Abstract
While the semen analysis has traditionally been relied upon to differentiate fertile and infertile men, its utility has been questioned in the current era of assisted reproductive technologies. The desire for more sophisticated diagnostic and predictive tools has led to increased use of sperm DNA damage in the management of male infertility. Despite the availability of numerous assays to measure sperm DNA damage, our understanding of the etiology, measurement, and clinical implications of sperm DNA damage remains incomplete. While the current evidence is fraught with heterogeneity that complicates attempts at comparison and meta-analysis, there does appear to be a role for sperm DNA damage in the development and maintenance of pregnancy in the era of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). However, as noted by the American Society for Reproductive Medicine, the routine and widespread use of sperm DNA damage testing is not yet supported. Further studies are needed to standardize the measurement of sperm DNA damage and to clarify the exact role of sperm DNA damage within the myriad of other male and female factors contributing to reproductive outcomes in IVF and ICSI.
Highlights
The semen analysis has traditionally been used to differentiate fertile and infertile men
This review seeks to examine the existent literature to discuss our current understanding of sperm DNA damage, the tools available for measuring sperm DNA damage, and their associations with reproductive outcomes after use of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in an attempt to clarify the role of these tests in the management of male infertility
Unlike Zhao’s meta-analysis, which suggests a different impact for sperm DNA damage on IVF versus ICSI, Robinson [34] and Zini [35] both found that the significant associations between high sperm DNA damage and miscarriage rates did not depend on the method of fertilization used
Summary
The semen analysis has traditionally been used to differentiate fertile and infertile men. With the advent of IVF and ICSI, there has been a desire for more sophisticated diagnostic and predictive tools. Sperm DNA damage has been associated with adverse reproductive outcomes and has been increasingly used in the management of male infertility in the era of IVF and ICSI. Despite the availability of numerous laboratory assays to measure sperm DNA damage, the clinical utility of these tests and their potential roles in the algorithm of male infertility management have yet to be established. This review seeks to examine the existent literature to discuss our current understanding of sperm DNA damage, the tools available for measuring sperm DNA damage, and their associations with reproductive outcomes after use of IVF and ICSI in an attempt to clarify the role of these tests in the management of male infertility
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