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van Marion ES, Speksnijder JP, Hoek J, Boellaard WPA, Dinkelman-Smit M, Chavli EA, Steegers-Theunissen RPM, Laven JSE, Baart EB. Time-lapse imaging of human embryos fertilized with testicular sperm reveals an impact on the first embryonic cell cycle. Biol Reprod 2021; 104:1218-1227. [PMID: 33690817 PMCID: PMC8181962 DOI: 10.1093/biolre/ioab031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/08/2021] [Accepted: 02/18/2021] [Indexed: 11/14/2022] Open
Abstract
Testicular sperm is increasingly used during in vitro fertilization treatment. Testicular sperm has the ability to fertilize the oocyte after intracytoplasmic sperm injection (ICSI), but they have not undergone maturation during epididymal transport. Testicular sperm differs from ejaculated sperm in terms of chromatin maturity, incidence of DNA damage, and RNA content. It is not fully understood what the biological impact is of using testicular sperm, on fertilization, preimplantation embryo development, and postimplantation development. Our goal was to investigate differences in human preimplantation embryo development after ICSI using testicular sperm (TESE-ICSI) and ejaculated sperm. We used time-lapse embryo culture to study these possible differences. Embryos (n = 639) originating from 208 couples undergoing TESE-ICSI treatment were studied and compared to embryos (n = 866) originating from 243 couples undergoing ICSI treatment with ejaculated sperm. Using statistical analysis with linear mixed models, we observed that pronuclei appeared 0.55 h earlier in TESE-ICSI embryos, after which the pronuclear stage lasted 0.55 h longer. Also, significantly more TESE-ICSI embryos showed direct unequal cleavage from the 1-cell stage to the 3-cell stage. TESE-ICSI embryos proceeded faster through the cleavage divisions to the 5- and the 6-cell stage, but this effect disappeared when we adjusted our model for maternal factors. In conclusion, sperm origin affects embryo development during the first embryonic cell cycle, but not developmental kinetics to the 8-cell stage. Our results provide insight into the biological differences between testicular and ejaculated sperm and their impact during human fertilization.
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Affiliation(s)
- E S van Marion
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - J P Speksnijder
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - J Hoek
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - W P A Boellaard
- Department of Urology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - M Dinkelman-Smit
- Department of Urology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - E A Chavli
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - R P M Steegers-Theunissen
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - J S E Laven
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - E B Baart
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Developmental Biology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Dutta S, Henkel R, Agarwal A. Comparative analysis of tests used to assess sperm chromatin integrity and DNA fragmentation. Andrologia 2020; 53:e13718. [PMID: 32628294 DOI: 10.1111/and.13718] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 05/23/2020] [Accepted: 05/28/2020] [Indexed: 12/12/2022] Open
Abstract
Male infertility has a complex etiology, and many times, the cause is unknown. While routine semen analysis provides an overview of basic semen parameters, such as sperm concentration, motility, viability and morphology, a significant overlap of these parameters has been reported in fertile and infertile men. Moreover, conventional semen parameters do not reveal the cellular or molecular mechanisms of sperm dysfunctions leading to infertility. Therefore, sperm functional parameters, including sperm chromatin integrity, are evaluated to provide information on subtle sperm defects that are not routinely identified. Incomplete or defective sperm chromatin condensation increases the susceptibility of the sperm DNA to oxidative damage or other factors. To evaluate sperm chromatin integrity, different methods with varying degrees of diagnostic and prognostic capabilities are available. Among these assays, SCSA, TUNEL and SCD assays are most commonly used. While these assays rather evaluate the DNA directly for damages, the aniline blue and chromomycin A3 stains test for the quality of chromatin condensation. Thus, this review discusses and compares different methods used to evaluate sperm chromatin integrity and condensation, and their inclusion in the routine evaluation of the male infertility.
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Affiliation(s)
- Sulagna Dutta
- Department of Oral Biology and Biomedical Sciences, Faculty of Dentistry, MAHSA University, Selangor, Malaysia
| | - Ralf Henkel
- Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa.,American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
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Javed A, Talkad MS, Ramaiah MK. Evaluation of sperm DNA fragmentation using multiple methods: a comparison of their predictive power for male infertility. Clin Exp Reprod Med 2019; 46:14-21. [PMID: 30827073 PMCID: PMC6436467 DOI: 10.5653/cerm.2019.46.1.14] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 01/29/2019] [Indexed: 02/01/2023] Open
Abstract
Objective The usual seminal profile has been customarily used for diagnosing male infertility based on an examination of semen samples. However, sperm DNA fragmentation has also been causally linked to reproductive failure, suggesting that it should be evaluated as part of male infertility assessments. To compare the ability of the five most widely utilized methodologies of measuring DNA fragmentation to predict male infertility and reactive oxygen species by Oxisperm kit assay. Methods In this case-control study, which received ethical committee approval, the participants were divided into fertile and infertile groups (50 patients in each group). Results The alkaline comet test showed the best ability to predict male infertility, followed by the terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL) assay, the sperm chromatin dispersion (SCD) test, and the sperm chromatin structure assay (SCSA), while the neutral comet test had no predictive power. For our patient population, the projected cut-off point for the DNA fragmentation index was 22.08% using the TUNEL assay, 19.90% using SCSA, 24.74% using the SCD test, 48.47% using the alkaline comet test, and 36.37% using the neutral comet test. Significant correlations were found between the results of the SCD test and those obtained using SCSA and TUNEL (r =0.70 and r =0.68, respectively; p<0.001), and a statistically significant correlation was also found between the results of SCSA and the TUNEL assay (r =0.77, p<0.001). Likewise, the results of the alkaline comet test showed significant correlations with those of the SCD, SCSA, and TUNEL tests (r =0.59, r =0.57, and r =0.72, respectively; p<0.001). Conclusion The TUNEL assay, SCSA, SCD, and the alkaline comet test were effective for distinguishing between fertile and infertile patients, and the alkaline comet test was the best predictor of male infertility.
