Huang X. Effect of sperm DNA fragmentation on the clinical outcomes for in vitro fertilization and intracytoplasmic sperm injection in women with different ovarian reserves. Fertil Steril 2015; 103:910-6. [PMID: 25747135 DOI: 10.1016/j.fertnstert.2015.01.014] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Revised: 12/30/2014] [Accepted: 01/09/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate effect of sperm DNA fragmentation (SDF) on clinical outcomes of assisted reproductive technology in women with normal ovarian reserve (NOR) versus reduced ovarian reserve (ROR). DESIGN Retrospective clinical study. SETTING University-affiliated tertiary teaching hospital. PATIENT(S) A total of 2,865 consecutive couples undergoing their first in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycle. INTERVENTION(S) SDF assessed using sperm chromatin dispersion in sperm samples 1-2 months before treatment. MAIN OUTCOME MEASURE(S) SDF, IVF, and ICSI outcomes. RESULT(S) The grouping criteria were [1] basal follicle stimulating hormone >10 IU/L, [2] antral follicle count <6, and [3] female age ≥38 years. Women fulfilling two of the three criteria were considered to have ROR, and those not meeting any criteria were considered to have NOR. The area under the receiver operating characteristic curve was 0.594 (0.539-0.648) for the ROR group and 0.510 (0.491-0.530) for the NOR group. A cutoff value for SDF to predict the clinical pregnancy rate (CPR) in the ROR group was 27.3%. When the SDF exceeded 27.3%, the live-birth and implantation rates in the ROR group were statistically significantly decreased, but the clinical pregnancy, live-birth, and implantation rates were not affected in the NOR group. The risk of early abortion increased significantly in the NOR group when the SDF exceeded 27.3%. CONCLUSION(S) Sperm DNA fragmentation has a greater impact on IVF and ICSI outcomes among women with ROR, so SDF testing may be of particular clinical significance for these couples.
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Affiliation(s)
- Jianyuan Jin
- Reproductive Medicine Center, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Chengshuang Pan
- Reproductive Medicine Center, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Qianjin Fei
- Reproductive Medicine Center, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Wuhua Ni
- Reproductive Medicine Center, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Xu Yang
- Reproductive Medicine Center, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Liya Zhang
- Reproductive Medicine Center, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Xuefeng Huang
- Reproductive Medicine Center, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.
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90
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Osman A, Alsomait H, Seshadri S, El-Toukhy T, Khalaf Y. The effect of sperm DNA fragmentation on live birth rate after IVF or ICSI: a systematic review and meta-analysis. Reprod Biomed Online 2014; 30:120-7. [PMID: 25530036 DOI: 10.1016/j.rbmo.2014.10.018] [Citation(s) in RCA: 201] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 10/14/2014] [Accepted: 10/29/2014] [Indexed: 01/17/2023]
Abstract
A systematic review and meta-analysis was conducted to evaluate the relationship between the extent of sperm DNA damage and live birth rate (LBR) per couple and the influence of the method of fertilization on treatment outcome. Searches were conducted on MEDLINE, EMBASE and Cochrane Library. Six studies were eligible for inclusion in the meta-analysis. Overall, LBR increased signficantly in couples with low sperm DNA fragmentation compared with those with high sperm DNA fragmentation (RR 1.17, 95% CI 1.07 to 1.28; P = 0.0005). After IVF and intracytoplasmic sperm injection (ICSI), men with low sperm DNA fragmentation had significantly higher LBR (RR 1.27, 95% CI 1.05 to 1.52; P = 0.01) and (RR 1.11, 95% CI 1.00 to 1.23, P = 0.04), respectively. A sensitivity analysis showed no statistically significant difference in LBR between low and high sperm DNA fragmentation when ICSI treatment was used (RR 1.08, 95% CI 0.39 to 2.96; P = 0.88). High sperm DNA fragmentation in couples undergoing assisted reproduction techniques is associated with lower LBR. Well-designed randomized studies are required to assess the role of ICSI over IVF in the treatment of men with high sperm DNA fragmentation.
