DIAGNOSTIC VALUE OF SPERM DNA FRAGMENTATION AND SPERM HIGHMAGNIFICATION FOR PREDICTING OUTCOME OF ASSISTED REPRODUCTION

TREATMENT
(#2)

A Journal Review Paper submitted to the

Faculty of Medical Laboratory Science Department
San Pedro College of Davao
12 C. Guzman St. Davao City

Submitted by
Dave Michael C. Marimon
Group 4 Bacteriology
Davao Regional Medical Center

November 2015

INTRODUCTION

Infertility is a common condition affecting one in six couples of

childbearing age. The common definition for male infertility is the presence
of an alteration in concentration, motility and/or morphology in at least one
sample of two sperm analyses, according to World Health Organization
guidelines.
Basic semen analysis may not provide all information to completely
evaluate male fertility status. Consequently, several investigators have
considered optimizing conventional routine methods to improve male
infertility diagnoses. Over the last two decades, the main investigation areas
have been focused on sperm function, morphology and nucleus assessment.
Major advances in the field of male infertility have been achieved, and these
advances have resulted in numerous techniques for evaluating sperm
chromatin quality and DNA fragmentation.
Sperm DNA fragmentation is increasingly suggested as a promising
fertility predictive factor. Although there are some studies with opposite
results, most of the published works report the association between DNA
damage and lower fertilization, impaired embryo cleavage and higher
miscarriage rates.

This study talks about the diagnostic usefulness of sperm DNA

integrity and sperm vacuolization for predicting outcome in infertile couples
undergoing IVF and ICSI treatments. The researchers have gathered certain
numbers of couples that are willing to participate and with informed consent
in this program as a treatment for their infertility. The proper collection of
semen samples was correctly implemented in order to achieve a reliable
results. They performed the DNA Fragmentation Assay and sperm
morphology assessment.
I find it interesting that the researchers have considered the
assessment of DNA damage as a possible prediction that a male is indeed
infertile. It has been stated that simple sperm analysis may not fully provide
all necessary information that could verify if a male is infertile. This test is a
good promising factor to detect cases of infertility, and with our current
advancements in laboratory tests such as improved version of the sperm
chromatin dispersion test using a standardized staining procedure and with a
skillful laboratory scientist, it can easily be performed. I also find the results
of this test a good standard that when spermatozoa conserved the integrity
of DNA, a peripheral halo of DNA loops around a central core was observed.
Spermatozoa with fragmented DNA produced very small halos or no halos at
all.
I wondered how much it would cost to engage in DNA Fragmentation
Test in order to confirm if one is infertile or not. Given the possible
interference or false results in a basic sperm analysis, approximately only a
little chance that would confirm that a male is infertile. IVF is already an
expensive procedure, so I think the couple must find ways to assess if the
result would turn out to have a healthy baby. According to this study, the
assessment of sperm DNA fragmentation was a better predictor of IVF
success than assessment of sperm using high magnification. Although
several studies have shown the prognostic and diagnostic limitations of the
routine semen parameters for the infertile couple, male infertility diagnosis is
still based on the traditional semen analysis in routine clinical practice.
However, these conventional semen parameters do not identify the subtle
abnormalities in the male genome characterized by damaged sperm DNA.