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Affiliation(s)
- Aamir Javed
- Department of Biotechnology, REVA University, Yelahanka, India
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Husna AU, Azam A, Qadeer S, Awan MA, Nasreen S, Shahzad Q, Fouladi-Nashta A, Khalid M, Akhter S. Sperm preparation through Sephadex ™ filtration improves in vitro fertilization rate of buffalo oocytes. Reprod Domest Anim 2017; 53:377-384. [PMID: 29239046 DOI: 10.1111/rda.13117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 10/02/2017] [Indexed: 12/01/2022]
Abstract
Routinely, swim-up method is used to separate high-quality sperm; however, long processing time and close cell-to-cell contact during the centrifugation step are inevitable elements of oxidative stress to sperm. The objective was to evaluate Sephadex™ and glass wool filtration to separate motile, intact and viable sperm for in vitro fertilization in buffalo. The cumulus-oocyte complexes (COCs) were collected from ovaries of slaughtered buffaloes by aspiration and matured for 24 hr in CO2 incubator at 38.5°C and 5% CO2 . Matured COCs were rinsed twice in fertilization TALP and placed in the pre-warmed fertilization medium without sperm. Cryopreserved buffalo semen was thawed at 37°C for 30 s and processed through Sephadex™ , glass wool filtration and swim-up (control). Total and motile sperm recovery rates were assessed, resuspended in fertilization TALP and incubated for 15-20 min in CO2 incubator. Samples prepared by each method were divided into two aliquots: one aliquot was studied for sperm quality (progressive motility, membrane integrity, viability, liveability), while the other was subjected to co-incubation with sets of 10-15 in vitro matured oocytes. Data on sperm quality were analysed by ANOVA, while in vitro fertilizing rates were compared by chi-squared test using SPSS-20. Least significant difference (LSD) test was used to compare treatment means. Glass wool filtration yielded higher total and motile sperm recovery rate, while Sephadex™ filtration improved (p < .05) sperm quality (progressive motility, membrane integrity, viability, liveability). Sperm preparation through Sephadex filtration yielded higher in vitro fertilization rate in terms of cleavage rate compared to glass wool filtration and swim-up (control). In conclusion, cryopreserved Nili-Ravi buffalo sperm selected through Sephadex filtration showed improved quality and yielded better fertilization rates (cleavage rate) of in vitro matured/fertilized oocytes. Sephadex filtration could be a promising technique for use in in vitro fertilization in buffalo.
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Affiliation(s)
- A U Husna
- Department of Zoology, Pir Mehr Ali Shah Arid Agriculture University Rawalpindi, Rawalpindi, Pakistan
| | - A Azam
- Department of Zoology, Pir Mehr Ali Shah Arid Agriculture University Rawalpindi, Rawalpindi, Pakistan
| | - S Qadeer
- Department of Biological Sciences, University of Sargodha-Mianwali Campus-Mianwali, Mianwali, Pakistan
| | - M A Awan
- Department of Zoology, Pir Mehr Ali Shah Arid Agriculture University Rawalpindi, Rawalpindi, Pakistan
| | - S Nasreen
- Department of Zoology, Pir Mehr Ali Shah Arid Agriculture University Rawalpindi, Rawalpindi, Pakistan
| | - Q Shahzad
- Buffalo Research Institute, Pattoki, District Kasur, Pakistan
| | - A Fouladi-Nashta
- The Royal Veterinary College, North Mymms Hatfield, Hertfordshire, UK
| | - M Khalid
- The Royal Veterinary College, North Mymms Hatfield, Hertfordshire, UK
| | - S Akhter
- Department of Zoology, Pir Mehr Ali Shah Arid Agriculture University Rawalpindi, Rawalpindi, Pakistan
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Sperm DNA fragmentation index and pregnancy outcome after IVF or ICSI: a meta-analysis. J Assist Reprod Genet 2014; 32:17-26. [PMID: 25392073 DOI: 10.1007/s10815-014-0374-1] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Accepted: 10/20/2014] [Indexed: 01/09/2023] Open
Abstract
PURPOSE The purpose of this study was to carry out a meta-analysis for a comprehensive understanding and estimation of the association between sperm DNA Fragmentation Index (DFI) and pregnancy outcome after in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment. METHODS Studies concerning the link of DFI with pregnancy outcome were included after literature search of database PUBMED, EMBASE, MEDLINE. Related information was extracted from the eligible studies by two independent authors and a meta-analysis was conducted by using STATA 12.0 software. Pregnancy outcomes consisted of biochemical pregnancy (BP), clinical pregnancy (CP) and pregnancy loss (PL). The studies included for meta-analysis were divided into three groups according to the DFI threshold value (DFI >27 %, 15-27 %, ≤15 % group). The odds ratio (OR ) and their 95 % confidence intervals (95 % CIs) were used to evaluate the association between DFI and pregnancy outcome. RESULTS Twenty articles were included in our meta-analysis. The results indicated that infertile couples were more likely to get pregnant if DFI was less than threshold value (For threshold value > 27 % and 15-27 % group, combined overall OR (95 % CI) = 1.437 (1.186-1.742), 1.639 (1.093-2.459) respectively). However, when stratified by DFI detection methods, using sperm chromatin structure assay (SCSA) as the DFI test method, the results indicated a similar CP rate between groups with a high DFI or a lower DFI value (SCSA, For threshold value >27 % and 15-27 % group, combined overall OR (95 % CI) = 1.242(0.978-1.577), 1.480(0.921-2.377) respectively). The meta-analysis based on BP (overall OR (95 % CI) = 0.952 (0.697-1.302)) and PL((For DFI >27 %, 15-27 %, ≤15 % group, OR (95 % CI) = 0.786 (0.491-1.258), 1.509 (0.655-3.476), (0.538 (0.264-1.097) respectively) outcome yielded nonsignificant results. CONCLUSIONS The predication value of DFI for IVF or ICSI outcome is not confirmed in our meta-analysis. Further better designed studies with larger subjects involved are needed to better address this issue.
