MP76-19 DNA FRAGMENTATION MAPPING OF THE MALE GENITAL TRACT

Abstract

You have accessJournal of UrologyInfertility: Basic Research, Physiology, Pathophysiology1 Apr 2015MP76-19 DNA FRAGMENTATION MAPPING OF THE MALE GENITAL TRACT Ashley Winter, Bobby Najari, Gianpiero Palermo, Darius Paduch, and Marc Goldstein Ashley WinterAshley Winter More articles by this author , Bobby NajariBobby Najari More articles by this author , Gianpiero PalermoGianpiero Palermo More articles by this author , Darius PaduchDarius Paduch More articles by this author , and Marc GoldsteinMarc Goldstein More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2935AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Traditionally, sperm located distally in the male genital tract have better capacity for fertilization. This notion has been challenged by recent reports of better outcomes using testicular sperm in men who have high ejaculated sperm DNA fragmentation index (DFI). Whether the vas deferens, epididymis, or testis is a better source for sperm with lower DFI is not clear. METHODS Men had DFI measured on both testicular, ductal (epididymis or vas deferens), and ejaculated sperm. Testicular, ductal, and ejaculated DFI were compared with a paired t-test. RESULTS Fifteen men were prospectively studied (Table 1). Eight men had surgical sperm extraction and DFI mapping as treatment for high DFI in the ejaculate and failed IVF treatments. Five men had surgical retrieval as treatment for obstructive azoospermia, two for anejaculation. Twelve men had both testicular and ductal samples with DFI. The ductal DFI was higher than the testicular DFI on the left side (19.7 ±7.2 vs 13.3 ±6.5, p<0.001), the right side (18.1 ±6.7 vs 14.4 ±6.7, p=0.006), and combined bilateral sides (18.4 ±6.8 vs 13.8 ±6.5, p<0.001). No men had a lower epididymal DFI vs testicular DFI on the left, but two (17%) men had lower epididymal DFI on the right (25.9 vs 26.2 and 14.3 vs 17.4). Six men had paired ejaculated sperm DFI and testicular sperm DFI. Testicular sperm has significantly lower DFI than ejaculated sperm on the left (6.5 ±3.1 vs 20.6 ±12.6, p=0.022) and combined bilateral (8.1 ±4.6 vs 21.8 ±10.2, p=0.002), but not the right (13.1 ±6.1 vs 20.4 ±7.6, p=0.307). Three patients had both ejaculated sperm DFI and ductal sperm DFI, and there was no difference on the left (p=0.504), the right (p=0.913), or combined bilateral (p=0.458). Eight men had IVF outcomes available post-procedure; five men's partners (63%) had clinical pregnancies, 3 did not achieve biochemical pregnancy. CONCLUSIONS For men in whom surgical sperm retrieval is indicated, testicular sperm consistently has lower DFI than ductal sperm. Ductal sperm had similar DFI to ejaculated sperm. In men with high ejaculated sperm DFI or obstructive azoospermia, a testicular sperm source should be considered. Table 1. Clinical Characteristics Parameter Mean ±SD Age, years 49.7 ±11.1 Female age 38.2 ±4.3 FSH, mIU/mL 7.9 ±0.7 Testosterone, ng/dL 228.3 ±71.4 Ejaculate DFI, % 19.1 ±12.1 Volume, mL 1.4 ±1.1 Concentration, mil/L 29.9 ±35.5 Motility, % 26.3 ±24.2 © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e991 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ashley Winter More articles by this author Bobby Najari More articles by this author Gianpiero Palermo More articles by this author Darius Paduch More articles by this author Marc Goldstein More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...