Abstract
Reproductive diseases have become a growing worldwide problem and male factor plays an important role in the reproductive diagnosis, prognosis and design of assisted reproductive treatments. Sperm cell holds the mission of carrying the paternal genetic complement to the oocyte in order to contribute to an euploid zygote with proper DNA integrity. Sperm DNA fragmentation had been used for decades as a male fertility test, however, its usefulness have arisen multiple debates, especially around Intracytoplasmic Sperm Injection (ICSI) treatments. In the recent years, it has been described that different types of sperm DNA breaks (single and double strand DNA breaks) cause different clinical reproductive effects. On one hand, single-strand DNA breaks are present extensively as a multiple break points in all regions of the genome, are related to oxidative stress and cause a lack of clinical pregnancy or an increase of the conception time. On the other hand, double-strand DNA breaks are mainly localized and attached to the sperm nuclear matrix as a very few break points, are possibly related to a lack of DNA repair in meiosis and cause a higher risk of miscarriage, low embryo quality and higher risk of implantation failure in ICSI cycles. The present work also reviews different studies that may contribute in the understanding of sperm chromatin as well as treatments to prevent sperm DNA damage.
Highlights
Different fertility societies around the globe and the World Health Organization estimate that infertility is present in between 7% and 15% of couples in reproductive age [1,2]
In front of a fertility disorder or a fertility treatment, microscopic semen analysis measuring sperm concentration, motility and morphology has been the traditional and important first approach to male infertility and, a high decrease of these parameters had been associated to a lack of achievement of natural pregnancy [7] and nowadays home-based technologies in order to advance the first diagnosis are emerging [8]
Figure structureofofthe thesperm sperm compacted in protamines that toroid form toroid structures linked by regions compacted in histones and attached to the nuclear linked by MAR regions compacted in histones and attached matrix. (A) represents an intact chromatin. (B) represents chromatin with single-strand breaks (red to the nuclear matrix. (A) represents an intact chromatin. (B) represents chromatin with lines). (C) represents chromatin with extensive double-strand breaks. (D) represents chromatin with single-strand breaks. (C) represents chromatin with extensive double-strand breaks
Summary
Different fertility societies around the globe and the World Health Organization estimate that infertility is present in between 7% and 15% of couples in reproductive age [1,2]. In a high number of cases female factors and especially female age [3], are the most important causes of infertility, different male factors are present in at least 50% of the couples presenting this disorder [4]. In front of a fertility disorder or a fertility treatment, microscopic semen analysis measuring sperm concentration, motility and morphology has been the traditional and important first approach to male infertility and, a high decrease of these parameters had been associated to a lack of achievement of natural pregnancy [7] and nowadays home-based technologies in order to advance the first diagnosis are emerging [8]. In most cases these parameters are not indicative of the positive performance of assisted reproduction techniques (ART) [5,9]. A deeper study is necessary in most cases to elucidate the alteration in order to design the best treatment in each case
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