Clin Exp Reprod Med.  2018 Sep;45(3):101-109. 10.5653/cerm.2018.45.3.101.

What should be done for men with sperm DNA fragmentation?

• Kim GY

• KMID: 2419525
• DOI: http://doi.org/10.5653/cerm.2018.45.3.101

Abstract

In an age when a small quantity of sperm can lead to pregnancy through in vitro fertilization or intracytoplasmic sperm injection, selecting healthy sperm is important. Sperm DNA fragmentation (SDF) is known to be higher in infertile men. Terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling (TUNEL) and the alkaline comet test are SDF tests that directly measure DNA damage and have shown closer correlations with assisted reproduction results than indirect tools such as the sperm chromatin structure assay or the sperm chromatic dispersion test. It is difficult; however, to endorse a single test as the best test overall; instead, it is best to select a testing method based on each patient's clinical condition and goals. In a couple struggling with infertility, if the male partner has a high level of SDF, he should aim to decrease SDF through lifestyle modifications, antioxidant treatment, and ensuring an appropriate duration of abstinence, and physicians need to treat the underlying diseases of such patients. If sperm DNA damage continues despite the patient's and physician's efforts, other methods, such as micromanipulation-based sperm selection or testicular sperm extraction, should be used to select healthy sperm with nuclear DNA integrity.

Keyword

Assisted reproductive technique; DNA fragmentation, Infertility; Sperm

MeSH Terms

Chromatin
Deoxyuridine
DNA Damage
DNA Fragmentation*
DNA*
Fertilization in Vitro
Humans
Infertility
Life Style
Male
Methods
Pregnancy
Reproduction
Reproductive Techniques, Assisted
Sperm Injections, Intracytoplasmic
Spermatozoa*
Chromatin
DNA
Deoxyuridine