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HDAC inhibitor confers radiosensitivity to prostate stem-like cells. Br J Cancer 2013; 109:3023-33. [PMID: 24220693 PMCID: PMC3859953 DOI: 10.1038/bjc.2013.691] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/05/2013] [Accepted: 10/09/2013] [Indexed: 01/06/2023] Open
Abstract
Background: Radiotherapy can be an effective treatment for prostate cancer, but radiorecurrent tumours do develop. Considering prostate cancer heterogeneity, we hypothesised that primitive stem-like cells may constitute the radiation-resistant fraction. Methods: Primary cultures were derived from patients undergoing resection for prostate cancer or benign prostatic hyperplasia. After short-term culture, three populations of cells were sorted, reflecting the prostate epithelial hierarchy, namely stem-like cells (SCs, α2β1integrinhi/CD133+), transit-amplifying (TA, α2β1integrinhi/CD133−) and committed basal (CB, α2β1integrinlo) cells. Radiosensitivity was measured by colony-forming efficiency (CFE) and DNA damage by comet assay and DNA damage foci quantification. Immunofluorescence and flow cytometry were used to measure heterochromatin. The HDAC (histone deacetylase) inhibitor Trichostatin A was used as a radiosensitiser. Results: Stem-like cells had increased CFE post irradiation compared with the more differentiated cells (TA and CB). The SC population sustained fewer lethal double-strand breaks than either TA or CB cells, which correlated with SCs being less proliferative and having increased levels of heterochromatin. Finally, treatment with an HDAC inhibitor sensitised the SCs to radiation. Interpretation: Prostate SCs are more radioresistant than more differentiated cell populations. We suggest that the primitive cells survive radiation therapy and that pre-treatment with HDAC inhibitors may sensitise this resistant fraction.
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Ribas-Maynou J, García-Peiró A, Fernández-Encinas A, Abad C, Amengual MJ, Prada E, Navarro J, Benet J. Comprehensive analysis of sperm DNA fragmentation by five different assays: TUNEL assay, SCSA, SCD test and alkaline and neutral Comet assay. Andrology 2013; 1:715-22. [DOI: 10.1111/j.2047-2927.2013.00111.x] [Citation(s) in RCA: 156] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 05/31/2013] [Accepted: 06/03/2013] [Indexed: 01/21/2023]
Affiliation(s)
- J. Ribas-Maynou
- Departament de Biologia Cellular, Fisiologia i Immunologia; Universitat Autònoma de Barcelona; Bellaterra; Spain
| | | | - A. Fernández-Encinas
- Departament de Biologia Cellular, Fisiologia i Immunologia; Universitat Autònoma de Barcelona; Bellaterra; Spain
| | - C. Abad
- Servei d'Urologia; Corporació Sanitària Parc Taulí; Sabadell, Institut Universitari Parc Taulí - UAB; Sabadell; Spain
| | - M. J. Amengual
- UDIAT; Centre Diagnòstic, Corporació Sanitària Parc Taulí; Sabadell; Institut Universitari Parc Taulí - UAB; Sabadell; Spain
| | - E. Prada
- Servei de Ginecologia; Hospital Universitari Mútua de Terrassa; Terrassa; Spain
| | - J. Navarro
- Departament de Biologia Cellular, Fisiologia i Immunologia; Universitat Autònoma de Barcelona; Bellaterra; Spain
| | - J. Benet
- Departament de Biologia Cellular, Fisiologia i Immunologia; Universitat Autònoma de Barcelona; Bellaterra; Spain
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Weingeist DM, Ge J, Wood DK, Mutamba JT, Huang Q, Rowland EA, Yaffe MB, Floyd S, Engelward BP. Single-cell microarray enables high-throughput evaluation of DNA double-strand breaks and DNA repair inhibitors. Cell Cycle 2013; 12:907-15. [PMID: 23422001 DOI: 10.4161/cc.23880] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
A key modality of non-surgical cancer management is DNA damaging therapy that causes DNA double-strand breaks that are preferentially toxic to rapidly dividing cancer cells. Double-strand break repair capacity is recognized as an important mechanism in drug resistance and is therefore a potential target for adjuvant chemotherapy. Additionally, spontaneous and environmentally induced DSBs are known to promote cancer, making DSB evaluation important as a tool in epidemiology, clinical evaluation and in the development of novel pharmaceuticals. Currently available assays to detect double-strand breaks are limited in throughput and specificity and offer minimal information concerning the kinetics of repair. Here, we present the CometChip, a 96-well platform that enables assessment of double-strand break levels and repair capacity of multiple cell types and conditions in parallel and integrates with standard high-throughput screening and analysis technologies. We demonstrate the ability to detect multiple genetic deficiencies in double-strand break repair and evaluate a set of clinically relevant chemical inhibitors of one of the major double-strand break repair pathways, non-homologous end-joining. While other high-throughput repair assays measure residual damage or indirect markers of damage, the CometChip detects physical double-strand breaks, providing direct measurement of damage induction and repair capacity, which may be useful in developing and implementing treatment strategies with reduced side effects.
