Abstract
The study determined the impact of advanced male ageing (≥50 years) on sperm chromatin integrity and early embryo morphological development in intra-cytoplasmic sperm injection (ICSI) technique cycles. Six hundred subfertile men were age-grouped; X1 (50 to 59 years), X2 (60 to 69), and X3 (≥70), were compared with 600 fertile males of known fertility (Y, age 25 - 35 years). Oocytes from 254 women, aged ≤ 30 years, were included. Sperm were analyzed using acridine orange fluorescence test (AOT) and categorized: “low”, “inter-mediate” and “high” damage. After ICSI, embryos were evaluated and categorized as “good”, “fair” or “poor” quality. Embryonic morphological development was assessed at three stages: fertilization, early and late paternal effect. The AOT results were: X1: low = 29, intermediate = 53 and high = 118; X2: low = 11, intermediate = 42 and high = 147; X3: low = 8, intermediate = 24 and high = 168; Y: Low = 486, intermediate = 71 and high = 43. The fertilization rate was: X1, 329/350 (93.7%); X2, 298/350 (85.1%); X3, 225/350 (64.1%) and, Y, 350/350 (100%). Associations between increasing age and sperm chromatin damage (χ2 (723.249, 6) p < 0.0001), increasing age and inability to fertilize (χ2 (210.990, 3) p < 0.0001) were observed. Associated with increasing age was the significant proportion of morphologically poor quality embryos over the five days after fertilization. Male age ≥ 50 years, is highly associated with abnormal sperm chromatin organization, an inability to adequately fertilize with ICSI methodology, an increase in the number of poor quality embryos and, a corresponding decrease in the number of good quality embryos five days after fertilization.
Highlights
Sperm dysfunction is one of the most common causes of male subfertility
The goal of the present study is to determine the influence of advanced paternal age on sperm chromatin integrity during intra-cytoplasmic sperm injection (ICSI) technique cycles associated with male factor infertility, and controlling for partner female age
A total of 1550 oocytes were retrieved at ovum pick up (OPU) from the 254 women
Summary
Sperm dysfunction is one of the most common causes of male subfertility. Sperm quality has a direct impact on fertilization and embryonic development [1]. Immature spermatozoa generate high levels of reactive oxygen species (ROS) which are implicated in chromatin damage and are likely to cause unfavorable arrangements in protamination and chromatin packaging [3]. Chromatin damage has been detected in spermatozoa from fertile men [6]. Chromatin damage is observed in infertile or sub-fertile men, and in other age related and pathogenic conditions including, genital and systemic infections, cancers, drugs, radio and chemotherapy, hyperthermia, tobacco smoking, and varicocele. These diseased conditions are associated with changed (high) levels of ROS [7]
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