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Affiliation(s)
- A Osman
- Assisted Conception Unit, Guys Hospital, Great Maze Pond, SE1 9RT, UK.
| | - H Alsomait
- Assisted Conception Unit, Guys Hospital, Great Maze Pond, SE1 9RT, UK
| | - S Seshadri
- Assisted Conception Unit, Guys Hospital, Great Maze Pond, SE1 9RT, UK
| | - T El-Toukhy
- Assisted Conception Unit, Guys Hospital, Great Maze Pond, SE1 9RT, UK
| | - Y Khalaf
- Assisted Conception Unit, Guys Hospital, Great Maze Pond, SE1 9RT, UK
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91
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Decrease in fertilization and cleavage rates, but not in clinical outcomes for infertile men with AZF microdeletion of the Y chromosome. ZYGOTE 2014; 23:771-7. [PMID: 25315024 DOI: 10.1017/s096719941400046x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This study aimed to explore whether the presence of a Y chromosome azoospermia factor (AZF) microdeletion confers any adverse effect on embryonic development and clinical outcomes after intracytoplasmic sperm injection (ICSI) treatment. Fifty-seven patients with AZF microdeletion were included in the present study and 114 oligozoospermia and azoospermia patients without AZF microdeletion were recruited as controls. Both AZF and control groups were further divided into subgroups based upon the methods of semen collection: the AZF-testicular sperm extraction subgroup (AZF-TESE, n = 14), the AZF-ejaculation subgroup (AZF-EJA, n = 43), the control-TESE subgroup (n = 28) and the control-EJA subgroup (n = 86). Clinical data were analyzed in the two groups and four subgroups respectively. A retrospective case-control study was performed. A significantly lower fertilization rate (69.27 versus 75.70%, P = 0.000) and cleavage rate (89.55 versus 94.39%, P = 0.000) was found in AZF group compared with the control group. Furthermore, in AZF-TESE subgroup, the fertilization rate (67.54 versus 74.25%, P = 0.037) and cleavage rate (88.96 versus 94.79%, P = 0.022) were significantly lower than in the control-TESE subgroup; similarly, the fertilization rate (69.85 versus 75.85%, P = 0.004) and cleavage rate (89.36 versus 94.26%, P = 0.002) in AZF-EJA subgroup were significantly lower than in the control-EJA subgroup; however, the fertilization rate and cleavage rate in AZF-TESE (control-TESE) subgroup was similar to that in the AZF-EJA (control-EJA) subgroup. The other clinical outcomes were comparable between four subgroups (P > 0.05). Therefore, sperm from patients with AZF microdeletion, obtained either by ejaculation or TESE, may have lower fertilization and cleavage rates, but seem to have comparable clinical outcomes to those from patients without AZF microdeletion.