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Affiliation(s)
- David M Weingeist
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
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Effects of centrifugation through three different discontinuous Percoll gradients on boar sperm function. Anim Reprod Sci 2011; 127:62-72. [DOI: 10.1016/j.anireprosci.2011.06.009] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Revised: 06/14/2011] [Accepted: 06/27/2011] [Indexed: 11/19/2022]
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Mitchell LA, De Iuliis GN, Aitken RJ. The TUNEL assay consistently underestimates DNA damage in human spermatozoa and is influenced by DNA compaction and cell vitality: development of an improved methodology. ACTA ACUST UNITED AC 2011; 34:2-13. [PMID: 20158539 DOI: 10.1111/j.1365-2605.2009.01042.x] [Citation(s) in RCA: 129] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The purpose of this study was to evaluate the terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL) assay as a method for assessing DNA damage in human spermatozoa. The conventional assay was shown to be insensitive and unresponsive to the DNA fragmentation induced in human and mouse spermatozoa on exposure to Fenton reagents (H₂O₂ and Fe(2+) ). However, both time- and dose-dependent responses could be readily detected if the chromatin was exposed to 2 mm dithiothreitol (DTT) for 45 min prior to fixation. This modified version of the assay significantly enhanced the TUNEL signals generated by subpopulations of spermatozoa isolated on discontinuous Percoll gradients as well as the responses triggered by reagents (arachidonic acid and menadione) that are known to stimulate superoxide anion production by human spermatozoa. DTT exposure also improved the signals detected with chromomycin A₃ (CMA₃), a probe designed to determine the efficacy of chromatin protamination, and enhanced the correlation observed between this criterion of sperm quality and the TUNEL assay. Finally, the output of the TUNEL assay was found to be highly correlated with sperm vitality. The TUNEL methodology was therefore further refined to incorporate a vital stain that covalently bound to intracellular amine groups in non-viable cells. This tag remained associated with the spermatozoa during fixation and processing for the TUNEL assay so that ultimately, both DNA integrity and vitality could be simultaneously assessed in the same flow cytometry assay. The methods described in this article are simple and robust and should facilitate research into the causes of DNA damage in human spermatozoa.
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Affiliation(s)
- L A Mitchell
- The ARC Centre of Excellence in Biotechnology and Development, Reproductive Science Group, Discipline of Biological Sciences, School of Environmental and Life Sciences, University of Newcastle, Newcastle, NSW, Australia
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Chi HJ, Chung DY, Choi SY, Kim JH, Kim GY, Lee JS, Lee HS, Kim MH, Roh SI. Integrity of human sperm DNA assessed by the neutral comet assay and its relationship to semen parameters and clinical outcomes for the IVF-ET program. Clin Exp Reprod Med 2011; 38:10-7. [PMID: 22384412 PMCID: PMC3283044 DOI: 10.5653/cerm.2011.38.1.10] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Revised: 12/24/2010] [Accepted: 12/31/2010] [Indexed: 11/09/2022] Open
Abstract
Objective To explore potential relationships between sperm DNA integrity and both semen parameters and clinical outcomes. Methods Semen analysis of 498 samples was performed according to the 2010 criteria of the World Health Organization. The sperm DNA fragmentation Index (DFI) of the semen samples was assessed using a neutral comet assay. Results Sperm DFI showed a significant correlation with semen parameters, including the patient's age, sperm viability, motility, morphology, and number of leukocytes (p<0.05). The sperm DFI values for asthenozoospermic (15.2%), oligoteratozoospermic (18.3%), asthenoteratozoospermic (17.5%), and oligoasthenoteratozoospermic semen samples (21.3%) were significantly higher than that observed in normozoospermic semen samples (10.5%, p<0.05). A sperm DFI value of 14% was used as a threshold of sperm DFI in assessing whether DNA was highly damaged. In 114 IVF-ET cycles, the fertilization rate of the sperm DFI <14% group (70 cycles, 61.7%) was significantly higher than that observed for the ≥14% group (44 cycles, 55.3%), but there was no difference in the other clinical outcomes between the two groups. In the ≥14% group, the pregnancy rates of the ICSI cycles (40.0%) and half-ICSI (44.0%) were higher than conventional IVF cycles (30.7%), but the difference was not statistically significant. Conclusion Along with the conventional semen analysis, the sperm DFI assessed using the comet assay was shown to improve the quality of the semen evaluation. To evaluate the precise effect of ICSI on pregnancy rates in the patients who demonstrate high sperm DFI values, further study is necessary.
