According to WHO, Infertility is a condition where a couple is unable to conceive spontaneously despite having unprotected, regular sexual intercourse for more than a year. Infertility is a health problem affecting approximately 15% of all couples trying to conceive. In 20% of the couples, the main cause is solely male related (WHO 2000) which is a major concern as it is a clinical challenge of increasing significance.
Over the past decade, male factor has become the leading cause of sub-fertility among couples seeking treatment with IVF. Therefore, semen analysis plays an important role in diagnosing the male factor. Semen possesses a smallest and physically active cell called “the sperm” that is highly specialized for one simple function- “Fertilization of the egg”. Semen analysis provides a small work-up of sperm like sperm number, motility and morphology. These parameters indicate only the physical appearance of a spermatozoa.
Even if all these parameters are normal, there can still be some damage in the DNA material that is present inside the sperm head. Infertile men are shown to have significantly more sperm DNA damage compared to fertile men (Saleh et al., 2002) and the time for a spontaneous pregnancy to happen is proved to be longer in couples where the male partner has an increased amount of sperm with DNA damage.
DNA (Deoxyribo Nucleic Acid) is the strand present in chromosomes that help in fertilizing the eggs and initializing a healthy embryo. When this strand separates or breaks into pieces, it basically causes the DAMAGE and this is commonly called as DNA fragmentation. This has been suggested as one of the causes for male sub- fertility.
Sperm DNA Fragmentation:
The Sperm DNA fragmentation test measures the stability of the DNA in sperm and provides an estimate of the level of DNA damage in the sperm. Couples who have experienced recurrent miscarriages, or several unsuccessful treatment cycles, are recommended with this test, as it can help to diagnose the levels of DNA fragmentation.
Very few men are offered sperm DNA integrity analysis during their fertility work-up and are therefore not aware of the problem. This, despite the fact that in 10-25% of men diagnosed with unexplained infertility, sperm DNA damage can at least partly explain their childlessness. DNA damage can increase with age, so a man in his 50’s or 60’s may have a higher percentage of sperm fragmentation than someone in his 20’s. Other factors — such as exposure to various chemicals or toxic agents, excessive heat, chemotherapy, radiation, smoking, obesity, air pollution, nutritional deficiencies and diabetes can cause DNA damage.
However, there is good news! There is hope that antioxidant vitamins can help minimize the damage.
One of the treatment options for sperm DNA fragmentation test in male infertility is ICSI which remains the gold standard embryology procedure to tackle male infertility, but success lies in selection of normal efficient sperm prior to ART. Good sperms are selected & injected into the oocytes within a few hours of ejaculation (or surgically retrieved sperms) which can commence a healthy pregnancy.
Sperm DNA integrity plays an important role in fertility and conception.
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