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92
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Wang M, Sun J, Wang L, Gao X, Lu X, Wu Z, Wang Y, Liu K, Tao J, Wu Y. Assessment of density gradient centrifugation (DGC) and sperm chromatin dispersion (SCD) measurements in couples with male factor infertility undergoing ICSI. J Assist Reprod Genet 2014; 31:1655-63. [PMID: 25227693 DOI: 10.1007/s10815-014-0339-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Accepted: 08/28/2014] [Indexed: 10/24/2022] Open
Abstract
PURPOSE To investigate how effectively density gradient centrifugation (DGC) improves sperm nuclear integrity and to determine whether the sperm chromatin dispersion (SCD) test of sperm nuclear integrity in native or DGC-treated semen can predict the outcome of assisted reproductive technology (ART) in couples undergoing intracytoplasmic sperm injection (ICSI). METHODS The DNA integrity of spermatozoa from 63 male factor infertility patients undergoing ICSI was analyzed by the SCD test before and after DGC. The predictive value of the sperm DNA fragmentation index (DFI) for ART outcomes was assessed in a cohort of 45 patients who were undergoing fresh embryo transfer. For the analysis, they were divided into pregnant and non-pregnant groups and, independently, into high sperm DFI (DFI > 30%) and low sperm DFI (DFI ≤ 30%) groups. Both raw and DGC semen parameters were examined. RESULTS In the asthenospermia and oligozoospermia groups, DGC decreased the sperm DFI from 31.5 ± 19.7 and 28.5 ± 10.3 to 19.2 ± 18.3 and 16.0 ± 12.8, respectively (P < 0.01). DGC decreased the sperm DFI in the severe oligozoospermia group from 41.4 ± 19.0 to 36.3 ± 20.6 (P > 0.01). The pregnant and non-pregnant groups did not differ in their fertilization rate and sperm DFI in native or DGC semen (P > 0.05). There was also no significant difference between the high sperm DFI (DFI > 30%) and low sperm DFI (DFI ≤ 30 %) groups with regard to fertilization rate, implantation rate, and clinical pregnancy rate for both native and DGC semen (P > 0.05). The patients undergoing ICSI with a high sperm DFI had a higher pregnancy loss rate (defined as spontaneous miscarriage or biochemical pregnancy) compared with patients with a low sperm DFI in both the native and DGC semen groups. CONCLUSIONS DGC highly significantly reduces sperm DNA fragmentation in the semen of ICSI patients, with the exception of those with severe oligozoospermia. The results of the SCD test of sperm DNA fragmentation in native or DGC semen do not correlate with the fertilization rate, implantation rate, or clinical pregnancy rate in patients undergoing ICSI.
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Affiliation(s)
- Min Wang
- Reproductive Medical Center, International Peace Maternity and Child Health Hospital Affiliated, Shanghai Jiaotong University, Shanghai, People's Republic of China
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93
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Ramalho-Santos J. Sins of the fathers: sperm DNA damage in the context of assisted reproduction. Hum Reprod 2014; 29:2356-8. [DOI: 10.1093/humrep/deu229] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
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94
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Simon L, Murphy K, Shamsi MB, Liu L, Emery B, Aston KI, Hotaling J, Carrell DT. Paternal influence of sperm DNA integrity on early embryonic development. Hum Reprod 2014; 29:2402-12. [PMID: 25205757 DOI: 10.1093/humrep/deu228] [Citation(s) in RCA: 174] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
STUDY QUESTION Does sperm DNA damage affect early embryonic development? SUMMARY ANSWER Increased sperm DNA damage adversely affects embryo quality starting at Day 2 of early embryonic development and continuing after embryo transfer, resulting in reduced implantation rates and pregnancy outcomes. WHAT IS KNOWN ALREADY Abnormalities in the sperm DNA in the form of single and double strand breaks can be assessed by an alkaline Comet assay. Some prior studies have shown a strong paternal effect of sperm DNA damage on IVF outcome, including reduced fertilization, reduced embryo quality and cleavage rates, reduced numbers of embryos developing into blastocysts, increased percentage of embryos undergoing developmental arrest, and reduced implantation and pregnancy rates. STUDY