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Ahmad L, Jalali S, Shami SA, Akram Z, Batool S, Kalsoom O. Effects of cryopreservation on sperm DNA integrity in normospermic and four categories of infertile males. Syst Biol Reprod Med 2010; 56:74-83. [PMID: 20170281 DOI: 10.3109/19396360903428352] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study examined the effects of cryopreservation on DNA integrity of spermatozoa from 34 fertile subjects and 166 infertile subjects comprised of 80 teratospermic, 32 normospermic, 30 astheno-teratospermic, and 24 oligo-astheno-teratospermic individuals. Semen samples were prepared by swim-up and the Percoll density gradient centrifugation method (Pdgc) prior to freezing in liquid nitrogen. Neat and prepared samples were supplemented with cryoprotectant (SpermFreez) in cryoampoules and were frozen using the static phase vapor cooling procedure. Sperm DNA integrity of all thawed samples was determined using the alkaline comet assay. It was noticed that the sperm DNA integrity of frozen samples of fertile subjects was considerably higher than that of infertile subjects with greater catch-up integrity similar to the fresh samples. Freezing caused less chromatin damage to sperm of Pdgc samples from both fertile and infertile subjects as was compared to the neat and swim-up samples. It is concluded that the increase in comet frequency of frozen-thawed samples from infertile subjects was more prominent (8.25-22.78%; P<0.01) than in the fresh samples. Frozen-thawed samples from Ts (Teratospermic individuals) and ATs (Astheno-teratozoosspermic) showed higher level of OTM (Olive tail moment) indicating a higher level of chromatin fragmentation than fertile, Ns (Normospermics), and OATs (Oligo-astheno-teratozoospermics).
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Affiliation(s)
- Laiq Ahmad
- Department of Animal Sciences, Quid-i-Azam University, Islamabad, Pakistan.
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Barratt CLR, Aitken RJ, Björndahl L, Carrell DT, de Boer P, Kvist U, Lewis SEM, Perreault SD, Perry MJ, Ramos L, Robaire B, Ward S, Zini A. Sperm DNA: organization, protection and vulnerability: from basic science to clinical applications--a position report. Hum Reprod 2010; 25:824-38. [PMID: 20139429 DOI: 10.1093/humrep/dep465] [Citation(s) in RCA: 192] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
This article reports the results of the most recent in a series of EHSRE workshops designed to synthesize the current state of the field in Andrology and provide recommendations for future work (for details see Appendix). Its focus is on methods for detecting sperm DNA damage and potential application of new knowledge about sperm chromatin organization, vulnerability and repair to improve the diagnosis and treatment of clinical infertility associated with that damage. Equally important is the use and reliability of these tests to identify the extent to which environmental contaminants or pharmaceutical agents may contribute to the incidence of sperm DNA damage and male fertility problems. A working group (for workshop details, see Appendix) under the auspices of ESHRE met in May 2009 to assess the current knowledgebase and suggest future basic and clinical research directions. This document presents a synthesis of the working group's understanding of the recent literature and collective discussions on the current state of knowledge of sperm chromatin structure and function during fertilization. It highlights the biological, assay and clinical uncertainties that require further research and ends with a series of 5 key recommendations.
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Affiliation(s)
- Christopher L R Barratt
- Reproductive and Developmental Biology, Maternal and Child Health Science Laboratories, Centre for Oncology and Molecular Medicine, Ninewells Hospital, University of Dundee, Dundee DD1 9SY, UK.
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14
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de Boer P, Ramos L, de Vries M, Gochhait S. Memoirs of an insult: sperm as a possible source of transgenerational epimutations and genetic instability. Mol Hum Reprod 2009; 16:48-56. [PMID: 19897543 DOI: 10.1093/molehr/gap098] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Male transgenerational epigenetic effects have been discovered in the discipline of mouse radiation genetics, using genetic and non-genetic readouts. The mechanism to explain the origin of the transmission of epigenetic and genetic instability is still unknown. In a search for a hypothesis that could satisfy the data, we propose that regulation of chromosome structure in the germline, by the occupancy of matrix/scaffold associated regions, contains molecular memory function. The male germline is strikingly dynamic as to chromatin organization. This could explain why experience of irradiation stress leaves a persistent mark in the male germline only. To be installed, such memory requires both S-phase and chromatin reorganization during spermatogenesis and in the zygote, that likely also involves reorganization of loop domains. By this reorganization, another layer of information is added, needed to accommodate early embryonic development. Observations point at the involvement of DNA repair as inducer of transgenerational epigenetic modulation. Nuclear structure, chromatin composition and loop domain organization are aspects of human sperm variability that in many cases of assisted reproduction is increased due to inclusion of more incompletely differentiated/maturated sperm nuclei. Adjustment of loop domains in early embryo development can be anticipated and zygotic and cleavage stage S-phase repair activity will have to deal with potential paternal DNA lesions. Therefore, by changing male nucleus structure due to reproduction from impaired spermatogenesis, the transgenerational information content could be changed as well. We discuss aspects of male reproductive performance in the context of this hypothesis.
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Affiliation(s)
- P de Boer
- Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Ahmad L, Jalali S, Shami SA, Akram Z. Sperm Preparation: DNA Damage by Comet Assay in Normo- and Teratozoospermics. ACTA ACUST UNITED AC 2009; 53:325-38. [DOI: 10.1080/01485010701730963] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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16
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Ning Li, Elashoff DA, Robbins WA, Lin Xun. A hierarchical zero-inflated log-normal model for skewed responses. Stat Methods Med Res 2008; 20:175-89. [DOI: 10.1177/0962280208097372] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although considerable attention has been given to zero-inflated count data, research on zero-inflated lognormal data is limited. In this article, we consider a study to examine human sperm cell DNA damage obtained from single-cell electrophoresis (COMET assay) experiment in which the outcome measures present a typical example of log-normal data with excess zeros. The problem is further complicated by the fact that each study subject has multiple outcomes at each of up to three visits separated by six-week intervals. Previous methods for zero-inflated log-normal data are based on either simple experimental designs, where comparison of means of zero-inflated log-normal data across different experiment groups is of primary interest, or longitudinal measurements, where only one observation is available for each subject at each visit. Their methods cannot be applied when multiple observations per visit are possible and both inter- and intra-subject variations are present. Our zero-inflated model extends the previous methods by incorporating a hierarchical structure using latent random variables to take into account both inter- and intra-subject variations in zero-inflated log-normal data. An EM algorithm has been developed to obtain the Maximum likelihood estimates of the parameters and their standard errors can be estimated by parametric bootstrap. The model is illustrated using the COMET assay data.
