Abstract
Despite a thorough work-up, the underlying cause remains unknown in a large proportion of cases with recurrent implantation failure. Sperm plays an incontrovertible role in initiating and maintaining a successful pregnancy. Thus, male factor evaluation could provide insight into the etiology of unexplained implantation failure. Sperm genetics and epigenetics are burgeoning areas in infertility research, providing new insights into the diagnosis and management of recurrent implantation failure. This chapter reviews the current evidence on sperm chromosomal aneuploidy and sperm DNA damage, with a focus on recurrent pregnancy loss and implantation failure. Potential causes of sperm DNA damage, including oxidative stress, and different diagnostic methods for detection of sperm DNA fragmentation are summarized. Roles of modifiable risk factors such as alcohol, smoking, varicocele, testicular heat stress, medications, and environmental toxins are discussed, and recommendations are made regarding potential therapeutic options and interventions. Finally, alternative and newer methods for sperm retrieval and selection for assisted reproductive technology are discussed, and opportunities for future assessment and treatment of male factors in recurrent implantation failure are covered.
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