DESIGN, SIZE, DURATION A cross-sectional study of 215 men from infertile couples undergoing assisted reproduction techniques at the University of Utah Center for Reproductive Medicine. PARTICIPANTS/MATERIALS, SETTING, METHODS Sperm from men undergoing ART were analyzed for DNA damage using an alkaline Comet assay and classified into three groups: 'low damage' (0-30%), 'intermediate damage' (31-70%) and 'high damage' (71-100%). The cause of couples' infertility was categorized into one of the three types (male, female or unexplained). Each embryo was categorized as 'good', 'fair' or 'poor' quality, based on the number and grade of blastomeres. The influence of sperm DNA damage on early embryonic development was observed and classified into four stages: peri-fertilization effect (fertilization rate), early paternal effect (embryonic days 1-2), late paternal effect (embryonic days 3-5) and implantation stage effect. MAIN RESULTS AND THE ROLE OF CHANCE The paternal effect of sperm DNA damage was observed at each stage of early embryonic development. The peri-fertilization effect was higher in oocytes from patients with female infertility (20.85%) compared with male (8.22%; P < 0.001) and unexplained (7.30%; P < 0.001) infertility factors. In both the early and late paternal effect stages, the low DNA damage group had a higher percentage of good quality embryos (P < 0.05) and lower percentage of poor quality embryos (P < 0.05) compared with the high DNA damage group. Implantation was lower in the high DNA damage (33.33%) compared with intermediate DNA damage (55.26%; P < 0.001) and low DNA damage (65.00%; P < 0.001) groups. The implantation rate was higher following blastocyst transfer (58.33%), when compared with early stage blastocyst (53.85%; P = 0.554) and cavitating morula transfers (34.40%; P < 0.001). Implantation was higher when the female partner age was ≤35 years when compared with >35 year age group (52.75 versus 35.44%; P = 0.008). LIMITATIONS, REASONS FOR CAUTION A potential limitation of this study is that it is cross-sectional. Generally in such studies more than one variable could affect the outcome. Analyzing sperm is one part of the equation but a number of environmental and female factors also have the potential to influence embryo development and implantation. Furthermore, the selection of morphologically normal and physiologically motile sperm may result in isolation of sperm with reduced DNA damage. Therefore, selecting the best available sperm for ICSI may lead to experimental bias, as the selected sperm do not represent the overall sperm population in which the DNA damage is measured. Similar studies on selected sperm and with a larger sample size are now required. WIDER IMPLICATIONS OF THE FINDINGS The paternal influence of damaged chromatin is more prominent after zygotic transcriptional activation. A prolonged paternal effect on the developing embryo may be due to the active repair mechanism present in oocytes that tends to overcome the damaged paternal chromatin. The probability of eliminating an embryo fertilized by a sperm with damaged DNA is higher at the blastocyst stage than the cleavage stage; therefore blastocyst transfer could be recommended for better implantation success. Finally, we recommend ICSI treatment for patients with a higher percentage of sperm with DNA damage as well as additional studies with a larger sample size aimed at assessing DNA damage analysis as a diagnostic tool for IVF. STUDY FUNDING/COMPETING INTERESTS This work was supported by the University of Utah internal funds. The authors declare no competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- L Simon
- Andrology and IVF Laboratory, Department of Surgery (Urology), University of Utah, Salt Lake City, UT 84108, USA
| | - K Murphy
- Andrology and IVF Laboratory, Department of Surgery (Urology), University of Utah, Salt Lake City, UT 84108, USA
| | - M B Shamsi
- Andrology and IVF Laboratory, Department of Surgery (Urology), University of Utah, Salt Lake City, UT 84108, USA
| | - L Liu
- Andrology and IVF Laboratory, Department of Surgery (Urology), University of Utah, Salt Lake City, UT 84108, USA
| | - B Emery
- Andrology and IVF Laboratory, Department of Surgery (Urology), University of Utah, Salt Lake City, UT 84108, USA
| | - K I Aston
- Andrology and IVF Laboratory, Department of Surgery (Urology), University of Utah, Salt Lake City, UT 84108, USA
