Clinical implementation of sperm DNA fragmentation studies in the assessment of male unexplained infertility

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Abstract

Background
About 15% of infertile males have normal semen parameters. DNA fragmentation could logically be an additional valuable tool for fertility estimation along with the conventional semen analysis. The connection between infertility and sperm disomy is well reported. The effect of high sperm DNA fragmentation on the results of natural pregnancy and assisted reproductive technology is recorded. There are growing data on the specific characteristics of a man's environment and lifestyle through a variety of physical, chemical, and biological factors in relation to sperm DNA integrity. This work aimed to assess the important role of DNA fragmentation as a diagnostic tool in the diagnosis and explanation of unexplained male infertility and to determine the prevalence of sperm disomy in cases of male infertility.
Patients and methods
This study included twenty infertile men with severe idiopathic oligoasthenoteratozoospermia (group I), 20 infertile men with normal semen parameters (group II), and 10 fertile males as controls. Chromosomal study of peripheral blood, fluorescent in-situ hybridization assessment of sperm using the cocktail X, Y probe, and the Alkaline Comet Assay were performed.
Results
A positive correlation was observed between DNA damage and total disomy. Sperm DNA fragmentation percentage was increased in patients of group II than in patients of group I.
Conclusion
Sperm DNA integrity is essential for the normal production process and its evaluation is recommended in infertile men, especially in infertile men with normal standard semen parameters after repeated analyses. Irrespective of semen parameters, genetic counseling should be provided to infertile men.

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