Clinical Importance of Sperm DNA Damage assessment on ART Outcomes

Considering that standard semen analysis fails to predict male fertility in up to about 40% of the cases, scientists searched for parameters and methodologies to close this obvious gap in andrological diagnostics. As sperm DNA damage has an inverse correlation with ART success, there is ever-increasing support in the literature for routine sperm DNA fragmentation test alongside semen analysis to provide a more informed choice of ART treatment. DNA testing is essential since high DNA damage increases risk of pregnancy loss, regardless of which test is used [SCSA (perm chromatin structure assay), TUNEL (terminal transferase dUTP nick-end labelling), or alkaline Comet assay]. Moreover, 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. In fact, these tests help couples make informed decisions about their ART treatment pathway, reducing the financial, emotional and psychological burdens and increasing clinic success rates. Nevertheless, through research into various DNA fragmentation assays, clinical thresholds need to be set so that clinics using the tests will be able to interpret them easily. However, with current treatment pathways, sperm DNA quality is not assessed and therefore not considered to be a severe sperm abnormality. This requires revision given the plethora of studies supporting its inclusion and the inadequacy of conventional Semen analysis. Taken all together, large studies are required with standardized protocols to reduce interlaboratory variation to strengthen the evidence base for sperm DNA testing for clinical use.

کلیدواژه ها:

DNA damage ، Human sperm ، Sperm DNA fragmentation tests ، Assisted reproductive technology outcomes ، Male infertility