| | - J Hotaling
- Andrology and IVF Laboratory, Department of Surgery (Urology), University of Utah, Salt Lake City, UT 84108, USA
| | - D T Carrell
- Andrology and IVF Laboratory, Department of Surgery (Urology), University of Utah, Salt Lake City, UT 84108, USA Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT 84108, USA Department of Human Genetics, University of Utah, Salt Lake City, UT 84108, USA
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95
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Tandara M, Bajić A, Tandara L, Bilić-Zulle L, Šunj M, Kozina V, Goluža T, Jukić M. Sperm DNA integrity testing: big halo is a good predictor of embryo quality and pregnancy after conventional IVF. Andrology 2014; 2:678-86. [DOI: 10.1111/j.2047-2927.2014.00234.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 04/19/2014] [Accepted: 05/12/2014] [Indexed: 01/06/2023]
Affiliation(s)
- M. Tandara
- Department of Human Reproduction; Clinic for Women's Diseases and Obstetrics of University Hospital Center Split; Split Croatia
| | - A. Bajić
- Department of Human Reproduction; Clinic for Women's Diseases and Obstetrics of University Hospital Center Split; Split Croatia
| | - L. Tandara
- Department of Medical Laboratory Diagnosis; University Hospital Center Split; Split Croatia
| | - L. Bilić-Zulle
- Clinical Department of Laboratory Diagnosis; Clinical Hospital Center Rijeka and Department of Medical Informatics; Rijeka University School of Medicine; Rijeka Croatia
| | - M. Šunj
- Department of Human Reproduction; Clinic for Women's Diseases and Obstetrics of University Hospital Center Split; Split Croatia
| | - V. Kozina
- Department of Histology and Embryology; School of Medicine; University of Zagreb; Zagreb Croatia
| | - T. Goluža
- Department of Gynecology and Obstetrics; School of Medicine; University of Zagreb; Zagreb Croatia
| | - M. Jukić
- Department of Human Reproduction; Clinic for Women's Diseases and Obstetrics of University Hospital Center Split; Split Croatia
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96
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Belloc S, Hazout A, Zini A, Merviel P, Cabry R, Chahine H, Copin H, Benkhalifa M. How to overcome male infertility after 40: Influence of paternal age on fertility. Maturitas 2014; 78:22-9. [DOI: 10.1016/j.maturitas.2014.02.011] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 02/19/2014] [Accepted: 02/21/2014] [Indexed: 12/13/2022]
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97
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Ni W, Xiao S, Qiu X, Jin J, Pan C, Li Y, Fei Q, Yang X, Zhang L, Huang X. Effect of sperm DNA fragmentation on clinical outcome of frozen-thawed embryo transfer and on blastocyst formation. PLoS One 2014; 9:e94956. [PMID: 24733108 PMCID: PMC3986272 DOI: 10.1371/journal.pone.0094956] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 03/21/2014] [Indexed: 12/20/2022] Open
Abstract
During the last decades, many studies have shown the possible influence of sperm DNA fragmentation on assisted reproductive technique outcomes. However, little is known about the impact of sperm DNA fragmentation on the clinical outcome of frozen-thawed embryo transfer (FET) from cycles of conventional in vitro fertilization (IVF) and intra-cytoplasmic sperm injection (ICSI). In the present study, the relationship between sperm DNA fragmentation (SDF) and FET clinical outcomes in IVF and ICSI cycles was analyzed. A total of 1082 FET cycles with cleavage stage embryos (C-FET) (855 from IVF and 227 from ICSI) and 653 frozen-thawed blastocyst transfer cycles (B-FET) (525 from IVF and 128 from ICSI) were included. There was no significant change in clinical pregnancy, biochemical pregnancy and miscarriage rates in the group with a SDF >30% compared with the group with a SDF ≤30% in IVF and ICSI cycles with C-FET or B-FET. Also, there was no significant impact on the FET clinic outcome in IVF and ICSI when different values of SDF (such as 10%, 20%, 25%, 35%, and 40%) were taken as proposed threshold levels. However, the blastulation rates were significantly higher in the SDF ≤30% group in ICSI cycle. Taken together, our data show that sperm DNA fragmentation measured by Sperm Chromatin Dispersion (SCD) test is not associated with clinical outcome of FET in IVF and ICSI. Nonetheless, SDF is related to the blastocyst formation in ICSI cycles.