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Affiliation(s)
- Ning Li
- Department of Epidemiology and Biostatistics, College of Public Health and Health Professions, University of Florida, Gainesville, FL,
| | - David A. Elashoff
- Department of Biostatistics, School of Public Health, University of California at Los Angeles, Los Angeles, CA, USA
| | - Wendie A. Robbins
- School of Nursing, University of California at Los Angeles, Los Angeles, CA, USA
| | - Lin Xun
- School of Nursing, University of California at Los Angeles, Los Angeles, CA, USA
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17
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Baumgartner A, Cemeli E, Anderson D. The comet assay in male reproductive toxicology. Cell Biol Toxicol 2007; 25:81-98. [PMID: 17972149 DOI: 10.1007/s10565-007-9041-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2007] [Accepted: 10/03/2007] [Indexed: 01/23/2023]
Abstract
Due to our lifestyle and the environment we live in, we are constantly confronted with genotoxic or potentially genotoxic compounds. These toxins can cause DNA damage to our cells, leading to an increase in mutations. Sometimes such mutations could give rise to cancer in somatic cells. However, when germ cells are affected, then the damage could also have an effect on the next and successive generations. A rapid, sensitive and reliable method to detect DNA damage and assess the integrity of the genome within single cells is that of the comet or single-cell gel electrophoresis assay. The present communication gives an overview of the use of the comet assay utilising sperm or testicular cells in reproductive toxicology. This includes consideration of damage assessed by protocol modification, cryopreservation vs the use of fresh sperm, viability and statistics. It further focuses on in vivo and in vitro comet assay studies with sperm and a comparison of this assay with other assays measuring germ cell genotoxicity. As most of the de novo structural aberrations occur in sperm and spermatogenesis is functional from puberty to old age, whereas female germ cells are more complicated to obtain, the examination of male germ cells seems to be an easier and logical choice for research and testing in reproductive toxicology. In addition, the importance of such an assay for the paternal impact of genetic damage in offspring is undisputed. As there is a growing interest in the evaluation of genotoxins in male germ cells, the comet assay allows in vitro and in vivo assessments of various environmental and lifestyle genotoxins to be reliably determined.
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Affiliation(s)
- A Baumgartner
- Division of Biomedical Sciences, University of Bradford, Richmond Road, Bradford, West Yorkshire BD7 1DP, UK
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18
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Yamauchi Y, Shaman JA, Boaz SM, Ward WS. Paternal pronuclear DNA degradation is functionally linked to DNA replication in mouse oocytes. Biol Reprod 2007; 77:407-15. [PMID: 17494913 DOI: 10.1095/biolreprod.107.061473] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
We recently demonstrated that mouse spermatozoa contain a mechanism to degrade their DNA into loop-sized fragments of about 50 kb, mediated by topoisomerase IIB, termed sperm chromatin fragmentation (SCF). SCF is often followed by a more complete digestion of the DNA with a sperm nuclease. When SCF-induced spermatozoa are injected into oocytes, the paternal pronuclei degrade their DNA after the initiation of DNA synthesis, but the maternal pronuclei are unaffected and replicate normally. Here, we tested whether the nuclease activity changes in spermatozoa of different maturation stages, and whether there is a functional relationship between the initiation of DNA synthesis and paternal DNA degradation induced by SCF in the zygote. We found that spermatozoa from the vas deferens have a much higher level of SCF activity than those from the cauda epididymis, suggesting that spermatozoa may acquire this activity in the vas deferens. Furthermore, paternal pronuclei formed in zygotes from injecting oocytes with SCF-induced vas deferens spermatozoa degraded their DNA, but this degradation could be inhibited by the DNA synthesis inhibitor, aphidicolin. Upon release from a 4 h aphidicolin-induced arrest, DNA synthesis was initiated in maternal pronuclei, while the paternal pronuclei degraded their DNA. Longer aphidicolin arrest resulted in the paternal pronuclei replicating their DNA, suggesting that delaying the initiation of DNA synthesis allowed the paternal pronuclei to overcome the SCF-induced DNA degradation pathway. These results suggest that the paternal DNA degradation, in oocytes fertilized with SCF-induced spermatozoa, is coupled to the initiation of DNA synthesis in newly fertilized zygotes.
