Sperm Chromatin and ART (IUI, IVF and ICSI) Pregnancy

Abstract

Diagnosis of male infertility has been based mainly on the traditional semen parameters, namely, concentration, motility and morphology. In assisted reproductive technologies (ART), sperm samples are prepared by methods such as swim-up or density-gradient centrifugation to sort out sperm populations believed to have the highest fertilization potential. Traditionally, results of semen analysis and sperm preparation have been the fundaments on which clinicians could base their decision of what ART method should be used for a given couple. It has, however, become apparent that none of these procedures are sufficient for the determination of male fertility capacity. Owing to the lack of adequate methods to evaluate the fertility potential of a couple, the choice of ART method is made more or less blindly. A continuous search for better markers of male fertility has led to an increased focus on sperm chromatin integrity testing in fertility workup and ART. Numerous sperm DNA integrity tests have been developed. In the context of fertility, the comet, TUNEL, and Sperm Chromatin Structure assays are the most frequently used. Sperm DNA fragmentation has shown to be an independent predictor of success in couples undergoing intrauterine insemination. More contrasting data exist regarding the role of sperm DNA fragmentation in relation to fertilization, pre-embryo development and pregnancy outcome in in vitro fertilization and intracytoplasmic sperm injection (ICSI).