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Affiliation(s)
- Wuhua Ni
- Reproductive Medical Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Shiquan Xiao
- Reproductive Medical Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiufang Qiu
- Reproductive Medical Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jianyuan Jin
- Reproductive Medical Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chengshuang Pan
- Reproductive Medical Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yan Li
- Reproductive Medical Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Qianjin Fei
- Reproductive Medical Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xu Yang
- Reproductive Medical Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Liya Zhang
- Reproductive Medical Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xuefeng Huang
- Reproductive Medical Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
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98
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Anifandis G, Bounartzi T, Messini CI, Dafopoulos K, Markandona R, Sotiriou S, Tzavella A, Messinis IE. Sperm DNA fragmentation measured by Halosperm does not impact on embryo quality and ongoing pregnancy rates in IVF/ICSI treatments. Andrologia 2014; 47:295-302. [PMID: 24621442 DOI: 10.1111/and.12259] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2014] [Indexed: 12/26/2022] Open
Abstract
Sperm DNA fragmentation (SDF) has been proposed to be one of the main markers regarding male infertility. A prospective study was performed to assess primarily whether sperm DNA damage has any impact on embryological data and secondarily on pregnancy rates. This prospective study evaluated the sperm DNA damage in fresh ejaculated sperm samples from couples undergoing IVF/ICSI treatments, using the improved SCD method, known as Halosperm(®) . The results were evaluated by performing statistical analysis with the statistical package of SPSS v17. A total of 156 fresh semen samples derived from 156 couples undergoing 156 IVF/ICSI cycles. From the 156 couples, 139 finally reached the embryo transfer (ET) procedure. Overall, SDF did not correlate with embryological data, while ongoing pregnancy rate/ET was 21.6%. SDF only correlated with sperm characteristics. After the categorisation of SDF (≤35% and >35%), according to the specific references of the method used, embryological data were comparable as also ongoing pregnancy rates. Using the SCD method, sperm DNA damage is associated neither with embryological data nor to pregnancy rates. However, we should not rule out the fact that extremely high DNA damages are associated with total pregnancy failure.
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Affiliation(s)
- G Anifandis
- Department of Obstetrics and Gynaecology, School of Health Sciences, Faculty of Medicine, University of Thessalia, Larissa, Greece
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99
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Kadioglu TC, Aliyev E, Celtik M. Microscopic varicocelectomy significantly decreases the sperm DNA fragmentation index in patients with infertility. BIOMED RESEARCH INTERNATIONAL 2014; 2014:695713. [PMID: 24712000 PMCID: PMC3966333 DOI: 10.1155/2014/695713] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Revised: 01/27/2014] [Accepted: 01/27/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Varicocele is associated with high levels of DNA damage in spermatozoa due to oxidative stress and elevated levels of sperm DNA fragmentation, which has been currently proposed to be an essential additional diagnostic test to be recommended for patients with clinical varicocele. The aim of this study was to evaluate the parameters of semen and the DNA fragmentation index (DFI) in patients with varicocele before and after varicocelectomy. METHODS The details of 92 consecutive patients were retrospectively analyzed from January 2010 to December 2012. The sperm samples were evaluated according to the World Health Organization Guidelines. Sperm DNA damage, characterized as DFI, was evaluated by sperm chromatin structure assay using flow cytometry. RESULTS There was a statistically significant improvement in the semen concentration, the total motile count, the total normal sperm count, and the sperm DNA fragmentation index (DFI; the percentage of sperm with denatured DNA) after varicocelectomy. There was a large decrease in DFI from a preoperative mean of 42.6% to a postoperative mean of 20.5% (P < 0.001). A higher preoperative DFI was associated with a larger decrease in postoperative DFI, and significant negative correlations were observed between the DFI and sperm motility (r = -0.42, P < 0.01). CONCLUSION Our data suggest that varicocelectomy can improve multiple semen parameters and sperm DNA damage in infertile men with varicocele. The patients with preoperative defects in those parameters showed greater improvement postoperatively. Further research in this area is needed to understand the exact mechanisms of DNA damage in infertile men with varicocele.