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Affiliation(s)
- Yasuhiro Yamauchi
- Institute for Biogenesis Research, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii 96822, USA
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Li MW, Baulch JE. Heritable Effects on DNA Damage Following Paternal F0 Germline Irradiation. MALE-MEDIATED DEVELOPMENTAL TOXICITY 2007. [DOI: 10.1039/9781847557643-00149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Ming-Wen Li
- Center for Health and the Environment, University of California Davis CA
| | - Janet E. Baulch
- Center for Health and the Environment, University of California Davis CA
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20
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Samardzija M, Karadjole M, Getz I, Makek Z, Cergolj M, Dobranic T. Effects of bovine spermatozoa preparation on embryonic development in vitro. Reprod Biol Endocrinol 2006; 4:58. [PMID: 17101040 PMCID: PMC1647281 DOI: 10.1186/1477-7827-4-58] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2006] [Accepted: 11/13/2006] [Indexed: 11/10/2022] Open
Abstract
The aim of our research was to examine the ability of density gradient preparation BoviPure and swim up method on bull sperm separation and in vitro embryo production (IVP) systems. Frozen/thawed semen from six Simmental bulls was pooled and treated using both methods. The sperm motility, concentration, membrane activity, membrane integrity and acrosomal status were evaluated and compared before and after sperm processing using BoviPure and swim up methods. We also evaluated and compared cleavage rates, embryo yield and quality between the methods. There were significant differences (P < 0.05) between the sperm characteristics before and after BoviPure, but not after swim up method. However, there were significant differences for sperm results among those two mentioned methods. A total of 641 oocytes were matured and fertilized in vitro and cultured in SOFaaBSA. The percentage of cleavage (Day 2) and the percentage of hatched embryos (Day 9) were similar for both methods. However, embryo production rate (Day 7) was significantly higher using BoviPure method (P < 0.05). Also, total cell number and embryo differential staining (inner cell mass and trophectoderm cells) of Day 7 morulas and blastocysts showed that BoviPure treated sperm displayed higher quality embryos compared to swim up method (P < 0.05). Our results indicate that BoviPure method has an enhanced capacity in sperm selection for in vitro embryo production when compared with swim up method. So, we concluded that BoviPure could be considered as a better alternative to swim up method for separating bull spermatozoa from frozen/thawed semen for IVP of bovine embryos.
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Affiliation(s)
- Marko Samardzija
- Clinic for Obstetrics and Reproduction, Faculty of Veterinary Medicine, University of Zagreb, Heinzelova 55, Zagreb, Croatia
| | - Martina Karadjole
- Clinic for Obstetrics and Reproduction, Faculty of Veterinary Medicine, University of Zagreb, Heinzelova 55, Zagreb, Croatia
| | - Iva Getz
- Clinic for Obstetrics and Reproduction, Faculty of Veterinary Medicine, University of Zagreb, Heinzelova 55, Zagreb, Croatia
| | - Zdenko Makek
- Clinic for Obstetrics and Reproduction, Faculty of Veterinary Medicine, University of Zagreb, Heinzelova 55, Zagreb, Croatia
| | - Marijan Cergolj
- Clinic for Obstetrics and Reproduction, Faculty of Veterinary Medicine, University of Zagreb, Heinzelova 55, Zagreb, Croatia
| | - Tomislav Dobranic
- Clinic for Obstetrics and Reproduction, Faculty of Veterinary Medicine, University of Zagreb, Heinzelova 55, Zagreb, Croatia
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Cesari A, Kaiser GG, Mucci N, Mutto A, Vincenti A, Fornés MW, Alberio RH. Integrated morphophysiological assessment of two methods for sperm selection in bovine embryo production in vitro. Theriogenology 2006; 66:1185-93. [PMID: 16647751 DOI: 10.1016/j.theriogenology.2006.03.029] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2006] [Accepted: 03/02/2006] [Indexed: 11/28/2022]
Abstract
Extensive work was done regarding the ability of Swim up and Percoll gradient to select functional sperm for in vitro embryo production (IVP) systems. The aim of this work was to compare Swim up and Percoll as methods of sperm selection by ultrastructural, biochemical and functional studies. Frozen-thawed semen from two bulls (Experiments 1 and 2, respectively) were treated using Swim up or Percoll discontinuous gradients. Motility, sperm membrane ultrastructure, sperm proteins, in vitro embryo production (insemination doses, cleavage, embryo yield and quality) and embryo sex ratio were scored and compared. Electron transmission microscopy of outer sperm membranes showed higher (P<0.05) percentage of sperm with lost acrosomes in Percoll treated samples compared to Swim up. A differential protein pattern was also detected. When in vitro embryo production was performed, Percoll gradient produced higher (P<0.05) number of fertilizing doses (7.6 versus 5.9, Bull 1; 13.5 versus 7.8, Bull 2) and higher sperm motility (90% versus 76.6%, Bull 1; 81.7% versus 68.3%, Bull 2) than Swim up. The percentage of cleavage (Day 3) was similar in both treatment groups, whereas embryo production rate (Day 7) was higher (39.4% versus 30.2%, Bull 1; 38% versus 32.4%, Bull 2; P<0.05) when Percoll gradient was used. The percentage of hatched embryos (Day 11) and sex ratio did not differ. Total cell counting and embryo differential staining (inner cell mass and trophoblast cells) of Day 7 embryos showed that Percoll treated sperm produced better quality embryos compared to Swim up. We concluded that Percoll had a better performance selecting sperm and an enhanced capacity for embryo production when compared with the Swim up procedure; this could be attributed to a better acrosome exocytosis, associated to the absence of certain membrane proteins.
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Affiliation(s)
- A Cesari
- Instituto de Investigaciones Biológicas, Facultad de Ciencias Exactas y Naturales, UNMdP. CC:1245 (7600) Mar del Plata, Buenos Aires, Argentina.