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Affiliation(s)
- Teoman Cem Kadioglu
- Department of Urology, Istanbul School of Medicine, University of Istanbul, 34365 Istanbul, Turkey
| | - Emin Aliyev
- Department of Urology, Istanbul School of Medicine, University of Istanbul, 34365 Istanbul, Turkey
| | - Murad Celtik
- Department of Urology, Istanbul School of Medicine, University of Istanbul, 34365 Istanbul, Turkey
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100
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Simon L, Liu L, Murphy K, Ge S, Hotaling J, Aston KI, Emery B, Carrell DT. Comparative analysis of three sperm DNA damage assays and sperm nuclear protein content in couples undergoing assisted reproduction treatment. Hum Reprod 2014; 29:904-17. [PMID: 24619433 DOI: 10.1093/humrep/deu040] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION Is there an association between sperm DNA damage, measured by three different assays, sperm nuclear protein content and clinical outcomes in assisted reproduction treatment (ART)? SUMMARY ANSWER Sperm DNA damage measured by terminal deoxynucleotidyltransferase-mediated dUTP nick-end labelling (TUNEL) and the Comet assay were significantly associated with ART outcomes in our single institution study. WHAT IS KNOWN ALREADY Abnormal protamine expression is known to be associated with sperm DNA damage and male infertility. A number of studies have shown a significant relationship between sperm DNA damage and ART outcomes. To date, there are no large studies providing direct comparisons of DNA damage tests within the same study population. Thus, the prognostic value for each method remains unknown. STUDY DESIGN, SIZE, DURATION Cross-sectional study of 238 men from infertile couples undergoing ART at the University Center for Reproductive Medicine, Utah, USA, between April 2011 and March 2013. PARTICIPANTS/MATERIALS, SETTING, METHODS Sperm from men undergoing ART were tested for DNA damage using the alkaline Comet assay, TUNEL and flow cytometric chromatin evaluation (FCCE) assays. Histone retention was analysed using the aniline blue staining method, whereas protamine content (proteins P1 and P2) and ratio were analysed using acid urea gel electrophoresis. The prognostic value of each sperm DNA test to predict clinical pregnancy was calculated. MAIN RESULTS AND THE ROLE OF CHANCE Histone retention was associated with sperm DNA damage (P < 0.001), reduced embryo quality (P = 0.005) and clinical pregnancies (P < 0.001). The mean percentage of sperm with DNA damage was significantly higher in sperm from non-pregnant couples compared with that from pregnant couples, as measured by TUNEL assay (15.04 ± 1.16% versus 8.79 ± 0.56%; P < 0.001) and alkaline Comet assay (72.79 ± 2.49% versus 55.86 ± 2.29%; P < 0.001). There was no association between clinical pregnancies and DNA fragmentation index measured by FCCE (12.97 ± 1.46 versus 14.93 ± 1.65; P = 0.379). Of the protamine parameters analysed, only the P1/P2 ratio was associated with sperm count (P = 0.013), men's age (P = 0.037), maturity (P = 0.049) and blastocyst quality (P = 0.012). Histone retention and sperm DNA damage measured by Comet and TUNEL assays were associated with fertilization rate (P < 0.05), embryo quality (P < 0.05) and implantation rate (P < 0.05). LIMITATIONS, REASONS FOR CAUTION A potential drawback of this study is that it is cross-sectional. Generally in such studies there is more than one variable that could cause the effect. Analysing sperm is one part of the equation; there are also a number of female factors that have the potential to influence ART outcomes. Therefore, given the large and well-established role of female factors in infertility, normal sperm DNA integrity and protamination do not necessarily ensure clinical pregnancy in ART. Thus, female factors can reduce the prognostic value of sperm DNA tests. Further, our use of native semen instead of prepared sperm may have iatrogenically increased the DNA damage. WIDER IMPLICATIONS OF THE FINDINGS Alteration in sperm nuclear protein affects sperm DNA integrity. Further, with the current dataset, TUNEL and Comet assays appeared more predictive of ART success than FCCE. STUDY FUNDING/COMPETING INTEREST(S) No personal or direct financial support has been received for any of this work. The authors declare no competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- L Simon
- Andrology and IVF Laboratory, Department of Surgery (Urology), University of Utah, Salt Lake City, UT 84108, USA
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