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de Paula TS, Bertolla RP, Spaine DM, Cunha MA, Schor N, Cedenho AP. Effect of cryopreservation on sperm apoptotic deoxyribonucleic acid fragmentation in patients with oligozoospermia. Fertil Steril 2006; 86:597-600. [PMID: 16952507 DOI: 10.1016/j.fertnstert.2006.01.047] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2005] [Revised: 01/27/2006] [Accepted: 01/27/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To verify if the increase in sperm apoptotic DNA fragmentation during cryopreservation is greater in oligozoospermic patients than in normozoospermic controls. DESIGN Controlled prospective study. SETTING Patients in an academic research environment. PATIENT(S) Forty-seven patients with oligozoospermia (concentration <10 x 10(6) sperm/mL) and 30 normozoospermic men. INTERVENTION(S) Sperm cryopreservation using a standard protocol with a test-yolk buffer, glycerol as the cryoprotectant. MAIN OUTCOME MEASURE(S) Rate of apoptotic sperm DNA fragmentation as assessed by the terminal deoxynucleotidyl-mediated deoxyuridine triphosphate nickend labeling (TUNEL) assay, graded in apoptotic or nonapoptotic, before and after cryopreservation. RESULT(S) An increase in apoptotic DNA fragmentation was observed in all the groups, regardless of sperm concentration. Normozoospermic men presented a smaller rate of apoptotic DNA fragmentation than oligozoospermic patients, both in pre- and postcryopreservation samples. The increase in DNA fragmentation was similar in both groups. CONCLUSION(S) Cryopreservation induces apoptotic sperm DNA fragmentation in men, regardless of sperm concentration. Men with oligozoospermia present with higher precryopreservation and postcryopreservation apoptotic sperm DNA fragmentation. The increase in DNA fragmentation is similar in both groups.
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Gloor KT, Winget D, Swanson WF. CONSERVATION SCIENCE IN A TERRORIST AGE: THE IMPACT OF AIRPORT SECURITY SCREENING ON THE VIABILITY AND DNA INTEGRITY OF FROZEN FELID SPERMATOZOA. J Zoo Wildl Med 2006; 37:327-35. [PMID: 17319132 DOI: 10.1638/05-072.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
In response to growing terrorism concerns, the Transportation Security Administration now requires that all checked baggage at U.S. airports be scanned through a cabinet x-ray system, which may increase risk of radiation damage to transported biologic samples and other sensitive genetic material. The objective of this study was to investigate the effect of these new airport security regulations on the viability and DNA integrity of frozen felid spermatozoa. Semen was collected from two domestic cats (Felis silvestris catus) and one fishing cat (Prionailurus viverrinus), cryopreserved in plastic freezing straws, and transferred into liquid nitrogen dry shippers for security screening. Treatment groups included frozen samples from each male scanned once or three times using a Transportation Security Administration-operated cabinet x-ray system, in addition to non-scanned samples (i.e., negative control) and samples previously scanned three times and exposed to five additional high-intensity x-ray bursts (i.e., positive control). Dosimeters placed in empty dry shippers were used to quantify radiation exposure. Following treatment, straws were thawed and spermatozoa analyzed for post-thaw motility (percentage motile and rate of progressive movement), acrosome status, and DNA integrity using single-cell gel electrophoresis (i.e., the comet assay). Dosimeter measurements determined that each airport screening procedure produced approximately 16 mrem of radiation exposure. Our results indicated that all levels of radiation exposure adversely affected (P < 0.05) post-thaw sperm motility, but the percentage of acrosome-intact spermatozoa did not differ (P > 0.05) among treatment groups. Results also showed that the amount of double-stranded DNA damage was greater (P < 0.05) in sperm samples from both cat species scanned three times compared to samples scanned once or negative controls. Findings suggest that new airport security measures may cause radiation-induced damage to frozen spermatozoa and other valuable biologic samples transported on passenger aircraft and that alternative modes of sample transportation should be used whenever possible.
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Affiliation(s)
- Kayleen T Gloor
- Center for Conservation and Research of Endangered Wildlife, Cincinnati Zoo and Botanical Garden, 3400 Vine Street, Cincinnati, Ohio 45220-1399, USA
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Abstract
Over the past 25 years, various methods have been developed to measure sperm DNA strand breaks in situ. Currently, there are four major tests of sperm DNA fragmentation, including the Comet, Tunel, sperm chromatin structure assay (SCSA) and the acridine orange test (AOT). The Comet assay is a light microscope technique where the sperm cells are mixed with melted agarose and then placed on a glass slide. The cells are lysed and then subjected to horizontal electrophoresis. The Tunel assay, another light microscope technique, transfers labeled nucleotide to the 3'OH group of a broken DNA strand with the use of terminal deoxynucleotidyl transferase. The fluorescence intensity of each scored sperm is determined as a "yes" or "no" for sperm on a light microscope slide or by channels of fluorescent intensity in a flow cytometer. The light microscope-based AOT, uses the metachromatic properties of acridine orange to stain sperm cells. The SCSA treats sperm with low pH to denature DNA at the sites of DNA strand breaks, followed by acridine orange (AO) staining of green for native DNA and red for denatured DNA as measured by flow cytometry (FCM) as well as % sperm with high DNA stainability (HDS: immature sperm with intact DNA related to decreased fertilization rates). The SCSA method has defined a 27-30% DNA fragmentation index (DFI) as the point in which a man is placed into a statistical category of taking a longer time to in vivo pregnancy, intra uterine insemination (IUI) and more routine in vitro fertilization (IVF) cycles or no pregnancy. Current data suggest that intracytoplasmic sperm injection (ICSI) may help overcome the diminished pregnancy prognosis with high DFI over the other ART or natural methods.
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Affiliation(s)
- Donald P Evenson
- Department of Chemistry and Biochemistry, South Dakota State University, Brookings, 57007, USA.
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